Impacts for the Child

In a nutshell guide:

Neglect is considered to be just as harmful and damaging for children and young people as other forms of child maltreatment. The impacts of neglect can be far-reaching and long-lasting.
When assessing the impacts, consider all the dimensions of children’s developmental needs in the Assessment Framework: Health, education, emotional and behvaioural development, identity, family and social relationships, social presentation and self-care skills.
Neglect can be especially damaging in children’s early years, but it can impact development throughout childhood and adolescence.
Neglect’s impacts are often cumulative, due to its often chronic nature. In other words, the impacts can stack up through childhood leading to widespread harm for a child. Therefore, the length a child/young person is neglected is an important consideration.
Experiencing neglect as a child/young person can increase the risks of a range of negative health, emotional and social outcomes in adult life. This includes mental health difficulties, substance misuse issues and a range of socioemotional problems.

Brandon et al. (2014) (Department for Education (publishing.service.gov.uk)) suggest on pages 8-10:

The harm of neglect

Neglect is considered to be at least as damaging, if not more so, than other forms of maltreatment because its impact is the most far-reaching and difficult to overcome (Gilbert et al., 2009). Neglect in the early years may be the most damaging from the point of view of long-term mental health or social functioning…

Impact of neglect on children’s development

Neglect is rarely life threatening but has the potential to compromise a child’s development significantly, across multiple domains. Because neglect frequently coexists with other forms of maltreatment, it can be difficult to disentangle its unique consequences. Nevertheless, there is now a relatively robust consensus based on a range of empirical evidence that demonstrates its adverse impact on all the seven dimensions of development identified in the Assessment Framework: health, education, identity, emotional and behavioural development, family and social relationships, social presentation and self-care skills (see Tanner and Turney, 2003; Norman et al., 2012; Hildyard and Wolfe, 2002; Manly et al., 2001).

While neglect is thought to be particularly damaging in the first two to three years of life – a formative period for social, emotional and neurobiological development – it can compromise development throughout childhood and adolescence…

Persistent, severe neglect indicates a breakdown or a failure in the relationship between parent and child. This may be reflected in maladaptive attachment patterns; for example, neglected children are as likely as children maltreated in other ways to develop disorganised attachment styles (Barnett, Ganiban and Cicchetti, 1999). However, they differ from other maltreated children in that they show more evidence of delayed cognitive development, poor language skills, and poor social skills and coping abilities (Hildyard and Wolfe, 2002). They may also present as dependant and unhappy, and display a range of pathological behaviours (see Egeland et al, 1983; Ward, Brown and Westlake, 2012). Children who are neglected from early infancy may find that as their need for nurturing or responsive relationships goes ignored, they withdraw from relationships, feel a greater sense of failure and may even blame themselves for the neglect they experience (Manly et al, 2001).

Cumulative impact

The impact of neglect is not only widespread, affecting a wide range of developmental domains, it is also cumulative. Neglected infants and toddlers show a dramatic decline in overall developmental scores between the ages of 9 and 24 months (Egeland and Sroufe, 1981; Naughton et al, 2013). They also show a progressive decline in their cognitive function throughout the pre-school years (Strathearn et al, 2001). Neglected infants who initially display secure attachments increasingly develop insecure and disorganised attachment styles as they grow older (Howe, 2005). These findings imply that the longer pre-school children are exposed to neglect, the greater will be the harm. Longer duration of neglect has also been associated with an increased pattern of neural reactivity to social threat (McCrory et al., 2012). Hindley and colleagues’ systematic review of risk factors for the recurrence of maltreatment highlights the cumulative nature of neglect since it is the most likely form of maltreatment for a child to re-experience (Hindley et al, 2006).

Long-standing consequences

Neglect in the early years has long-standing consequences that can endure throughout childhood, adolescence and well into adulthood (Stein et al, 2009; Rees et al, 2011). Neglected babies and toddlers may develop both internalising (depressed, withdrawn, lacking in self-confidence) and externalising (acting out, aggressive, impulsive) behavioural problems in later childhood (English et al., 2005)…

Neglect in childhood is also associated with a range of mental health problems in adulthood. As adults, neglected children are more likely to develop major depressive disorders (Widom et al., 2007) and post-traumatic stress disorder (Widom et al., 1999). Physical neglect in childhood is associated with greater functional and social impairment in adults with schizophrenia (Gil et al., 2009). Robust evidence has also been found for relationships between childhood neglect and anxiety disorders, suicide attempts, substance misuse, risky sexual behaviours and sexually transmitted infections in adulthood (see Norman et al., 2012 for further details). There are also long term physical consequences of neglect in adulthood which can include an increased risk of hypertension, and chronic pain syndromes (Anda et al., 2006).

Moran (2009) (https://www.basw.co.uk/system/files/resources/basw_43707-5_0.pdf) suggests on pages 6-7:

Neglect has a wide-ranging impact on children. In a summary of the literature in this area, Horwath (2007) suggests that neglect can have a damaging affect on all of the developmental needs of a chid, including physical, socio-emotional, cognitive and behavioural development…

Neglect can have negative effects across the lifespan. In infancy and preschool, neglected children are more likely to show inadequate growth and failure to thrive, more extreme mood swings, non-compliance and less positive affect (Howe, 2005). At primary school age, they are more likely to be socially isolated, lack social skills and appear withdrawn (Hildyard and Wolfe, 2002). They may show other signs of neglect such as consistent hunger and fatigue, apathy, poor hygiene, inadequate clothing, and bald patches on the scalp or other skin afflictions, and achieve less well educationally (Berry et al, 2003). Neglect also interferes with the acquisition of emotional understanding and emotion regulation. Neglected children may also crave physical contact and attention and hence may be prey to sexual abusers (Horwath, 2007). By adolescence, neglected children are more likely to have dropped out of school and be involved in substance misuse (Eriksson and Egeland, 2002). They may continue to be socially withdrawn, are more likely to be bullied, and may be likely to attempt suicide (Cullingford and Morrison, 1997). There is also a higher rate of antisocial and violent behaviour among adolescents who have experienced neglect (Smith et al, 2005).