What is neglect?
Neglect is defined in Working Together to Safeguard Children as: “The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development”.
Neglect may occur during pregnancy because of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:
- provide adequate food, clothing, or shelter (including exclusion from home or abandonment).
- protect a child from physical and emotional harm or danger.
- ensure adequate supervision (including the use of inadequate caregivers).
- ensure access to appropriate medical care or treatment.
- It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.
Nutritional neglect: When a child is provided with inadequate calories for normal growth/’to thrive’ or when childhood obesity occurs due to the provision of an unhealthy diet.
Emotional neglect: When a child doesn’t get the nurture or stimulation they need to form secure and positive attachments, for example, they are ignored, humiliated or isolated.
Physical neglect: When a child’s basic needs associated with food, clothing and shelter are not met, for example, not providing appropriate clothing, food, cleanliness and living conditions.
Lack of supervision and guidance: When a child fails to be provided with adequate guidance and supervision to protect them from harm, for example, leaving them with inappropriate carers or abandoning them.
Educational neglect: When a child is not given access to education, for example, parents/carers fail to support their learning, respond to special needs or show an interest in the child’s education (Horwarth 2007).
Medical (including dental) neglect: When a child is denied medical or dental care, to treat or prevent an illness or condition, for example, ignoring or refusing recommendations and failing to seek medical attention.
Several risk factors increase the likelihood of neglect in some families. Families may have a combination of the following risk factors:
Child risk factors:
- Complex needs, for example, neurodiversity, health, including mental health
- Special educational needs and disabilities (SEND)
- Children with disabilities
- Behavioural problems
- Chronic ill health
- Adverse childhood experiences (ACEs)
- Lack of a caring relationship
Parental risk factors:
- Poor mental health
- Substance misuse
- Domestic violence and abuse
- Previous adverse childhood experiences (ACEs)
- History of neglect
- Neurodiversity
Wider risk factors:
- Poverty / affluence*
- Unemployment
- Poor social / family support (social isolation)
- Learning difficulties
- Lack of experience of positive parenting in childhood
- Emotionally unavailable/ detached parents
- Inadequate housing
- Cultural competence of practitioners resulting in the normalisation of neglect
*Whilst poverty is a recognised feature, not all the risk factors are exclusive to children and young people living in poor households. Practitioners must also remain alert to neglect by affluence. Affluent neglect is considered when neglect is experienced by children in wealthy families. This can be more difficult to spot, as the kind of neglect experienced by children and young people in these circumstances is often emotional. There are a few risks that children from all walks of life face; being a child in an affluent family is often perceived to protect those children from some of these dangers. Children from wealthier, more “stable” families aren’t as sheltered from neglect as is often assumed.
Cumulative harm refers to the effects of multiple adverse circumstances and events in a child’s life (Bryce, 2018). It may be caused by an accumulation of a single adverse circumstance or event, or by multiple different circumstances and events. The unremitting daily impact of these experiences on the child can be profound and exponential, and diminish a child’s sense of safety, stability and wellbeing (Bromfield and Miller 2007).
Forms of neglect
Howe (2005) highlighted four defining forms of neglect, with each form associated with different effects on both children and their parents, which has implications for the type of intervention and support offered. These are:
Ranges from ignoring the child to complete rejection. Children suffer persistent emotional ill treatment; they feel worthless and inadequate. Their parent may keep them silent or scapegoats them and shows them no affection or emotion.
Ranges from inconsistent parenting to chaotic parenting. Parents’ feelings dominate, children are demanding/action seeking and there is constant change and on-going disruption/chaos.
Ranges from a parent being withdrawn or detached with the greater focus being on themselves than their children and is characterised by a parent or carer, typically being, uninterested and unresponsive to professionals. The parent/carer does not understand the child’s needs and believes nothing will or needs to change. They will fail to meet their child’s emotional or physical needs and will appear passive in the face of apparent need.
Ranges from a child being left to cry for prolonged periods, to a child being left to die. The child and the home will be smelly and dirty. Children are deprived of love, stimulation, and emotional warmth. The children may be completely ignored and left unsupervised within their own home or out on the streets.
Failure of provision and failure of supervision
It may be difficult to distinguish between neglect and material poverty but persistent failure to provide basic needs is integral to neglect. Some families face great adversity; however, aspects of neglect cannot be dismissed. Neglect can be a serious form of maltreatment, even fatal, and can be described as a failure of provision and a failure of supervision.
Failure of provision is the persistent failure to meet a child’s basic physical or psychological needs, for example:
- Repeated, inadequate provision of food, clothing and shelter.
- Inadequate attention to a child’s medical or health needs.
- Indifferent parenting having an impact on a child’s emotional development and sense of belonging.
- Exposing the child to physical circumstances that are inappropriate or unsafe for their child’s developmental stage.
- Children frequently missing school, being unprepared for a school day, for example, having breakfast and the correct essentials or parents/carers not supporting a child’s learning or securing education for their child – see educational neglect advice for further information.
The Child Safeguarding Practice Review Panel Annual Report 2022-23 highlights the risks of harm can be exacerbated when children are not in school. They can become ‘invisible’ to services where neglect and other abuse goes unnoticed.
Failure of supervision means the level of guidance and supervision is inadequate to ensure that a child is physically safe and protected from harm, for example:
- A parent or carer has failed to protect a child from physical and emotional harm or danger.
- A parent or carer has failed to ensure adequate supervision including the use of inadequate caregivers.
- The explanation for an injury (for example, burns, sunburn, ingestion of harmful substances, road traffic incidents) suggests a lack of supervision.
- Abandonment of a child or young person.
Criminal neglect
Section 1(1) Children and Young Persons Act 1933 was amended on 3 May 2015, by Part 5 Section 66 of the Serious Crime Act 2015. The amended version provides that the offence is made out if:
- a person who has attained the age of sixteen years;
- who has responsibility for any child or young person under that age; willfully (i.e. intentionally or recklessly – see R v Turbill and Broadway [2013] EWCA Crim 1422);
- assaults, ill-treats (whether physically or otherwise), neglects, abandons or exposes him, or causes or procures him to be assaulted, ill-treated (whether physically or otherwise), neglected, abandoned, or exposed;
- in a manner likely to cause him unnecessary suffering or injury to health (whether the suffering or injury is of a physical or a psychological nature).