Child neglect and emotional maltreatment
- Erin E Endom, MD
Erin E Endom, MD
- Assistant Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Daniel M Lindberg, MD
Daniel M Lindberg, MD
- Section Editor — Pediatric Psychosocial Emergencies
- Associate Professor of Emergency Medicine and Pediatrics
- University of Colorado Kempe Center
- Teresa K Duryea, MD
Teresa K Duryea, MD
- Section Editor — General Pediatrics
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Child maltreatment is intentional harm or threat of harm to a child by a person who is acting in the role of caretaker . Four categories of child maltreatment are commonly described: physical abuse, sexual abuse, emotional abuse, and child neglect. Child neglect and emotional abuse will be reviewed here. Physical abuse and sexual abuse are discussed separately. (See appropriate topic reviews).
Child neglect is the most prevalent form of child abuse, accounting for more than one-half of cases reported to child protection services [2-5]. Child neglect is defined by the National Center of Child Abuse and Neglect as failure to provide for a child's basic physical, emotional, educational, or medical needs [2,6]. Specific types of neglect are defined as follows:
●Physical neglect – Failure to provide adequate food, clothing, shelter, hygiene, protection; inadequate supervision with risk of harm to the child.
●Emotional neglect – Failure to provide love, affection, security, and emotional support; failure to provide psychological care when needed; spouse abuse in presence of the child. (See "Intimate partner violence: Childhood exposure".)
●Educational neglect – Failure to enroll the child in school or ensure school attendance or home schooling; failure to address specific educational needs.
- Wissow LS. Child abuse and neglect. N Engl J Med 1995; 332:1425.
- Ludwig S. Child abuse. In: Textbook of Pediatric Emergency Medicine, 5th ed, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p.1761.
- The Third National Incidence Study of Child Abuse and Neglect. National Center on Child Abuse and Neglect; US Department of Health anad Human Services, Washington DC, 1996.
- Dubowitz H, Giardino A, Gustavson E. Child neglect: guidance for pediatricians. Pediatr Rev 2000; 21:111.
- Centers for Disease Control and Prevention (CDC). Nonfatal maltreatment of infants--United States, October 2005-September 2006. MMWR Morb Mortal Wkly Rep 2008; 57:336.
- Brayden RM, Altemeier WA, Tucker DD, et al. Antecedents of child neglect in the first two years of life. J Pediatr 1992; 120:426.
- Helfer RE. The neglect of our children. Pediatr Clin North Am 1990; 37:923.
- Golden MH, Samuels MP, Southall DP. How to distinguish between neglect and deprivational abuse. Arch Dis Child 2003; 88:105.
- Wang CT, Daro D. Current trends in child abuse reporting and fatalities: The results of the 1997 Annual Fifty State Survey, Prevent Child Abuse America, Chicago 1998.
- Gilbert R, Widom CS, Browne K, et al. Burden and consequences of child maltreatment in high-income countries. Lancet 2009; 373:68.
- McCurdy K, Daro D. Current trends in child abuse reporting and fatalities. The National Center on Child Abuse Prevention and Research, Working Paper No. 808. National Committee to Prevent Child Abuse, Chicago 1994.
- Berkowitz CD. Fatal child neglect. Adv Pediatr 2001; 48:331.
- Margolin L. Fatal child neglect. Child Welfare 1990; 69:309.
- Landen MG, Bauer U, Kohn M. Inadequate supervision as a cause of injury deaths among young children in Alaska and Louisiana. Pediatrics 2003; 111:328.
- Gillham B, Tanner G, Cheyne B, et al. Unemployment rates, single parent density, and indices of child poverty: their relationship to different categories of child abuse and neglect. Child Abuse Negl 1998; 22:79.
- Gaudin JM Jr, Polansky NA, Kilpatrick AC, Shilton P. Family functioning in neglectful families. Child Abuse Negl 1996; 20:363.
- Accardo PJ, Whitman BY. Children of mentally retarded parents. Am J Dis Child 1990; 144:69.
- Coohey C. Neglectful mothers, their mothers, and partners: the significance of mutual aid. Child Abuse Negl 1995; 19:885.
- Harrington D, Black MM, Starr RH Jr, Dubowitz H. Child neglect: relation to child temperament and family context. Am J Orthopsychiatry 1998; 68:108.
- Gaudin JM Jr, Polansky NA, Kilpatrick AC, Shilton P. Loneliness, depression, stress, and social supports in neglectful families. Am J Orthopsychiatry 1993; 63:597.
- Polansky NA, Gaudin JM Jr, Ammons PW, Davis KB. The psychological ecology of the neglectful mother. Child Abuse Negl 1985; 9:265.
- Coohey C. Home alone and other inadequately supervised children. Child Welfare 1998; 77:291.
- Jessee SA. Orofacial manifestations of child abuse and neglect. Am Fam Physician 1995; 52:1829.
- American Academy of Pediatrics Committee on Early Childhood, Adoption, and Dependent Care: Oral and dental aspects of child abuse and neglect. Pediatrics 1986; 78:537.
- Lavelle JM, Shaw KN, Seidl T, Ludwig S. Ten-year review of pediatric bathtub near-drownings: evaluation for child abuse and neglect. Ann Emerg Med 1995; 25:344.
- National Institute for Health and Clinical Excellence. When to suspect child maltreatment. July 2009. http://www.nice.org.uk/CG89 (Accessed on September 21, 2009).
- Dubowitz H, Papas MA, Black MM, Starr RH Jr. Child neglect: outcomes in high-risk urban preschoolers. Pediatrics 2002; 109:1100.
- Buchanan A, Oliver JE. Abuse and neglect as a cause of mental retardation: a study of 140 children admitted to subnormality hospitals in Wiltshire. Br J Psychiatry 1977; 131:458.
- Kendall-Tackett KA, Eckenrode J. The effects of neglect on academic achievement and disciplinary problems: a developmental perspective. Child Abuse Negl 1996; 20:161.
- Allen RE, Oliver JM. The effects of child maltreatment on language development. Child Abuse Negl 1982; 6:299.
- Kotch JB, Lewis T, Hussey JM, et al. Importance of early neglect for childhood aggression. Pediatrics 2008; 121:725.
- Ludwig S, Rostain A. Family function and dysfunction. In: Developmental-Behavioral Pediatrics, 4th, Carey WB, Crocker AC, Coleman WL, et al (Eds), Saunders Elsevier, Philadelphia 2009. p.103.
- Block RW, Krebs NF, American Academy of Pediatrics Committee on Child Abuse and Neglect, American Academy of Pediatrics Committee on Nutrition. Failure to thrive as a manifestation of child neglect. Pediatrics 2005; 116:1234.
- Dubowitz H, Finkel MA. Child abuse and neglect. In: Primary Pediatric Care, 4th, Hoekelman RA (Ed), Mosby, St. Louis 2001. p.682.
- Jenny C, Committee on Child Abuse and Neglect, American Academy of Pediatrics. Recognizing and responding to medical neglect. Pediatrics 2007; 120:1385.
- Dubowitz H. Preventing child neglect and physical abuse: a role for pediatricians. Pediatr Rev 2002; 23:191.
- Medical necessity for the hospitalization of the abused and neglected child. American Academy of Pediatrics. Committee on Hospital Care and Committee on Child Abuse and Neglect. Pediatrics 1998; 101:715.
- Religious objections to medical care. American Academy of Pediatrics Committee on Bioethics. Pediatrics 1997; 99:279.
- Asser SM, Swan R. Child fatalities from religion-motivated medical neglect. Pediatrics 1998; 101:625.
- Moyer VA, U.S. Preventive Services Task Force. Primary care interventions to prevent child maltreatment: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013; 159:289.
- DePanfilis D, Salus MK. A coordinated response to child abuse and neglect: A basic manual. National Center on Child Abuse and Neglect; US Department of Health and Human Services: Administration for Children and Familiies, Washington, DC 1992.
- Hamarman S, Bernet W. Evaluating and reporting emotional abuse in children: parent-based, action-based focus aids in clinical decision-making. J Am Acad Child Adolesc Psychiatry 2000; 39:928.
- Nelms BC. Emotional abuse: helping prevent the problem. J Pediatr Health Care 2001; 15:103.
- Kent A, Waller G. Childhood emotional abuse and eating psychopathology. Clin Psychol Rev 2000; 20:887.
- Hibbard R, Barlow J, Macmillan H, et al. Psychological maltreatment. Pediatrics 2012; 130:372.
- National Center of Child Abuse and Neglect. National Center of Child Abuse and Neglect, Washington, DC 1997.
- Kairys SW, Johnson CF, Committee on Child Abuse and Neglect. The psychological maltreatment of children--technical report. Pediatrics 2002; 109:e68.
- Campbell AM, Hibbard R. More than words: the emotional maltreatment of children. Pediatr Clin North Am 2014; 61:959.
- Kaplan SJ, Pelcovitz D, Labruna V. Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: Physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry 1999; 38:1214.
- Hart SN, Brassard MR. A major threat to children's mental health. Psychological maltreatment. Am Psychol 1987; 42:160.
- Garbarino J. Psychological child maltreatment. A developmental view. Prim Care 1993; 20:307.
- Campo AT, Rohner RP. Relationships between perceived parental acceptance-rejection, psychological adjustment, and substance abuse among young adults. Child Abuse Negl 1992; 16:429.
- Vissing YM, Straus MA, Gelles RJ, Harrop JW. Verbal aggression by parents and psychosocial problems of children. Child Abuse Negl 1991; 15:223.
- Mullen PE, Martin JL, Anderson JC, et al. The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse Negl 1996; 20:7.
- Johnson JG, Cohen P, Smailes EM, et al. Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Compr Psychiatry 2001; 42:16.
- Dube SR, Anda RF, Felitti VJ, et al. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA 2001; 286:3089.
- CHILD NEGLECT
- - Physical neglect
- - Emotional neglect
- - Educational neglect
- - Medical neglect
- - Hospitalization
- - Medical neglect
- - Prevention
- Mandated reporting
- - Recommendations
- EMOTIONAL MALTREATMENT
- - Categories
- - Risk factors
- Clinical features
- - Substantiation
- - Sequelae
- - Reporting
- SUMMARY AND RECOMMENDATIONS
- Child neglect
- Emotional maltreatment