Neglect - Suspected Child Abuse
Among children confirmed by Child Protective Services (CPS) of being maltreated, 61% experienced neglect. Characteristics indicative of child neglect include poor hygiene, poor weight gain, inadequate medical care, and frequent absences from school. Risk factors for neglect include poverty, familial stressors, mental illness, and substance abuse by caregivers. Abused children are at risk of becoming abusers themselves as adults. Neglect can be divided into the following categories: physical, educational, emotional, and medical.
Physical neglect is the most common type of abuse and can often present with cutaneous manifestations. Lack of access to basic necessities, inadequate supervision, and poor emotional support can severely impact the child's development. Physical neglect may result in failure to thrive, malnutrition, illness, or even physical injury including lacerations, bruises, and burns.
Educational neglect refers to the failure of a caregiver to enroll a child in school or provide the appropriate educational training. This increases the child's risk of poor intellectual and emotional development and can lead to poor self-image and destructive behavior.
Emotional and psychological neglect can range from withholding affection and ridiculing to even engaging in extreme spousal abuse in a child's presence. It is often the most difficult situation to substantiate in a legal context. Symptoms in children include poor school performance, eating disorders, sleep disorders, vague physical complaints, and emotional disturbance. Specific parental behaviors considered to be emotional maltreatment include the following:
- Verbally assaulting
- Isolating the child from normal social contacts
- Terrorizing with extreme forms of punishment
- Corrupting or exploiting
Medical neglect refers to the failure to provide appropriate health care to a child, therefore placing the child at risk for death or permanent disability or disfigurement. Suspicion for medical neglect increases when a caregiver ignores medical recommendations for a child with a treatable disease or refuses medical care in an emergency. Parents may refuse certain medical care because of religious beliefs, anxiety, or financial issues. However, CPS intervenes when the child has an acute medical emergency, a life-threatening disease not being treated, or a disease that may result in chronic disability if not treated.
Child abuse is a problem of epidemic proportions affecting children of all ages and economic and cultural backgrounds. It is estimated that each year over 3 million children are victims of abuse, with close to 2,000 fatalities secondary to maltreatment. Neglect is the most common form of abuse and can have devastating consequences on a child's development.
T76.02XA – Child neglect or abandonment, suspected, initial encounter
419686005 – Neglected child
- Anorexia nervosa
- Gluten enteropathy
- Acquired zinc deficiency or hereditary acrodermatitis enteropathica
- Iron deficiency
- Failure to thrive
- Collagen vascular diseases including lupus erythematosus
Children who appear malnourished may be suffering from a number of medical conditions that affect their ability to grow and gain weight, including the following: inborn errors of metabolism, growth hormone deficiency, cystic fibrosis, anorexia nervosa, formula intolerance or food allergy, gastrointestinal disorders (gastroesophageal reflux, celiac sprue, Crohn's disease), or HIV.