Childhood Neglect - pg. 2

Types of Neglect

Educational Neglect

Permitted Chronic Truancy - Habitual truancy averaging at least 5 days a month was classifiable under this form of maltreatment if the parent/guardian had been informed of the problem and had not attempted to intervene.

Failure to Enroll/Other Truancy - Failure to register or enroll a child of mandatory school age, causing the school-aged child to remain at home for non-legitimate reasons (e.g., to work, to care for siblings, etc.) an average of at least 3 days a month.

Inattention to Special Education Need Emotional - Refusal to allow or failure to obtain recommended remedial educational services, or neglect in obtaining or following through with treatment for a child's diagnosed learning disorder or other special education need without reasonable cause.

Emotional Neglect

Inadequate Nurturance/Affection - Marked inattention to the child's needs for affection, emotional support, attention, or competence.

Chronic/Extreme Abuse or Domestic Violence - Chronic or extreme spouse abuse or other domestic violence in the child's presence.

Permitted Drug/Alcohol Abuse - Encouraging or permitting drug or alcohol use by the child; cases of the child's drug/alcohol use are included here if it appeared that the parent/guardian had been informed of the problem and had not attempted to intervene.

Permitted Other Maladaptive Behavior - Encouragement or permitting of other maladaptive behavior (e.g., severe assaultiveness, chronic delinquency) in circumstances in which the parent/ guardian had reason to be aware of the existence and seriousness of the problem but did not attempt to intervene.

Refusal of Psychological Care - Refusal to allow needed and available treatment for a child's emotional or behavioral impairment or problem in accord with competent professional recommendation.

Delay in Psychological Care - Failure to seek or provide needed treatment for a child's emotional or behavioral impairment or problem which any reasonable layman would have recognized as needing professional psychological attention (e.g., severe depression, suicide attempt).

Other Emotional Neglect - Other inattention to the child's developmental/emotional needs not classifiable under any of the above forms of emotional neglect (e.g., markedly overprotective restrictions which foster immaturity or emotional over-dependence, chronically applying expectations clearly inappropriate in relation to the child's age or level of development, etc.)

These two types of neglect are a little more recent in being recognized. Both can be difficult to diagnose and difficult to treat.

Prenatal Exposure to Drugs

Considerable controversy surrounds the issue of prenatal exposure of infants to drugs and alcohol. Courts are still debating whether such exposure is neglectful behavior on the part of a pregnant woman. Pregnant women who abuse alcohol, however, have exposed their fetuses to the serious mental and physical disabilities known as fetal alcohol syndrome. An estimated 73 percent of pregnant 12 to 34 year old women have used alcohol sometime during their pregnancy. The incidence of fetal alcohol syndrome is 1.9 births per 1,000. Prenatal exposure to cocaine and other drugs also results in negative developmental consequences for 30 to 40 percent of the estimated 500,000-740,000 drug-exposed infants in the United States.

Failure to Thrive/Malnutrition

Children whose physical development falls below the third percentile in height and or weight for no known medical reason have been designated non-organic failure to thrive. Recent thinking calls for categorizing all children whose development is thus significantly impeded by inadequate nutritional intake as acutely malnourished. The parents' failure to provide necessary nutritional and/or emotional nurturing, often in spite of efforts to do so, presents a challenging problem which has proven difficult to remedy beyond immediate improvements with hospitalization. Failure to thrive children respond with improved weight gain and developmental progress to inpatient hospital treatment, which includes intensive enhancement of nutritional and emotional nurturing. Normal developmental progress frequently does not continue when the children are returned home to the care of parents, and follow-up studies indicate continuing developmental delays in about half of the children. Outcomes of intervention appear to be related to the cause of failure to thrive and the parents' degree of awareness and cooperation with the treatment. The less chronic the developmental failure and the greater awareness and cooperation of parents, the more positive the outcomes.

Deficits in the critical bonding and attachment process between parent and child are thought to be at least partially responsible for the significant developmental delays among children. Depression and other personality problems in the parents, lack of knowledge about child care, poverty, and other sources of social stress have been identified as contributing causes of non-organic failure to thrive.

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