Tuesday, 12 March 2013

The Neglect of neglect

It’s salutary to see reports of research by Dr. Ruth Gardner (University of East Anglia and NSPCC) involving analysis of Serious Case Reviews [1] conducted between 2005 and 2011. http://www.bbc.co.uk/news/education-21714645

She found that in the cases where a child had been made subject to a child protection plan [2], 101 out of 175 cases (58%) involved neglect. This confirms how serious the consequences of neglect can be.

It is very worrying that Ruth Gardner has to remind us that neglect is just as grave as physical or sexual abused. Apparently a survey of social workers conducted last year revealed many felt cases of neglect are the most likely to be awarded low priority.

We all need to be clear that neglect can, and does, kill children. Not so long ago in Birmingham, England, seven-year old Khyra Ishaq was starved to death [3]. In another horrifying case, this time in 2004, five children were found in appalling conditions and near death in another English city, Sheffield [4]

The long-term impact on children who survive neglect – in the absence of other forms of maltreatment - can be very damaging. Studies [5] by researchers such as Teicher (2000), Shonkoff and Phillips (2000) and Perry (2009) show how ‘global’ neglect [6] can have a devastating impact on the developing brains of small children, resulting in a reduced number of neural pathways being available for the child to learn. In turn this has a long-term debilitating impact on educational and social functioning.

An excellent summary of the effects of neglect and other forms of maltreatment can be found on the Child Welfare Information Gateway website [7]

So why is neglect sometimes seen as low priority by professionals trying to protect children?

I know I’ve said some of this before, but it’s worth saying it again. I think that it is not so much that professionals do not recognise and understand neglect, but they find it difficult to respond to.

Neglect is often an incremental phenomenon. Often there is no single clear event or crisis, but there is an ongoing, progressive deterioration in the child’s circumstances and conditions. That can make knowing when to intervene difficult and sometimes social workers become ‘acclimatised’ because changes in the family’s circumstances are small, frequent, cumulative and difficult to detect.

The second problem is one of resources. Turning around a situation of neglect can require a long-term commitment of resources to a family. Sometimes it is hard for professionals to admit that these efforts have been in vain, so there is often an argument for just trying one more thing.

Thirdly some neglectful parents can inspire great sympathy and compassion. They may not be failing because they do not love their children or because they do not aspire to be good parents. They may be trying their best and still failing. Often deficits in their own histories explain their inability to give their children the care they need. So it can be painful for professionals to think in terms of removing children.

Professionals have to wrestle with these difficulties and, of course, they will not always get it right. What is completely unacceptable, however, is for agencies to downgrade neglect, just because it is difficult.


[1] Serious Case Reviews are conducted in England in circumstances where a child known to safeguarding services or other welfare agencies dies or suffers another serious negative outcome.

[2] Previous referred to as ‘being on the Child Protection Register’


Teicher, M.D. (2000). “Wounds that time won’t heal: The neurobiology of child abuse.”
Cerebrum: The Dana Forum on brain science, 2(4), 50-67

Shonkoff, J. P., & Phillips, D. A. (2000).
From neurons to neighborhoods: The science of early childhood development.
Washington, D.C.: National Academy Press.

Perry, B. D. “Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics”
Journal of Loss and Trauma, 14:240–255, 2009

[6] Global neglect means neglect combined in multiple ways – e.g. different types of physical and emotional neglect, such as leaving alone, not responding to the child’s needs, not feeding etc.

[7] Child Welfare Information Gateway website: