Kafas 2009
Kafas 2009
Kafas 2009
12 10:32
Citation: C. Stavrianos, D. Stavrianou, I. Stavrianou, P. Kafas: Child Neglect: a review. The Internet
Journal of Forensic Science. 2009 Volume 4 Number 1. DOI: 10.5580/1c7d
Keywords: Child neglect, risk factors, protective factors, parental/family protective factors,
social/environmental protective factors, dental neglect, prevention
Abstract
Child Neglect is a phenomenon that is found in the modern societies. Usually, it is mistaken with child
abuse and for this reason, not many studies have been taken place. However, there are many risk
factors that can been seen, and also there are many protective factors that can be used, in order to
reduce child neglect rates. Scientists are aware of the forms
(emotional/physical/nutritional/educational) of child neglect and their consequences. Now days,
medical and social services staff concentrates on prevention strategies.
Introduction
Child maltreatment is defined as all forms of physical and/or emotional ill-treatment, sexual abuse,
neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential
harm to the child’s health, survival, development or dignity; in the context of a relationship of
responsibility, trust or power.
Physical abuse;
Sexual abuse;
Neglect;
Neglect
Neglect is the persistent failure to meet the child’s basic physical and/or psychological needs, likely to
result in the serious impairment of the child’s health or development. It may involve a parent or carer
failing to provide adequate food, shelter and clothing, failing to protect from physical harm or danger
or the failure to ensure access to appropriate medical care or treatment. It may also include neglect
of, or unresponsiveness to, a child’s basic emotional needs. 2, 3.
The victims’ age, the setting in which the neglect occurs and the relationship between victim and
perpetrator emphasize the complexity of this social, human rights, legal and social issue.
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A number of factors contribute to a higher occurrence in child maltreatment. As far as the parents or
caregivers are concerned, the risk factors concerning them are plenty and refer to the persons who
generally have difficulties in establishing emotional and therefore physical bonds with their babies.
This result is a lack of understanding of their child’s needs band there is a subsequent deficiency of
communication, which itself leads to lack of self-control and use in violence. Also poor care for the
child is caused by use of alcohol or drugs, by occurrence of illness such as depression, or simply low
self-esteem and young age. 4, 5, 6.
In many cases an unwanted baby, who may cry persistently or may have various physical
abnormalities and may demonstrate hyperactivity or impulsivity or a chronic illness, can be the cause
for the maltreatment of this specific baby. 6, 7.
In contemporary societies family bonds vary and often the “unclear” family has collapsed, with the
result of failure of connecting between members of family and lack of sentimental attachment, as well
as no existence of emotional safety nets between child and parents. There is a feeling of isolation
among children which can lead them to criminal activities in a community that actually tolerates
violence and suffers from inequality, poverty, drug and alcohol abuse, unemployment and
environmental pollution.
Generally, children live in a society, which has no programmes to shelter them from maltreatment
and offers them no alternative way of living. Instead violence is legalized through the media, child
labor blossoms and child pornography and prostitution thrives. 8, 9.
Protective Factors
Researchers, practitioners, and policy makers are now increasingly thinking about protective factors
within children and families that can reduce risks, build family capacity, and foster resilience. In
1987, case studies of three victims of child maltreatment began to shed light on the dynamics of
survival in high-risk settings. Resilience in maltreated children was found to be related to personal
characteristics that included a child’s ability to: recognize danger and adapt, distance one from
intense feelings, create relationships that are crucial for support, and project oneself into a time and
place in the future in which the perpetrator is no longer present. 10
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Parent and family, protective factors that may protect children include secure attachment with
children, parental reconciliation with their own childhood history or abuse, supportive family
environment including those with two-parent households, household rules and monitoring of the
child, extended family support, stable relationship with parents, family expectations of pro-social
behavior, and high parental education. Social and environmental risk factors that may protect
children include middle to high socioeconomic status, access to health care and social services,
consistent parental employment, adequate housing, family participation in religious faith, good
schools, and supportive adults outside the family who serve as role models or mentors.--- Some
recent studies have found that families with two married parents encounter more stable home
environments, fewer years in poverty, and diminished material hardship. 11 Common protective
factors are cited below in Table 1.
Child neglect is a phenomenon that is not very well known due to limited research on child neglect
and the meshing of child neglect with child abuse. There are disagreements among neglect
researchers about several important issues; such as whether to frame child neglect as a child’s
unmet needs or as omissions in parental behavior. It has therefore been difficult to develop a
standard conceptual definition of child neglect. 12 .
A new measure of perceptions of child neglect, for use in community samples, has been developed
and it is named Community Norms of Child Neglect Scale (CNCNS).
The CNCNS differentiates among four subtypes of neglect (failure to provide for basic needs, lack of
supervision, emotional neglect, and educational neglect).Scenarios ranging in seriousness for each
subtype were presented to large community sample. Confirmatory factor analyses indicated that a
four-factor model provided a better fit to the data than did a a model specifying only one overall
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neglect factor, suggesting this sample distinguished among the four subtypes of neglect. Scientists
tested measurement equivalence across individuals who work with children and lay community
respondents and across rural and urban respondents, with results indicating a very similar structure
across these groups. These initial reliability and validity data suggest that the CNCNS may be of use
in comparing perceptions of child neglect among individuals and across communities. 13
Emotional abuse, while frequent, was seldom the focus of the child protection services investigation.
The nature of this abuse was not minor, but rather likely to be dangerous to the mental health and
well being of these children. Furthermore, emotional abuse in samples of young adolescents, at least,
was likely to be accompanied by other forms of maltreatment, especially physical abuse and/or
neglect. 15
Dental Neglect
Dental neglect (Fig. 2), as defined by the American Academy of Pediatric Dentistry, is the “willful
failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of
oral health essential for adequate function and freedom from pain and infection.” Dental caries,
periodontal diseases, and other oral conditions, if left untreated, can lead to pain, infection, and loss
of function. These undesirable outcomes can adversely affect learning, communication, nutrition, and
other activities necessary for normal growth and development. Some children who first present for
dental care have severe early childhood caries (formerly termed “baby bottle” or “nursing” caries);
caregivers with adequate knowledge and willful failure to seek care must be differentiated from
caregivers without knowledge or awareness of their child's need for dental care in determining the
need to report such cases to child protective services. 16,17.
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Fig. 2. Neglect is the failure to provide for a child’s basic needs. This can include the failure to provide
medical or dental care
Failure to seek or obtain proper dental care may result from factors such as family isolation, lack of
finances, parental ignorance, or lack of perceived value of oral health. The point at which to consider
a parent negligent and to begin intervention occurs after the parent has been properly alerted by a
health care professional about the nature and extent of the child's condition, the specific treatment
needed, and the mechanism of accessing that treatment. Because many families face challenges in
their attempts to access dental care or insurance for their children, the clinician should determine
whether dental services are readily available and accessible to the child when considering whether
negligence has occurred. 16,17.
The physician or dentist should be certain that the caregivers understand the explanation of the
disease and its implications and, when barriers to the needed care exist, attempt to assist the
families in finding financial aid, transportation, or public facilities for needed services. Parents should
be reassured that appropriate analgesic and anesthetic procedures will be used to ensure the child's
comfort during dental procedures. If, despite these efforts, the parents fail to obtain therapy, the
case should be reported to the appropriate child protective services agency. 16,17.
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The negative impact of abuse and neglect on children and adolescents should not be underestimated,
especially in relation to its burden on physical and mental health. Often, children suffer more than
one form of maltreatment. A combination of emotional abuse and neglect, together with physical
and/or sexual abuse over time, has a greater impact than being victimized by severe physical
punishment or a single sexual assault. Furthermore, children who are maltreated by more than one
person consequently have more problems than those maltreated by one person. 1
Child maltreatment remains a major public health and social-welfare problem in high-income
countries. It substantially contributes to child mortality and morbidity and has long lasting effects on
mental health, drug and alcohol misuse (especially in girls), risky sexual behavior, obesity, and
criminal behavior, which persist into adulthood. Neglect is at least as damaging as physical or sexual
abuse in the long term but has received the least scientific and public attention. Generally
maltreated/neglected children show less confidence, joie de vivre and hope for the future. 18, 19.
Prevention
Researchers used prevention strategies, in early childhood, to fight against child maltreatment and
neglect. These methods include home visits, parent education classes, and provision of health
services. The conclusion is that the evidence base for programmes in early childhood to prevent child
maltreatment remains relatively weak. 20.
Conclusions
Child neglect is a health and social issue, that is not very well studied. Determining which child is in
need and clarifying what those needs are, requires professional judgment to be made by staff in all
agencies. If there is an indicator that a child may be a child in need and that there are moderate
concerns about a child, a referral to social services may be necessary, in order that more
comprehensive assessment can be undertaken.
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