Child neglect and psychological abuse
Child neglect (also called psychological abuse) is a form of child abuse that occurs when someone intentionally does not provide a child with food, water, shelter, clothing, medical care, or other necessities.
Other forms of child neglect include:
- Allowing the child to witness violence or severe abuse between parents or adults
- Ignoring, insulting, or threatening the child with violence
- Not providing the child with a safe environment and adult emotional support
- Showing reckless disregard for the child's well being
The rate at which children are physically and emotionally neglected is difficult to define.
Risk factors may include:
- Mental illness
- Stresses in the family
- Substance abuse by parents or caregivers
Abused children are at risk of becoming abusers themselves as adults.
Symptoms of psychological abuse may include:
- Difficulties in school
- Eating disorders, leading to weight loss or poor weight gain
- Emotional issues such as low self-esteem, depression, and anxiety
- Rebellious behavior
- Sleep disorders
- Vague physical complaints
See also: Failure to thrive
Exams and Tests
Children with suspected emotional abuse should be examined by a trained mental health professional. All neglected or psychologically abused children should be examined for other forms of physical abuse.
If you think a child is in immediate danger because of abuse or neglect, you should call 911.
If you suspect that a child is being abused, report it right away. Most states have a child abuse hotline. You may also use the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD).
The law requires health care workers, school employees, and child care professionals to report suspected abuse.
Treatment of the abused child may include nutritional and mental health therapy.
It may be necessary to remove the child from the home to prevent further abuse.
Treatment for abusers may involve parenting classes and treatment for mental illness, alcohol, or drug abuse.
There are many support groups available, including:
Prevent Child Abuse America - www.preventchildabuse.org
With treatment, many children and parents can be reunited as a family. The long-term outcome depends on:
- How severe the abuse was
- For how long the child was abused
- The success of therapy and parenting classes
As in all forms of child abuse, severe injury or death is possible.
Other long-term problems may include:
- Becoming an abuser in adulthood
- Lack of self confidence
- Rebellious behavior
When to Contact a Medical Professional
Call your health care provider if a child has:
- Physical changes, such as unexplained injuries, weight loss, or severe tiredness
- Unexplained behavior changes
Suspected child abuse of any form must be reported to the authorities.
Community programs, such as home visits by nurses and social workers, can help families change behaviors or prevent the start of abuse in high-risk families.
School-based programs to improve parenting, communication, and self-image can help prevent future abuse and may help to identify abused children.
Parenting classes are very helpful. Newlywed adults without children should be encouraged to take these classes before they have each child. The dynamics in the home change when each new child is born.
Johnson CF. Abuse and neglect of children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 36.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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