Physical neglect is an adverse childhood experience that can have long term effects on the child that suffers it. Sometimes physical neglect is intentional, but other times, it occurs due to circumstances outside the parents’ control. In either case, the effects are real and can impact the child physically and psychologically

What is physical neglect?

Physical neglect is often accompanied by emotional neglect. For the most part physical neglect is characterized by one or more of the following:

• Feeling hungry all the time, going without regular meals, or feeling like there is never enough to eat at home. The child may appear thin and always eating any available food, and perhaps even resort to stealing food from others.
• Lack of proper hygiene including not bathing regularly, brushing hair, and cleaning teeth. In severe cases, the child may have lice or other easily treated conditions that have been ignored.
• Having to wear dirty clothes or go without shoes. The clothes they do have may be ill fitting, have holes in them, or be inappropriate for weather conditions.
• Not having a warm, clean, safe home to live. The house might be in disrepair, messy, unhygienic, cold, or damp.
• Not having someone to protect them and provide them with a home free from violence and harm.
• Not getting adequate healthcare when required, such as dental treatment, glasses, vaccinations, and emergency treatment.
• Irregular or inadequate child supervision due to parents who are too drunk, high, mentally unstable, or wrapped up in their own lives.
• Complete or partial child abandonment, leaving the child alone for extended periods of time, or forcing the child to leave the home for extended periods.

As you can see there are many areas that make up physical neglect. Some are easily definable and some are more vague or open to interpretation. If a child arrives to school without a coat during winter one day, it could be that he forgot it in the car or left it on his way in. If that child arrives to school daily without a winter coat, then it is a pattern of behavior and more easily recognized. The same applies to all these areas. It isn’t so much a one-off instance of behavior, but a pattern over time that constitutes physical neglect.

My personal experience with physical neglect

When I was a kid I can remember many days when I sat at home by myself until my father would arrive home. He was a successful businessman, co-owner of his company, and routinely worked 16 hours a day. Unfortunately his new, younger partner didn’t care much for his previous kids, and would often be out as well.

He would give her a large sum of money to buy groceries for my sisters and me and she would buy about $20 dollars worth of Pop Tarts, then spend the rest on herself. She had quite the large collection of shoes and handbags. Yet this meant many days we sat in the house with nothing to eat, until my father arrived home late at night with some fast food dinner.

When I told my father there was no food, he would get angry and say he just gave her money. She would say she bought food and we ate it all, while she hid her newest shopping collections in the garage. This went on for years, with my sisters and I routinely having one large fast food meal a day.

Sadly, in my life there were many instances of different adverse childhood experiences. My particular scenario illustrates how my “successful” father was too busy with his company to worry about the basic needs of his children. We were left alone without adult supervision until just before bed time, there was no food in the house, and subsequently the house was often a mess. His girlfriend was too busy spending money on herself to care for the needs of the children living in the house. In fact, she went out of her way to take the grocery money allocated for food, an essential need, to spend on her own clothing and shoes.

This type of self-centered behavior of parents or caregivers toward the children in their care is a great example of what constitutes physical neglect.

What causes physical neglect?

You may assume that physical neglect is related to poverty and low income families, or those with a low education. From my personal example above you can guess that isn’t true. My father had a masters degree in IT, was the co-owner of a successful company, and lived in a huge house with a pool. From the outside, and from his bank balance, he was a very successful man.

Obviously physical neglect is present when there is poverty, low income, low education, or substance abuse issues. When a parent does not have access to money or the items they require to care for their child, then physical neglect is going to be more prevalent. But physical neglect is clearly not caused solely by those things, because it is present even in wealthy, well-educated groups as well.

Personally, I think one of the key causes of physical neglect is a sort of self-centered or disinterested disposition of parents or caregivers toward the child. In some cases this may be on purpose due to family dynamics or an open dislike for the child.

Alternatively it can be due to other problems the main caregiver is going through that they view as more important than the needs of the child. Perhaps a marital breakdown or loss of a partner has caused the remaining spouse to become depressed or suffer financial distress. Maybe the parent or caregiver suffers from mental health issues that are undiagnosed or untreated, leaving them unable to care for themselves let alone a child. Regardless of how physical neglect comes about, it is experienced by children from every social class, economic background, religion, and family dynamic.

What are the long term health and psychological effects of physical neglect?

Some of the more obvious consequences of physical neglect include permanent injuries resulting from inadequate supervision or inadequate hygiene. For example, a child may experience the loss of permanent teeth, improperly healed broken bones, or damaged eyesight or hearing. The child may exhibit delayed brain development and struggle with speech, reading, or motor skills. A child who has inadequate nutrition may be underweight from lack of food or overweight from poor nutritional value foods. Ongoing or untreated illnesses may result in complications that could have been avoided through early detection and treatment.

On a more emotional or psychological level, the consequences of physical neglect include low self-esteem, substance abuse, promiscuity, and self destructive behaviors later in life. The child can also go on to develop depression, anxiety, or other mental health disorders. It has also been found that children suffering from physical neglect are more prone to violence and criminal activity, as well as having difficulty in relationships with their own children.

Of course, this is not a one shoe fits all scenario and some amount of individual resilience comes into play. There will be many examples of people who suffered physical neglect and went on to be healthy, happy adults later in life. But the overwhelming evidence suggests that experiencing physical neglect in childhood is a predictor for some amount of emotional or psychological problems in adulthood.

Signs of physical neglect

Perhaps you are wondering what some of the signs to look out are to recognize a child suffering from physical neglect. Each individual case and circumstance will be different, and sometimes it may be very difficult to spot physical neglect. It is easy to see a child who looks unwashed or unclothed, but it is much hard to see a child with an empty belly who is alone at home for long periods of time.

Here are a few signs you can look out for, and it is good to remember you are looking for a consistent pattern of behavior, not a one off instance. Additionally if a child has one of these it doesn’t necessarily mean they are being neglected, but if the child shows multiple signs consistently, there is certainly a problem.

• A child who lacks clean clothing that is appropriate for weather conditions, fits the child, and is in good condition.
• A child who lacks regular basic hygiene appearing in dirty clothes, with un-brushed hair, dirty skin or fingernails, and smells bad.
• A child who is hungry, without lunch money, snacks, or a means to eat.
• A child who routinely steals things like food or money.
• A child who routinely appears ill, tired, or suffering from a condition that is easily treated with proper medical attention (for instance, head lice, skin rashes, or anemia).
• A child exhibiting delayed development without medical reasons such as poor language or social skills and who shows difficulty interacting with others.
• Unexplained or repeated accidental injuries caused by lack of supervision.
• Being left alone for long periods of time, locked out of the house, or in a home that is messy, cold, or otherwise unsafe.
• A child who is put in the position of carer for other family members, such as an older child having to look after younger siblings while the parent is absent.
• Changes in behavior including an increase in violence, clinginess, depression, anxiety, obsessive behavior, or the inability to concentrate.
• A child who routinely misses school or medical appointments.
• A child who has fallen into alcohol, drug abuse, self-harm or attempted suicide.

What can you do to help?

If you have any concerns about a particular child, it is important to speak to their teacher, school nurse, and where possible, the child themselves. Some children who are abused might not be ready to talk at first, but once they have built up a healthy relationship, they will open up. If the child then approaches you to reveal neglect, make sure to listen carefully without judgment and try to remain calm even though it is upsetting to hear. In this moment the child needs your strength and support by letting them know they have done the right thing.

In some cases a child might not even be aware that what they are experiencing is neglect. It is best that you do not approach the abuser themselves, and instead report to the relevant authorities as soon as possible. Not only would you be putting yourself at risk by confronting them, but you can also put the child at risk for “telling” on the abuser.

In the meantime it would be a good idea to make note of any instances of physical neglect or other abuse you have witnessed, and any future events you witnessed while waiting for an official to investigate. Some children may be more at risk to suffer neglect due to their circumstances. This includes children born prematurely, with disabilities, complex health needs, or living in foster care. Additionally, families experiencing some hardship such as extreme poverty, seeking asylum, domestic abuse, or suffering from drug or alcohol problems are also more at risk.

If you suspect someone of neglect within your household, or worry that your children may be suffering neglect due to life circumstances, it is important for you to reach out to get help. Local governments can help provide financially for people who find themselves with lack of money due to a job loss or death of their partner. They may even be able to provide you with one time grants to help pay for rent or other essential utilities. Many churches and local charities run free food and clothing banks to help provide for families in need.

If someone is preventing you reaching out for help, there are many charities that allow you to tip them off anonymously. Regardless of how you got into the situation you are in, the most important thing is for you to find help before it deeply impacts on your child.