Advanced Topics: Child Maltreatment Theory Course Presentations Southern Arkansas University Kimberly Keith, MEd, LPC

1. neglect Types of Neglect Risk and Protective Factors

2. Child Neglect: A Guide for Prevention, Assessment and Intervention. User Manual Series (2006) Children's Bureau Arkansas Child Maltreatment Assessment Protocol Arkansas Code 9-15-103. Definitions Types of Neglect

3. Level of Neglect Mild neglect usually does not warrant a report to CPS, but might necessitate a community-based intervention (e.g., a parent failing to put the child in a car safety seat). Moderate neglect occurs when less intrusive measures, such as community interventions, have failed or some moderate harm to the child has occurred (e.g., a child consistently is inappropriately dressed for the weather, such as being in shorts and sandals in the middle of winter). For moderate neglect, CPS may be involved in partnership with community support. Severe neglect occurs when severe or long-term harm has been done to the child (e.g., a child with asthma who has not received appropriate medications over a long period of time and is frequently admitted to the hospital). In these cases, CPS should be and is usually involved, as is the legal system. Chronic neglect is a persistent pattern of family functioning in which the caregiver has not sustained and/or met the basic needs of the children, which results in harm to the child.

4. Priority One Neglect FAILURE TO THRIVE Definition - A clinical term used by pediatric clinicians to describe infants and young children, generally 3 years of age and younger, who fail to grow as expected based on established growth standards for age and gender. Abandonment Definition - Desertion of a child without arranging for reasonable care and supervision. Includes cases in which children were not claimed within 2 days and cases in which children are left by parents or substitutes who gave no (or false) information about their whereabouts.

5. Priority One Neglect MEDICAL NEGLECT OF DISABLED INFANTS Definition - The withholding of appropriate nutrition, hydration, medication, or other medically indicated treatment from a disabled infant with a life-threatening condition. FAILURE TO PROTECT (Priority 1 or 2) Definition - Failure of an individual responsible for the care of a child to take reasonable action to protect that child from maltreatment when that individual had reasonable cause to believe that the child was in significant danger of being maltreated. This allegation may include situations in which a person with a documented history as an offender of child sexual abuse is allowed to be an unsupervised caretaker of a child.

6. Priority Two Neglect MEDICAL NEGLECT Definition - Lack of medical or mental treatment for a health problem or condition which, if untreated, could become severe enough to constitute a serious or long-term harm to the child; lack of follow-through on a prescribed treatment plan for a condition which could become serious enough to constitute serious or long-term harm to the child if the plan is unimplemented.

7. Priority Two Neglect LOCK-OUT Definition - The parent or caretaker has denied the child access to the home necessary to the safety and health of the child. Educational Neglect Permitted Chronic Truancy – Habitual truancy averaging at least 5 days a month if the parent or guardian is informed of the problem and has not attempted to intervene. Failure to Enroll/Other Truancy – Failure to register or enroll a child of mandatory school age, causing the child to miss at least one month of school, or a pattern of keeping a school-age child home for nonlegitimate reasons (to work, care for siblings, etc.) for an average of at least 3 days a month. Inattention to Special Education Need – Refusal to allow or failure to obtain recommended remedial education services, or in obtaining or following through with treatment for a child’s diagnosed learning disorder or other special education need without reasonable cause.

8. Priority Two Neglect INADEQUATE SUPERVISION Definition - The parent or caretaker has failed to appropriately supervise the juvenile which results in the juvenile being left alone at an inappropriate age or in inappropriate circumstances which put the juvenile in danger. Leaving the juvenile alone when the juvenile is too young to care for himself or for other children. Leaving a juvenile alone when the juvenile has a condition that requires close supervision. Leaving a juvenile in the care of an inadequate or inappropriate caretaker. Being present but unable to supervise because of the caretaker's condition. This includes the parent or caretaker who uses drugs or alcohol to the extent that it has the effect of producing a substantial state of stupor, unconsciousness, intoxication, or irrationality. This also includes the parent or caretaker who cannot adequately supervise the juvenile because of the parent's or caretaker's medical condition, behavioral, mental, or emotional problems, developmental disability, or physical handicap.

9. Inadequate Supervision The deciding factor in determining whether a particular situation constitutes neglect due to inadequate supervision will be whether a child is at risk of serious harm due to the lack of supervision. Child factors, in addition to the child’s age, include considerations such as what is the child like developmentally? Parent or caregiver factors include considerations of: What is the parent’s understanding of the child’s needs? Physical environment factors can also affect the potential for harm when children are left unsupervised.

10. Priority Two Neglect ENVIRONMENTAL NEGLECT I. Definition - The child's person, clothing, or living conditions are unsanitary to the point that the child's health is in significant danger of impairment. This may include infestations of rodents, spiders, insects, snakes, etc., human or animal feces, rotten or spoiled food and/or garbage which the child can reach. INADEQUATE CLOTHING Definition - Lack of adequate clothing to protect the child from the elements. INADEQUATE FOOD I. Definition - Lack of food adequate to sustain normal functioning. It is not as severe as malnutrition or failure to thrive, both of which require a medical diagnosis. INADEQUATE SHELTER Definition - Lack of shelter which is safe and which protects from the elements.

11. Priority Two Neglect Emotional Neglect Inadequate Nurturance or Affection – Marked inattention to the child’s needs for affection, emotional support, attention, or competence. (Though quite serious in their effects, these cases rarely reach child protection services. They are often not identified until a child protection case is opened through juvenile delinquency, truancy and other juvenile court cases.) Chronic or Extreme Spouse Abuse – Spousal violence in the child’s presence (Also severe in its effects, recent policy changes have raised state’s awareness of this form of neglect and we will likely see increases in families who receive child protection services due to domestic violence.)

12. Child Exposure to Domestic Violence 5-4-702. Enhanced penalties for offenses committed in presence of a child. (A) Any person who commits a felony offense involving assault, battery, domestic battery, or assault on a family member or household member, as provided in Arkansas Code 5-13-201 or Arkansas Code 5-26-303 - 5-26-311, may be subject to an enhanced sentence of an additional term of imprisonment of not less than one (1) year and not greater than ten (10) years if the offense is committed in the presence of a child. (1) "Child" means a person under sixteen (16) years of age; and (2) "In the presence of a child" means in the physical presence of a child or knowing or having reason to know that a child is present and may see or hear an act of assault, battery, domestic battery, or assault on a family member or household member.

13. Priority Two Neglect Permitted Drug or Alcohol Abuse Encouragement or permitting of drug or alcohol use by the child; includes cases in which the parent or guardian had been informed of the problem and had not attempted to intervene.

14. Tracey Feild, M.A. & Amy PrintzWinterfeld, J.D. Tough Problems, Tough Choices: Guidelines for Needs-Based Service Planning in Child Welfare. 2003. Casey Family Programs and The Annie E.Casey Foundation. Risk Factors in Neglect

15. Demographics of Neglect Mothers, both young and old Single-parent household Low Socio-economic status

16. Individual Risk Factors for Neglect Parental substance abuse Parents who abuse alcohol or drugs are 4 times more likely to neglect their children than parents who don’t Parental Illness or disability Emotional and mental disorders Depression Impulsivity Low empathy Perceived stress Obsessive compulsive disorder

17. Individual Risk Factors for Neglect Low level of intellectual functioning Lack of education in home management, child care, nutrition, etc. Parental history of childhood abuse and neglect Neglecting parenting style (low control, low responsiveness) Child health and disabilities

18. Mesosystem Factors in Neglect Financial stress Substandard housing Food Insecurity Dangerous neighborhood Lack of or difficulties with access to concrete supports (child care, health services, food programs)

19. Strengthening Families and Communities: 2009 Resource Guide Child Welfare Information Gateway, Children's Bureau, FRIENDS National Resource Center For Community-Based Child Abuse Prevention Protective Factors in Neglect

20. Nurturing and Attachment A child's early experience of being nurtured and developing a bond with a caring adult affects all aspects of behavior and development. When parents and children have strong, warm feelings for one another, children develop trust that their parents will provide what they need to thrive, including love, acceptance, positive guidance, and protection. Research shows that babies who receive affection and nurturing from their parents have the best chance of healthy development. A child's relationship with a consistent, caring adult in the early years is associated later in life with better academic grades, healthier behaviors, more positive peer interactions, and an increased ability to cope with stress.

21. Parental Resilience Parents who can cope with the stresses of everyday life, as well an occasional crisis, have resilience; they have the flexibility and inner strength necessary to bounce back when things are not going well. Multiple life stressors, such as a family history of abuse or neglect, health problems, marital conflict, or domestic or community violence—and financial stressors such as unemployment, poverty, and homelessness—may reduce a parent's capacity to cope effectively with the typical day-to-day stresses of raising children.

22. Knowledge of Parenting and of Child and Youth Development There is extensive research linking healthy child development to effective parenting. Children thrive when parents provide not only affection, but also respectful communication and listening, consistent rules and expectations, and safe opportunities that promote independence. Successful parenting fosters psychological adjustment, helps children succeed in school, encourages curiosity about the world, and motivates children to achieve.

23. Social Connections Parents with a social network of emotionally supportive friends, family, and neighbors often find that it is easier to care for their children and themselves. Most parents need people they can call on once in a while when they need a sympathetic listener, advice, or concrete support. Research has shown that parents who are isolated, with few social connections, are at higher risk for child abuse and neglect.

24. Concrete Support for Parents Many factors affect a family's ability to care for their children. Families who can meet their own basic needs for food, clothing, housing, and transportation—and who know how to access essential services such as childcare, health care, and mental health services to address family-specific needs—are better able to ensure the safety and well-being of their children. Partnering with parents to identify and access resources in the community may help prevent the stress that sometimes precipitates child maltreatment. Providing concrete supports may also help prevent the unintended neglect that sometimes occurs when parents are unable to provide for their children.

25. Sources Miller-Perrin, Cindy L. & Perrin, Robin. Child Maltreatment: An introduction. 2007. Thousand Oaks: Sage Dubowitz, H. et al. (2005) Examination of a Conceptual Model of Neglect. Child Maltreatment 10:2, pp. 173-189. Sage Child Neglect: A Guide for Prevention, Assessment and Intervention. User Manual Series (2006) Children's Bureau Tracey Feild, M.A. & Amy PrintzWinterfeld, J.D. Tough Problems, Tough Choices: Guidelines for Needs-Based Service Planning in Child Welfare. 2003. Casey Family Programs and The Annie E.Casey Foundation. Arkansas Child Maltreatment Assessment Protocol Arkansas Code 9-15-103. Definitions. Strengthening Families and Communities: 2009 Resource GuideChild Welfare Information Gateway, Children's Bureau, FRIENDS National Resource Center For Community-Based Child Abuse Prevention