Family and Children's
18, No. 1
What We Know about Neglect: Key Points from the Research
The latest science about the negative effects neglect can have on children is compelling. For those who must intervene, it can also be overwhelming.
The following information, drawn from a working paper by the National Scientific Council on the Developing Child (2012), summarizes key points from the research to keep in mind when working with children and families touched by neglect.
Children Can Recover
Neglect's negative effects can be reduced or reversed. Children can recover if they are removed from neglectful conditions and placed in nurturing environments.
Intervention Is Often Necessary
Simply ending the neglect usually isn't enough. Children who've been neglected often need appropriate, timely interventions before they can get better. To heal, children often require systematic, empirically supported, long-term (6 - 9 months or longer) interventions involving skilled, supportive caregiving.
The research also tells us that if severely neglected children don't get therapeutic, supportive care, they "remain at increased risk for a host of problems that have been found to continue through adolescence and into the adult years" (p. 9).
Recovery Speeds Vary
Many factors influence recovery from neglect. These include the severity, duration, and timing of the deprivation and the timing and type of intervention provided. Severe neglect, especially in early childhood, makes children more likely to withdraw when stressed and to show more anxiety and difficulty regulating their mood than children who experience less severe deprivation. Longer periods of neglect are associated with greater deficits in brain activity, attention and cognitive control, and academic achievement (p. 9).
Early Intervention Is Best
Children who get appropriate intervention for neglect are less likely to demonstrate long-term, adverse effects. This is particularly true for "extreme deprivation," which is rare.
If appropriate intervention occurs very early--in various studies the benchmark age for removal from extreme deprivation has been identified as 6, 12, or 24 months--substantially improved functioning in cognition, attention, memory, and executive functioning can be achieved. . . . Generally speaking, it appears that the more profound and pervasive the deprivation, the earlier the child needs to be removed in order to facilitate the greatest recovery (p. 9).
There Are Effective Approaches
Thankfully, there are interventions for neglect that work. The table on the next page describes some of the programs that have been proven to help caregivers respond to the needs of neglected children. Child welfare agencies and their partners--the courts, community-based programs, health and mental health professionals, schools, and others--should make a concerted effort to make these and other evidence-based interventions available in their communities.
Project Broadcast, a federally-funded effort to disseminate trauma-informed practices to child welfare-involved children in North Carolina, is an example of how state and federal agencies are contributing to the effort to expand the availability of effective programs. Among its other activities, Project Broadcast is training clinicians in Attachment and Biobehavioral Catch-up, described next page, in 9 demonstration counties (Buncombe, Craven, Cumberland, Hoke, Pender, Pitt, Scotland, Union, and Wilson). The goal is to eventually expand ABC and three other evidence-based interventions (Structured Psychotherapy for Adolescents Responding to Chronic Stress, Trauma-Focused Cognitive Behavioral Therapy, and Parent-Child Interaction Therapy) to all 100 North Carolina counties.
Don't Forget Prevention
The authors of the working paper conclude with a call for more effective outreach to families facing the kind of adversity that puts their young children at risk for significant neglect. They urge us to think broadly about prevention, noting that even programs that don't focus specifically on children can build caregiver capacities and family resources that can prevent neglect from occurring in the first place (p. 13). This, of course, can have a big, positive impact on child and family outcomes.
References for this and other articles in this issue