Signs of Neglect

Signs of Physical & Medical Neglect:

• The child lags in physical or language development.
• Chronic poor hygiene is evident.
  
  
  • A baby’s diaper is not changed for an extended period, causing infected rashes
  • Chronic head lice are untreated
  • Clothing or bedclothes are unwashed/soiled
  • There is no provision for a child to bathe or brush teeth
  • A child smells strongly of feces or urine on a regular basis
  • No provision is made for a child who is menstruating
• The child wears clothing that is inappropriate for the weather or for his/her size, such as:
  
  
  • No shoes or sandals in cold weather
  • No coat in freezing weather
  • Clothing that is ragged
  • Clothing that is too small
  • Clothing that is smelly, dirty and in disrepair
• The child is constantly hungry and/or malnourished. The child may be:
  
  
  • Begging for food
  • Hoarding food
  • Stealing food or money
• The adult may be:
  
  
  • Feeding a child a diet that lacks nutritional value
  • Feeding a child in a way that results in dangerous loss of weight
  • Feeding an infant a diet of water or skim milk instead of formula
  • Making no attempt to provide food for a child capable of feeding him or herself
  • Not feeding a young child at regular intervals
• There is a lack of preventative medical care.
  
  
  • Dental
  • Vision
  • Hearing
  • Immunizations
• There is a lack of or delay in necessary medical care (illness or injury), including not giving a child prescribed medicine or trying to set a broken limb without seeking medical help.
• There may be a lack of adequate/safe shelter including:
  
  
  • No heat in cold weather
  • Inoperable or nonexistent plumbing
  • Animal or human feces on the floor
  • Vermin in the house
  • Nails or glass or other sharp objects on floor or sticking out of walls
  • Fire hazards around or in the house
  • Toxic materials on the property
  • Rotting garbage strewn around the house or property
  • Exposed wiring
  • A roof that leaks directly onto beds
• There may be a constant lack of supervision. Examples might include:
  
  
  • A child not being watched despite being in a dangerous or risky situation
  • Elementary aged children being left alone at night or for long periods after school
  • Children under 12 supervising young children
  • A toddler being left alone in a car
  • A 10-year-old being left in charge of a 6-year-old medically fragile child
  • A parent being incapacitated due to drugs or alcohol, or sleeping while the child plays, thereby providing no supervision for the child
  • Locking a child in the house instead of getting a caregiver
  • Leaving a child with a caretaker incapable of providing adequate care. Children 6-10 years of age should receive supervision appropriate to their maturity, emotional security and capacity to handle emergencies
• There may be a lack of protection from harm. Examples include:
  
  
  • Allowing child to see or be involved in domestic violence
  • Allowing another adult to involve a child in reckless endangerment
  • Knowingly allowing your child to be sexually or physically abused
  • Allowing access to a child by a person who has physically or sexually abused the child
  • Allowing the child to be in the care of someone known to be violent or physically abusive
  • Not using a child car seat or restraints
  • Allowing a child to play with guns, knives or other dangerous objects
  • Allowing a child or preteen to experiment with drugs or alcohol
• Child abandonment is considered neglect. Children who are neglected may:
  
  
  • Exhibit constant fatigue and listlessness or fall asleep daily in class
  • Use drugs and/or alcohol at a young age or be addicted as teenagers
  • Become pregnant as teenagers
  • Exhibit learned helplessness--won’t try to do anything for themselves
  • Be independent beyond their age norms (e.g. talk about cooking own meals at a young age, refuse any adult assistance or support when needed, etc.)
  • Be overworked beyond their physical endurance at home
  • Be required to be responsible for younger siblings beyond age norms
    
    
    

Signs of Emotional & Educational Neglect:

A child who is emotionally or educationally neglected may:

• Lag in social, emotional or cognitive development (including speech)
• Not be given mental health treatment despite being at a clear risk for imminent harm due to emotional/mental problems (e.g., no mental health treatment for a suicidal child or a juvenile sex offender)
• Frequently be absent from school or frequently be tardy
• Come to school early and leave late or be afraid to leave
• Cling to adults, be needy for attention from adults or be wary of adults
• Act withdrawn, apathetic or lethargic
• Be fearful, especially of adults or authority figures, of not doing the right thing or of being left alone
• Act hopeless, act as if s/he is weary with life and has no future hopes
• Engage in delinquent acts such as destruction of property or theft
• Exhibit regressive behaviors
• Have an inability to make and keep friends
• Have eating disorders and/or be obese
• Display a lack of interest in self and/or others
• Talks about being confined or left alone for long periods
• Be described by the parent as “bad” or “difficult”
• Exhibit overly adaptive behaviors
• Exhibit behavior extremes (very passive or very aggressive; very compliant or very demanding)
• Behave destructively toward self and/or others

As with emotional abuse, it frequently takes numerous reports of chronic child neglect before CPS will screen a family and investigate. This is because the neglect must not just be a cultural phenomenon or a lifestyle choice. For example: heating with wood, washing in a stream, lighting a home with kerosene lamps, or lighting a home with candles can be lifestyle choices.

It also must be proved that the neglect is harming a child physically or emotionally or is placing the child's safety at extreme risk. Furthermore, the situation must not be temporary due to a life crisis, but rather a chronic situation. For example, one year I had a child who was living in a tent with no running water for several months. However, the family had just moved to the area and was in the process of building a house. The child always came to school fed, clean and adequately clothed, and besides, the parents showed an interest in his well being and education. So although poverty and an inadequate living situation were present, the situation would not be considered a case of neglect because it was temporary and the child’s basic needs were being met.

In order to get action on long-term neglect, it is important to document situations. Being able to give specific examples, such as: “On 1/17 she wore sandals with no socks to school when the temperature was 27 degrees outside,” will get better results than general statements such as, “She is never dressed in warm clothes.”  CPS cannot act on reports of domestic violence or drug and alcohol abuse unless it can be shown that the parent’s actions are putting the child’s safety at risk. If a child is injured during an incident of domestic violence or while a parent is incapacitated by drugs or alcohol, then CPS can address the domestic violence or drug and/or alcohol use. However, if there is known domestic violence or drug and alcohol abuse in the home, it is important to include this fact in your report.

Documenting attempts to discuss the problems of neglect with the parents is also necessary. CPS must rule out lack of parental knowledge in order to show neglect. If a child failed a vision test twice but you did not actually speak directly to the parent about the situation, it would not be considered medical neglect. However, if a child had an abscessed tooth that was causing her extreme pain at school and you not only notified the parent, but also provided information on where and how to get free dental care and the parent did not take action, that could be considered medical neglect. 

The difference is that:

1. The parent is aware.
2. Attempts to provide services have occurred.
3. The child is in pain and in danger of further infection.

When considering whether to make a report of possible neglect, you must first consider the protection of the child. Ask yourself, “Is this child in danger?” and “Is the situation affecting the child's physical, emotional or intellectual well being?” If the answer is yes, then a report needs to be made. Assess the current physical, emotional and developmental damage to the child. Consider also the possible cumulative effects of the situation not only on the child’s development, but also on the risk of injury or impairment. Ask yourself what conditions and circumstances exist that affect the risk of future neglect or harm. Keep in mind the parental functioning and motivation to care for the child. Also, remember that the poverty of the parents cannot be the sole basis for filing a report. Families can be poor and still provide adequate care for their children.