Acts of Omission: Child Neglect

by Child Welfare Information Gateway

More children suffer from neglect in the United States than from physical and sexual abuse combined. In spite of this, neglect has received significantly less attention than physical and sexual abuse by practitioners, researchers, and the media. One explanation may be that neglect is so difficult to identify. Neglect often is an act of omission, the absence of an action. But neglecting children's needs can be just as injurious as striking out at them. Understanding more about neglect-what it is, who is affected, what the consequences are, and what can be done about it-is an important step in addressing the problem.

How Big is the Problem?

The U.S. Department of Health and Human Services reports that in 1999, 58.4 percent of all child maltreatment victims were found to have been neglected. In other words, of the 826,000 maltreated children in the United States in 1999, 482,000 were neglected. Although the rate of neglect has decreased from 7.7 per 1,000 children in 1995 to 6.5 per 1,000 children in 1999, neglect remains the most common form of maltreatment.

But these numbers only include the children who have been reported to Child Protective Service (CPS) agencies and whose cases were substantiated. A study conducted in 1993 found that almost two million children were endangered by neglect in the United States. Clearly, the problem of neglect is pervasive.

What is Neglect?

This is not an easy question. In general, neglect is an act of omission. It is the failure of a child's primary caretaker to provide adequate food, clothing, shelter, supervision, and medical care. But what is adequate? And is it neglect if the primary caretaker is simply unable to provide for the child's needs, or must the caretaker "willfully" deprive the child? And is it neglect only if the child has suffered harm, or if the child is potentially at harm? And are there other types of deprivation not mentioned above-such as a failure to provide for a child's educational or emotional needs-that also should be classified as neglect? Both legal and research professionals struggle with these questions.

Legal Definitions

The Federal Child Abuse Prevention and Treatment Act (CAPTA) provides minimum standards for definitions. CAPTA states,

"The term 'child abuse and neglect' means, at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm" (42 U.S.C.A. §5106g(2) (West Supp. 1998).

Using this minimum standard as a foundation, each State provides its own definitions for child abuse and neglect. There are three places in State statutes in which abuse and neglect are defined: (1) reporting laws for child maltreatment, (2) criminal codes, and (3) juvenile court statutes.

A review of State reporting laws reveals that neglect frequently is defined by the States as deprivation of adequate food, clothing, shelter, or medical care. However, there is great variation among the States in operationalizing their definitions, which contributes to the lack of clarity on a national level. For example, approximately one-fifth of the States do not define neglect separately from abuse. Of those that do define neglect separately, some also define particular types of neglect, such as abandonment or medical neglect. In addition, many States address related issues in their statutes such as parental incapacity (i.e., parent is hospitalized or incarcerated) or injurious environments (i.e., child is exposed to criminal activity in the home). Most States also specify exemptions or issues to be taken into consideration, including religious exemptions for medical neglect and financial considerations for physical neglect.

Beyond State reporting laws, various State regulations, policies, and procedures provide guidance for child welfare professionals to determine whether or not neglect has occurred. Various agencies and workers interpret these guidelines as they make decisions about which reports to investigate, and which investigations will result in interventions. Clearly, there is no universal legal or practice definition of child neglect.

Research Definitions

There is little agreement among researchers regarding a conceptual or operational definition of neglect. Researchers lament this situation because a lack of consensus makes it difficult to compare findings across studies and difficult to apply findings to child welfare professionals' interventions. In addition to using various definitions, researchers also have used a variety of methods to measure neglect, including observations of the home, specific behavioral criteria, medical history, self-report measures, interviews, case record abstractions, and CPS case findings.

One important element of a child neglect definition or classification system is the identification of behaviors or conditions that are considered "neglectful." Some behaviors seem universally classified as neglect by researchers. These include:

• Inadequate nutrition, clothing, or hygiene
• Inadequate medical, dental, or mental health care
• Unsafe environments
• Inadequate supervision, including use of inadequate caretakers
• Abandonment or expulsion from the home.

About the Author

www.childwelfare.gov
Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.