Developmental impact of child neglect in early childhood

Child neglect, often overlooked, is the most common form of child maltreatment.^[1] Most perpetrators of child abuse and neglect are the parents themselves. A total of 79.4% of the perpetrators of abused and neglected children are the parents of the victims, and of those 79.4% parents, 61% exclusively neglect their children.^[2] The physical, emotional, and cognitive developmental impacts from child neglect in early childhood can be detrimental as the effects from the neglect can carry on into adulthood.

Physical Health Development

Research has shown that by the time a child reaches the age of six, if he/she has experienced adverse exposures, such as neglect, his/her chances of having overall poor physical health increases by two-fold.^[3] Infants can develop poor physical health if neglect starts even before the child is born. A child deprived of basic necessities, such as proper pre-natal care, is at risk of being born prematurely or having complications during birth.

A common outcome of medical neglect is failure to thrive in infants and children. This problem arises when a child is deprived of adequate nutrition or withheld from necessary medical attention required for proper physical growth and development.^[4] As a result, the neglected child is left with potentially permanent physical disabilities.

Social and Emotional Development

Attachment and Avoidance of Intimate Relationships

A developing child requires proper nutrition, protection, and regulation for healthy attachment. About 80% of neglected children display attachment disorder symptoms and eventually form insecure attachments to their caregivers as a result of caregivers' unresponsive interactions.^[5] This disturbed attachment to their primary caregiver alters future relationships with peers by becoming emotional and physically isolated from others reducing the likelihood of forming emotional connections.^[6] Moreover, as a result of their past maltreatment, neglected children feel that forming intimate relationships with others loses their control in life and exposes them by increasing their vulnerability.^[7]

Emotional Deregulation

Neglected children demonstrate lack of emotional regulation, understanding emotional expressions by others, and difficulty in distinguishing emotions.^[8] When posed with problem-solving tasks, neglected children reacted with anger and frustration, and were less enthusiastic with completing a new task.^[9] Neglected children often have distressing memories of their past to which they regulate their emotions by suppressing them.^[7]

Psychiatric Development

Childhood abuse and neglect can lead to developing posttraumatic stress disorder (PTSD), depression, and anxiety disorders later in life.^[10][11] Although major depression is not readily seen in younger children compared to adolescents, it is still prevalent.^[12]

Cognitive and Academic Development

Neuroimaging studies using magnetic resonance imaging have shown that the brain structure of a neglected child is significantly altered. The overall cerebral volume of the brain of a neglected child is significantly diminished, with a reduced midsagittal area of the corpus callosum, and the ventricular system is enlarged thereby resulting in decreased cognitive growth, development, and functioning.^[13][14] Further studies show that neglected children have poor cerebral hemisphere integration and underdevelopment of the orbitofrontal cortex region which affects the child’s social skills.^[15]

Studies on academic progress in neglected children have indicated that these children may experience a drop in their academic performance. Children who have experienced neglect are more likely to have attention deficits and poorer academic achievements.^[16] Further, neglect in early childhood can result in a rise in stress levels in the child.^[10] Elevated stress levels from neglect can lead to a release of higher levels of cortisol causing damage to the hippocampus which can affects a child’s learning and memory.^[17]

A study examining the motor, language, and cognitive development of neglected children showed that the scores from the Bayley Scales of Infant Development were significantly lower than non-maltreated children.^[9] Neglected children displayed poor self-control and a lack of creativity in solving problem.^[9] Standardized tests become a challenge for neglected children as they perform poorly on intellectual functioning and academic achievement.^[9] Further, neglected children perform significantly poorer on IQ tests than non-maltreated children.^[18]

References

1. ^ Dubowitz, H., Black, M.M., Starr, R.H. and Zuravin, S. (1993) A conceptual definition of child neglect. Criminal Justice and Behavior, 20, 1, 8-26.
2. ^ U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. (2007). Child maltreatment 2005. Washington, DC: U.S. Government Printing Office.
3. ^ Flaherty, E., Thompson, R., Litrownik, A., Theodore, A., English, D., Black, M., et al. (2006). Effect of early childhood adversity on child health. Archives of Pediatrics and Adolescent Medicine, 160, 1232-1238.
4. ^ Block, R.W. and Krebs, N.F. (2005). Failure to Thrive as a Manifestation of Child Neglect. Pediatrics. (116)5, 1234-1237.
5. ^ Cicchetti & Barnett, 1991. Attachment for infants in foster care: The role of caregiver state of mind. Child Development. 70, 1467-1477.
6. ^ Trickett, P.K., & McBride-Chang, C. (1995). The developmental impact of different forms of child abuse and neglect. Developmental Review, 15, 311-337.
7. ^ ^{a b} James, B. (1994). Handbook for treatment of attachment trauma problems in children. New York: Lexington Books.
8. ^ Pollak, S.D., Cicchetti, D., Hornung, K., and Reed, A. (2000).Recognizing emotion in faces. Developmental Psychology. 36, 679-688.
9. ^ ^{a b c d} Hildyard, K. L., & Wolfe, D. A. (2002). Child neglect: Developmental issues and outcomes. Child Abuse & Neglect, 26(6-7), 679-695.
10. ^ ^{a b} Widom (1999). Posttraumatic stress disorder in abused and neglected children grown up. American Journal of Psychiatry, 156, 1223–1229.
11. ^ Brown, J., Cohen, P., Johnson, J., & Smailes, E. (1999). Childhood abuse and neglect: Specificity of effects on adolescent and young adult depression and suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1490-1496.
12. ^ Harkness, K., & Lumley, M. (2008). Child abuse and neglect and the development of depression in children and adolescents. In J. Abela & B. Hankin (Eds.), Handbook of depression in children and adolescents. New York: The Guildford Press.
13. ^ De Bellis, M., Keshavan, M., Clark, D., Casey, B., Giedd, J., Boring, A., Frustaci, K., & Ryan, N. (1999). Developmental traumatology part II: Brain development. Biological psychiatry, 45, 1271-1284.
14. ^ De Bellis, M., & Thomas, L. (2003). Biologic findings of post-traumatic stress disorder and child maltreatment. Current Psychiatry Reports, 5, 108-117.
15. ^ Siegel D.J. (2001). Toward an interpersonal neurobiology of the developing mind: Attachment, “mindsight” and neural integration. Infant Mental Health Journal, 22(1-2), 67-94.
16. ^ Slade, E. P. and L. S. Wissow (2007) The influence of childhood maltreatment on adolescents’ academic performance. Economics of Education Review, 26 604–614.
17. ^ Middlebrooks, J.S. & Audage, N.C. (2008). The effects of childhood stress on health across the lifespan. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
18. ^ Gowen, J. (1993). Effects of neglect on the early development of children: final report. Washington, DC: National Clearinghouse on Child Abuse and Neglect, Administration for Children & Families.