CHILD NEGLECT

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CHILD NEGLECT
What is Neglect? Types of Neglect What
constitutes neglect Behavior of Parent or Harm
to child? How Many Children Are
Neglected? Vast Differences between
estimates Difficulty in defining and
measuring Cultural criterion Where to draw
the line Is failure to protect from observing
violence neglect? Is there any way to measure
neglect aside from the number of injured
children discovered? Most prevalent and least
researched form of child maltreatment Ways of
measuring neglect CPS, CTS scale, MNS-A and
MNS-C Consequences of Neglect IDV study,
Maine-NH study
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TYPES OF NEGLECTU.S. Department of Health and
Human Services as cited in Barnett

• Health care neglect (the refusal to provide
  physical and mental health care)
• Personal hygiene neglect (personal care and
  cleanliness standards are failed to be met)
• Nutritional neglect (failure to provide a
  nutritious and quality diet)
• Neglect of household safety (safety hazards
  either within the house or surrounding area pose
  danger to the child)
• Neglect of household sanitation (housekeeping and
  cleanliness standards are not met)
• Inadequate shelter (lack of stable home)
• Abandonment (physical abandonment)
• Supervisory neglect (parental supervision lacks
  to the extent that injury is possible)
• Educational neglect (parents dont provide the
  necessary care and supervision to promote
  education)
• Emotional neglect (security, support, and
  encouragement arent provided)
• Fostering delinquency (the encouragement of
  illegal behaviors)

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DEFINITION OF NEGLECT
Neglect is behavior by a caregiver that
constitutes a failure to act in ways that are
presumed by the culture of a society to be
necessary to meet the developmental needs of a
child and which are the responsibility of a
caregiver to provide.
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CONTROVERSIAL ELEMENTS IN THE DEFINITION
Behavior by a caregiver Essential to avoid
confounding the definition and measurement of
neglect with either the causes of neglect (such
as poverty or motive) or with the effects of
neglect such as physical or psychological damage
to the child. Crucial to measure causes or
effects. For example, service providers may
often also need data on injury, as this is often
prescribed by statute Causes and effects must
be measured separately from the caregiver
behavior that constitutes neglect.
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HARM TO THE CHILD IS NOT IGNORED BY A DEFINITION
THAT EXCLUDES HARM

• Actualy facilitates research to investigate the
  degree of harm associated with deviation from
  culturally established standards of care.
• Studies of this type
• First identifytype and frequency of neglectful
  behavior, defined as deviation from cultural
  standards.
• Next investigate the probability and degree of
  harm associated with those deviations from
  cultural standards
• Example standards for appropriate levels of
  supervision, such as leaving a seven year-old
  under the daily supervision of a 10 year-old
  sibling after school until a parent returns from
  work.
• What percent of such children are harmed?
• If harm is included in the definition, there
  is no way of measuring that.

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PRESUMED BY THE CULTURE
Except possibly at the extremes when a child
is seriously injured or dies, neglect is a
culturally constructed phenomenon Cultural
norms concerning neglect vary from society to
society. Within a given society they change
over time. Laotia, Cambodian, and many other
societies leaving an infant in the daylong
care of 7 or 8 year old siblings expected rather
than be considered neglect (Korbin Spilsbury,
1999). Contemporary USA both the infant and
the 7 or 8 year-old caregiver child would be
judged as neglected. For example, learning to
read and write was at one time a privilege of a
small minority of children rather than a
developmental need that, if not met, constitutes
neglect.
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RESPONSIBILITY OF A CAREGIVER

• Allows for a division of labor between
  caregivers.
• If there are two caregivers and only one is
  expected to provide food, and only one does, the
  other caregiver has not been neglectful.
• If both are expected to provide food and one
  does not, that is neglect by the caregiver who
  fails to provide food.
• This is the case even if the child gets enough
  to eat from the other caregiver because a
  primary caregiver has failed to meet the
  standards of the culture.

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PREVALENCE OF NEGLECTDIFFERENCES IN RATES FROM
THREE SOURCES
RATE NUMBER PER 1,000 OF CHILDREN Cases
reported to Child Protective Services, 1998
7.2 504,000 53 of all cases
reported to CPS National Incidence Study of
cases known to human 15.9 1,004,00
service professionals (random sample of 28
counties) National Survey of 1,000 parents,
1995 270.0 18,865,000 Cases known to
professionals is double Cases uncovered by 1995
survey of parents is 37 times greater WHAT
COULD EXPLAIN THESE DIFFERENCES?
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WHAT COULD EXPLAIN THESE DIFFERENCES?
MOST CASES NOT REPORTED Even human service
professionals do not report all (perhaps half
of cases they know about) DIFFERENT CRITERIA
FOR JUDGING A CASE TO BE NEGLECT National Survey
of parents used parents behavior CPS and human
service professionals tend to use injury to the
child Most neglect does not result in a
visible injury. The most frequent injury is
psychological and it is rarely observable
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HOW CAN NEGLECT BE MEASUREDASIDE FROM REPORTS TO
CPS?
Surveys Of Service Providers the least useful
approach Epidemiological Surveys studies of a
general population The CTS Neglect
Scale The Multimensional Neglect Scale Form
A Adolescent Report and Adult Recall Form
AS Short form as part of the PRP Form CR
Computer Administered For children 6-12 Form PR
Parent Self Report
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WHY HAVING OTHER MEASURES IS MPORTANT
Cases known to CPS are the tip of the
iceberg Provides more complete estimate of
prevalence But the criteria are not necessarily
the same A means of testing the effectiveness of
prevention and treatment programs More adequate
data on CPS cases, especially cases with other
presenting problems Research that will provide
the better understanding of the causes neglect
needed to develop "primary prevention" programs
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NATIONAL SURVEY OF 1,000 PARENTS(Straus et al,
1995)
THE CTS NEGLECT SCALE
Prevalence
Past Yr Scale and Items
Year Ever Chron
NA. Had to leave your child home alone, even
195 213 6.0 when you thought some adult
should be with him/her NC. Were not able to make
sure your child got 110 137 5.5 the
food he/she needed NE. Were so drunk or high that
you had a 33 5.9 2.3 Problem
taking care of your child ND. Were not able to
make sure your child got to 4 12 2.0
a doctor or hospital when he/she needed it. NB.
Were so caught up with problems that you
2 11 4.6 were not able to show or tell
your child that you loved him/her Neglect Scale
( sum of the 5 items) 270
306 6.9__________   Chronicity is the mean number
of times each act was reported among the subset
of parents who reported at least one
occurrence.  
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MULTIDIMENSIONAL NEGLECT SCALESHORT FORM (Form
MNS-AS)
  Cognitive needs My parents helped me with
homework if I needed help (R) My parents did not
help me to do my best in school Educational
Needs My parents made sure I went to school
(R) My parents did not care if I got into trouble
in school Emotional needs My parents helped me
when I had problems (R) My parents did not
comfort me when I was upset Physical needs My
parents gave me enough clothes to keep me warm
(R) My parents did not keep me clean (R)
REVERSED ITEMS RELIABILITY COEFFICIENT (ALPHA
.71)
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Table 3 Percent Reporting One or More Forms of
Each Type of Neglect, by Gender
7,500 Students in 14 Countries
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(No Transcript)
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Table 5a Neglect Total Scores in Rank Order by
Site, by Gender
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Figure 1 Interaction Effect of Gender and Site
for Total Neglect
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Multidimensional Neglect Scale-Child Report
(MNS-CR)

• Glenda Kaufman Kantor, Ph.D., Murray A. Straus,
  Ph.D., Melissa Holt, Ph.D,
• Family Research Laboratory, University of New
  Hampshire
• Lawrence Ricci, M.D. Kerry Drach, Psy.D.
• Spurwink Clinic, Portland Maine
• FOR CHILDREN 6-9 AND 10-15
• COMPUTER ADMINISTERD -- SOUND AND TOUCH SCREEN
• WARM-UP PICTURES DONE WITH RESEARCER
• COMPUTER GAME HALF WAY THROUGH

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Emotional Neglect Sample Item
Which girl is most like you?
This girls father makes her feel better when she
is sad or scared
This girls father doesnt make her feel better
when she is sad or scared
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Emotional Neglect Sample Item Cont.
Is this
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Cognitive Neglect Sample Item
Which girl is most like you?
This girls mother does not talk to her about
what she is learning in school
This girls mother talks to her about what she is
learning in school
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Supervision Neglect Sample Item(age 6-9)
Which boy is most like you?
This boys mother doesnt know where hes playing
outdoors
This boys mother knows where hes playing
outdoors
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Supervision Neglect Sample Item(age 10-15)
Which boy is most like you?
This boys father does not find out where he is
going after school
This boys father finds out where he is going
after school
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Hasnt left alone for a couple of days without
grown-ups
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Physical Neglect Sample Item
Which boy is most like you?
This boys mother makes sure he takes a bath
This boys mother does not make sure he takes a
bath
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Sees grown-ups in the house hitting each other
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Depression Sample Item
Which girl is most like you?
Some girls are unhappy a lot of the time
Other girls are pretty happy a lot of the time
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Depression Sample Item Cont.
Is this
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Sample Characteristics

• Clinical Sample
• N 143
• 57 6-9 years of age
• 43 10-15 yrs. of age
• 59 female
• 41 male
• 6 non-white

• Community Sample
• N 45
• 67 6-9 years of age
• 33 10-15 yrs. of age
• 53 female
• 47 male
• 38 non-white

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Child Behavioral Problems by MNS-CR Median
Split Scores
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Relations of Neglect to Depression and PPVT
Standard Scores Age 6-9

• Child Depression
• Neglect Total (r .54)
• Emotional Neglect (r .40)
• Cognitive Neglect (r .40)
• Supervision Neglect (r .41)
• Physical Neglect (r .45)
• Parental Alcohol Use (r .50)
• Childs Appraisal of Neglect (r .53)
• PPVT Standard Scores
• MNS-CR Total Score (r -.26)
• Physical Neglect (r -.36)
• Neglect Maltreatment Group (r -.38)

p .05, p .01
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Relations of Neglect to Depression and PPVT
Standard Scores Age 10-15

• Child Depression
• Neglect Total (r .35)
• Emotional Neglect (r .37)
• Cognitive Neglect (r .33)
• Supervision Neglect (r .49)
• Failure to Protect (r .58)
• Parental Alcohol Use (r .32)
• PPVT Standard Scores
• Childs Appraisal of Neglect (r -.30)
• Neglect Maltreatment Group (r -.50)

p .05, p .01
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SUMMARY
ESTIMATES OF NEGLECT VARY WIDELY Mainly because
they measure different phenomena Parent
behavior versus injury INFORMATION ABOUT NEGLECT
THAT DOES NOT COME TO THE ATTENTION OF CPS IS
NEEDED BECAUSE CPS CASES ARE A SMALL FRACTION OF
THE ACTUAL NUMBER OF CASES THE ABOVE STATEMENT
IS TRUE ONLY IF ONE MEASURES NEGLECT BY PARENT
BEHAVIOR IT IS POSSIBLE TO MEASURE NEGLECT IN
THE GENERAL POPULATION USE OF ONE OF THESE
MEASURES IN THE INTERNATIONAL DATING VIOLENCE
STUDY SHOWS THAT NEGLECT OCCURS WORLD-WIDE
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End for Soc 697
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(No Transcript)
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(No Transcript)
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(No Transcript)
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Central Aims of the Study

• Develop a standardized instrument to measure
  neglect
• Estimate the prevalence of different types of
  neglect in a community sample
• Describe characteristics of neglectful families
  in community and clinical samples
• Describe the relationship of neglect to child
  behavior problems family characteristics

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ACASI

• Audio enhanced version of the Computer Assisted
  Self-Administered Interview
• Uses an audio system and touch screen to
  interview child
• Scale version adapted by age and gender of the
  child and gender of the primary caretaker

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Child Self Report Neglect Scale

• Measures cognitive, emotional, supervision, and
  physical neglect
• Includes subscales on Child Endangerment
  exposure to parental conflict violence,
  abandonment, and parental alcohol abuse
• Includes subscale on childs general feelings or
  appraisals of each domain

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Eligibility

• Inclusionary Criteria- 6-15 yrs old
• Lived in foster care lt 6 months (age 6-9)
• Lived in foster care lt 1 year (age 10-15)
• Exclusionary Criteria-
• Visually impaired
• Hearing impaired
• No spoken language ability
• Non-English speaking
• Formal diagnosis of mental retardation
• Deemed not interviewable by clinician

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Maltreatment Types in Clinical Sample
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Total MNS-CR Scores by Sample Age 6-9

Significance, p lt.01
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MNS-CR Scores by Sample Age 6-9
p lt .01, p lt .05
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Total MNS-CR Scores by Sample Age 10-15
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MNS-CR Scores by Sample Age 10-15
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MNS-CR Scores by Neglect Age 6-9
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MNS-CR Scores by Psych. Abuse Age 6-9
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MNS-CR Scores by Neglect Age 10-15
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MNS-CR Scores by Psych. Abuse Age 10-15
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MNS-CR Scores by Past CPS Involvement
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MNS-CR Scores by Current CPS Involvement (Open
Case)
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PPVT Standard Scores by Presenting Maltreatment
Type
p lt .05, p lt .01

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Table 1 Comparison of Neglect Estimated
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Table 2 Reliability of Neglect
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Reliability Summary for MNS-CR Scores