The Impact of Neglect
Part of a series that summarizes essential scientific findings
An infants early adverse childhood experiences from birth to five years will undermine their developing brain. Young children need safe and secure environments in which to grow and learn creating a strong foundation that will encourage them to prosper and reach their full potential.
This is early period that develops the foundation of sound mental health of the child to experience, regulate, and express emotions and form the bonding of secure and nurturing relationships with caregivers.
Disruptions in this early childhood development can derail this development process, including social and emotional development, causing a Lifetime of implications.
When adult responses to children are unreliable, inappropriate, or simply absent, developing brain circuits can be disrupted, affecting how children learn, solve problems, and relate to others.
Responsive Relationships
Because responsive relationships are both expected and essential, their absence is a serious threat to a child’s development and well-being. Healthy brain architecture depends on a sturdy foundation built by appropriate input from a child’s senses and stable, interactive relationships with caring adults.
Sensing threat activates biological stress response systems, and excessive activation of those systems can have a toxic effect on developing brain circuitry.
Young children experience their world through their relationships with parents and other caregivers. Safe, stable, nurturing relationships and environments between children and their caregivers provide a buffer against the effects of potential stressors such as toxic stress and are fundamental to healthy brain development.
They also shape the development of children’s physical, emotional, social, behavioral, and intellectual capacities, which ultimately affect their health as adults. As a result, promoting safe, stable, nurturing relationships and environments can have a positive impact on a broad range of health problems and on the development of skills that will help children reach their full potential.
Safety, stability, and nurturing are three critical qualities of relationships that make a difference for children as they grow and develop. They can be defined as follows:
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Safety: The extent to which a child is free from fear and secure from physical or psychological harm within their social and physical environment.
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Stability: The degree of predictability and consistency in a child’s social, emotional, and physical environment.
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Nurturing: The extent to which a parent or caregiver is available and able to sensitively and consistently respond to and meet the needs of their child.
Science Helps Differentiate Four Types of Unresponsive Care
Chronic Neglect
Chronic neglect is associated with a wider range of damage than active abuse, but it receives less attention in policy and practice.
Neglect is the most prevalent form of maltreatment, and thus comprises the bulk of cases for Child Protective Service (CPS) agencies, yet it remains under-studied. Cases in which children experience repeated or “chronic” neglect are particularly concerning. A growing body of research indicates that the effects of chronic neglect create a harmful accumulation of problems for child well-being, including detrimental impact on early brain development, emotional regulation, and cognitive development.
Results with limited caregiver responsiveness demonstrated that families experiencing chronic neglect had multiple significant stressors (four or more stressors for all families in this study), such as domestic violence, poverty, children with behavioral problems, and/or substance abuse, indicating chaotic and toxic living environments.
Child Neglect is associated with a wide range of adverse issues. The latest report on child maltreatment from the U.S. Department Of Health and Human Services/Administration for Children and Families shows the latest data available. United States data report completed 2019 and published January 15, 2020. (1)
Chronic neglect is associated with a wider range of damage than active abuse, but it receives less attention in policy and practice. America's children suffered the most adverse abuse from "neglect."
The national rounded number of children who received a child protective services investigation response or alternative response increased 10.0 percent from 2013 (3,184,000) to 2017 (3,501,000).
The latest data shows neglect accounts for 75% of all child maltreatment.
INBRIEF: THE SCIENCE OF NEGLECT
A series of brief summaries of essential findings from recent scientific publications and presentations by the Center on the Developing Child at Harvard University
Severe Deprivation & Neglect
Studies on children in a variety of settings show conclusively that children exposed to severe deprivation or neglect early in ages 0-3 experience a range of mental health problems in early adulthood. Further studies show:
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it disrupts the ways in which children’s brains develop and process information, thereby increasing the risk for attentional, emotional, cognitive, and behavioral disorders.
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it alters the development of biological stress-response systems, leading to greater risk for anxiety, depression, cardiovascular problems, and other chronic health impairments later in life.
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it is associated with significant risk for emotional and interpersonal difficulties, including high levels of negativity, poor impulse control, and personality disorders, as well as low levels of enthusiasm, confidence, and assertiveness.
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it is associated with significant risk for learning difficulties and poor school achievement, including deficits in executive function and attention regulation, low IQ scores, poor reading skills, and low rates of high school graduation.
Childhood Emotional Deprivation: Happens when there is an extreme absence of emotional attention and/or response given to an infant or child by her primary caretakers. Has been documented in orphanages, and in families where there are extreme physical absence of caretakers, abuse and trauma.
Childhood Emotional Neglect (CEN): Happens when a child’s primary caretakers (usually his parents) fail to respond enough to the child’s emotional needs. Happens often in normal homes all over the world, even when the parents are physically present, and all the child’s material needs are met.
So both emotional neglect and emotional deprivation involve a shortage of emotional attention and response from caregivers, but they tend to happen in different types of situations, and can play out very differently in the children’s lives as they grow into adulthood.
Reversing Deprivation Neglect
The negative consequences of deprivation and neglect can be reversed or reduced through appropriate and timely interventions.
Dr. Nicole Bush and Dr. Alicia Lieberman have joined forces in the CTRP-Health study at the UCSF Child Trauma Research Program (CTRP)to examine the biological systems implicated in traumatic stress and their response to Lieberman’s child-parent interventions. In mothers and their children, Bush and colleagues are searching for biological markers of adversity in the at the ends of chromosomes, the immune system and other physiological stress response systems.
“People tend to blame a child for having a ‘bad attitude’ or behavior problems,” Bush said. She hopes to demonstrate that those issues are related to trauma and that an intensive intervention might fix a biological problem, for example by correcting a dysregulated immune system, which could reverse a range of biological, behavioral and psychological problems.
Focusing on children and adults
While early intervention is imperative in cases where children are experiencing Adverse Childhood Experiences (ACEs), Boyce said that one of the best things health professionals can do is give parents and children the opportunity to discuss traumatic events in their lives. “It helps both parents and kids immensely to just talk about this,” Boyce said.
Edward Machtinger, MD, a professor at UCSF contends that treating ACEs requires a focus on adults – the children who grew up with unresolved early life trauma who then may transmit ACEs to their own children through abuse, neglect or a dysfunctional home environment.
“At UCSF, they are innovating ways to address trauma as the primary underlying factor in the illnesses of our adult patients,” he said.
Machtinger is leading a series of studies implementing and evaluating a trauma-focused care model for dealing with the impact of lifelong abuse. The model incorporates several proven strategies, including creating a safe supportive clinical environment, empowering patients, and combating their social isolation and screening and treatment for post-traumatic stress disorder, chronic pain, substance abuse and mental illness.
In recognition that parents who have unresolved ACEs will have their parenting skills affected, Lieberman’s treatment helps heal both children experiencing adversity and the children’s parents or caretakers. Called Child-Parent Psychotherapy, the technique brings the two together to alleviate impact of ACEs on the child by helping the parent become a better protector for the child.
After treatment, not only are the physical and mental health indicators much better for the child, but they are much improved for the parent as well.
Resources:
1. Child Maltreatment 2019. Published: January 2021. An office of the Administration for Children & Families, a division of U.S. Department of Health & Human Services. This report presents national data about child abuse and neglect known to child protective services agencies in the U.S. https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2019_4.pdf
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National Institutes of Health—National Library of Medicine
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U.S. Department of Health and Human Services:
Center on the Developing Child (2013). The Science of Neglect(InBrief). Retrieved from www.developingchild.harvard.edu.
UCSF Departmrnt of Psychiatry- Institute of Neurosciences. Retrieved from https://psych.ucsf.edu/news/undoing-harm-childhood-trauma-and-adversity