Tackling Child Neglect

Research, Policy and Evidence-Based Practice

Ruth Gardner

• Editorial: Jessica Kingsley Publishers
• Año: 2016
• ISBN:
  9781784501655
• Categoría: Sozialwissenschaften
• Categoría: Sozialarbeit

With contributions from internationally recognized experts, this edited volume presents original thinking on the theory, research and practice surrounding child neglect.

Comprehensive and current, the book takes an expansive look at how we can better address this prevalent issue. It explores the effects of neglect on the developing child and makes recommendations on how to identify neglect at the earliest opportunity. It considers common causal and contributing factors in neglect cases and the impact of these on children. The book details effective intervention techniques alongside case vignettes and shows how change can be achieved. It highlights the importance of supporting parental care and developing parental responsibility in families where children are neglected. Chapters provide in-depth descriptive examples and include a summary of learning points.

Including practical suggestions for combating child neglect, this is an essential guide to best practice for students and practitioners working with children and families. The book also contains useful insights relevant to researchers and policy makers.

1

THE EFFECTS OF
CHILD NEGLECT

Understanding and responding

1

THE EFFECTS OF EMOTIONAL
NEGLECT DURING THE
FIRST TWO YEARS OF LIFE

Jane Barlow

Introduction

Neglect refers to the failure to provide a child with the type of care that has been identified as being necessary for them to achieve the development that is commensurate with their personal potential (WHO 1999). Emotional neglect refers explicitly to parenting that is emotionally or psychologically unavailable in terms of responding to the child’s needs. Emotional neglect is typically the result of omission in which the parent fails to respond to the child’s emotional needs (i.e. ignores a child who is distressed). In addition, young children may be exposed to acts of commission (i.e. emotional abuse rather than neglect), in which the parent responds in highly inappropriate ways, for example by frightening a child who is seeking comfort. During the early years, emotional neglect and abuse can co-occur, with parents alternating between being helpless and hostile (Lyons-Ruth et al. 2005) (see below). Both emotional neglect and abuse are of particular importance during the first two years of life because since the discovery of attachment in the 1960s, we have become aware of the importance for the child’s later attachment security of appropriate emotional responses to infant cues (DeWolf 1997). This research has in turn enabled us to begin to recognise the characteristics of parenting that can be defined as emotionally neglectful or abusive in terms of its role in the development of adverse outcomes.

This chapter will examine the ways in which parenting that is either emotionally neglectful or abusive in the early years has been studied in terms of the main methods and approaches that have been used. The key findings of this research are presented in terms of what is now known about the impact of early emotional neglect or abuse on the child’s long-term development. The chapter will conclude by describing the implications of these findings for future research, policy and practice.

Methods and approaches to the study of emotional neglect in the early years

Two key approaches can be identified to the study of emotional abuse and neglect in the early years. First, epidemiological studies, that examine the nature, causes and consequences of particular [health] problems, and that focus on:

•the impact over time of attachment security or insecurity

•the impact of different types of early parenting during the first two years, and

•the factors that can affect the ability of the parent to provide care (e.g. substance dependency and mental health problems).

Second, intervention studies that examine the impacts and benefits of improving parenting during this period, in terms of children’s long-term development. It should be noted that most of this research focuses on mothers, and only recently has research begun to examine the impact of parenting provided by fathers.

Epidemiological studies: The impact over time of attachment security or insecurity

Most of the epidemiological research consists of prospective longitudinal studies (i.e. that look forward over time) to examine the importance of the early years for later development. These studies consist of research that has focused on Bowlby’s (1973, 1982) concept of attachment, and has followed children from infancy to adulthood. The studies have enabled us to identify the importance of secure attachment in early childhood – i.e. at one year of age – in terms of a range of aspects of children’s later development. Secure attachment means that children are able to be comforted when they are distressed and to use their caregiver as a secure base from which to explore the world. In insecure attachment the child has difficulty obtaining comfort from their caregiver, showing signs of either avoidance or ambivalence when the attachment system is activated, and is also less able to use the parent as a secure base.

The Minnesota study, which began in 1975 and followed around 267 children from birth to age 40 years, showed poorer outcomes across key domains in childhood and early adolescence for infants who were independently observed to be insecurely attached. These domains included self-reliance; emotional regulation; and social competence (Sroufe 2005). This study found that insecurely attached children were more reliant on teachers and were also rated as highly dependent by the teachers through early childhood and into adolescence. They showed less positive affective expression, coped less well with social problems showing more frustration behaviour, aggression or resignation, and had more negative responses to the overtures of others including whining, fussing and frustration. Insecure children also had less overall social competence. They were less active in their peer group and more frequently isolated; in pre-school they showed less empathy; in middle school they had fewer reciprocated close friendships; and in adolescence they were less effective in their peer group. This study showed that in conjunction with a number of other variables, attachment accounted for as much as 50 per cent of the variance in children’s outcomes. It also showed that emotional unavailability on the part of a caregiver was one of the most serious forms of abuse because of its profound consequences in terms of the child’s long-term development.

A number of reviews have systematically collated evidence from studies that have examined the association between insecure attachment (described above) and disorganised attachment (i.e. in which the child shows contradictory behaviours, including both approaching and avoiding the caregiver when the attachment system is activated) and later psychopathology.

These studies show that insecure and disorganised attachment are significant predictors of later psychopathology (Green and Goldwyn 2002; van Ijzendoorn, Schuengel and Bakermans-Kranenberg 1999); of externalising disorders such as conduct and behaviour problems (Fearon et al. 2010); and of personality disorder, defined as mental health problems characterised by enduring maladaptive patterns of emotional regulation, relating and behaviour (Steele and Siever 2010). Individual empirical studies have also found an association between disorganised attachment and later mental health problems such as dissociation or detachment from physical and emotional experiences (Dutra and Lyons-Ruth 2005); post-traumatic stress disorder (PTSD) (MacDonald et al. 2008); and an increased likelihood of children experiencing symptoms that meet clinical criteria (Borelli et al. 2010).

In addition to prospective longitudinal studies, a number of retrospective studies (i.e. that look back in time) have examined the factors associated with long-term mental health problems in both children and adults. For example, a review of 13 studies that examined the attachment classification of patients diagnosed with borderline personality disorder (BPD), found that the attachment patterns most characteristic of such patients were unresolved, preoccupied and fearful, corresponding with insecure and disorganised types of attachment in childhood. This is suggested to explain the disturbed interpersonal relationships of patients with BPD (Agrawal et al. 2004).

Although a number of reviews of retrospective studies have examined the impact of child maltreatment and neglect on the developing brain (e.g. Grassi-Oliveira, Ashy and Stein 2008; Twardosz and Lutzker 2010), these have not separated out the results in terms of the specific impact of early neglect. The best evidence about the impact of early severe neglect on the brain is derived from prospective studies of children raised in institutional care, the evidence from which is set out below.

Epidemiological studies: The impact of different types of parenting during the early years

In addition to the above studies that have focused explicitly on the consequences for the child of different types of attachment in terms of their capacity for emotional regulation, there is now a large body of research that has examined the type of parenting that is needed during the first two years of life to promote the child’s capacity for affect or emotional regulation.

Residential institutions such as orphanages have allowed psychologists a number of opportunities to study directly the impact of the early environment on children’s emotional development. One of the key features characterising these institutions was a very low staff-to-baby ratio, resulting in these infants sadly experiencing what has now been described as ‘global early deprivation’ or ‘pervasive neglect’ (Rutter et al. 1998), meaning neglect of virtually all aspects of the child’s development other than their basic physical needs. Psychologists were able to examine the long-term impact on these children of being raised in an environment characterised by such neglect, and also to examine the consequences of removing children from these environments and placing them in foster care where they received individual care and attention.

These empirical studies showed that children raised in institutions for extensive periods, beginning during the immediate postnatal period and with little or no individual care, experienced a range of later problems across all aspects of their functioning. For example, studies show that such institutional care increased the likelihood of reactive attachment disorder (the inability to establish attachments with parents or caregivers) (Zeanah et al. 2005); psychiatric disorders (Zeanah et al. 2009); a range of neurological and behavioural problems (Zeanah et al. 2003); and deficits in memory and executive function (Bos et al. 2009). Importantly, these studies also showed that early removal from this environment could compensate for some of these early deficits (Zeanah et al. 2009).

In addition to research examining the impact of extreme neglect during the early years, there is also a body of research that has examined the impact of early emotional maltreatment, including neglect within families. The Minnesota Study found that such abuse was associated with a range of problematic behaviours in childhood, for example non-compliance; negativistic, impulsive behaviour; high dependence on teachers; nervous signs; self-abusive behaviour and other problems (...

Índice

• Cover
• Title Page
• Contents
• Foreword by David Howe
• Introduction
• Part 1: The Effects of Child Neglect
• Part 2: Perspectives on Child Neglect
• Part 3: Preventing and Reversing Child Neglect
• Subject Index
• Author Index
• Copyright
• Of Related Interest