Running head: SES AND RISK FACTORS FOR NEGLECT

Socioeconomic Status and Other Risk Factors for Child Neglect

Brent MacDonald
Amanda Medland
November 6, 2013

Running head: SES AND RISK FACTORS FOR NEGLECT

Socioeconomic Status and Other Risk Factors for Child Neglect

Neglect is a form of child maltreatment that has existed for many years. Cases of severe
neglect date back to Before Christ and these historical cases were documented as children raised
by animals, mainly by chance, but occasionally for experimental purposes. Like other forms of
maltreatment, neglect does not become public knowledge except for extreme cases of children
who experience significant injuries or succumb to death. The truth is that neglect in the present
day is much more common than is acknowledged, as it is the most common form of child
maltreatment. Within this, children may experience neglect in a multitude of varying degrees and
complexities, all of which can have lifelong effects on the child. When looking at prevention it is
important to identify the risk factors for neglect, which are most frequently reported within the
literature as low socioeconomic status and correlating risk factors to poverty.
Neglect
Neglect falls under the umbrella of child maltreatment as one of four acts; neglect,
physical abuse, emotional abuse, and sexual abuse. Neglectful maltreatment results in harm or a
greatly increased risk of harm in regards to the childs development physically, mentally,
educationally, socially and spiritually, as well as causes negative influences on development of
trust, power and dignity (Barkley & Mash, 2003; Jonson-Reid, Drake, & Zhou, 2013). According
to the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-V) this
includes abandonment, lack of appropriate supervision, failure to attend to necessary emotional
or psychological needs, failure to provide necessary education, medical care, nourishment,
shelter or clothing (pg. 718). Unlike the other forms of child maltreatment, neglect results from
a lack of participation on behaviour of the adult, as opposed to active behaviours forced onto a

Running head: SES AND RISK FACTORS FOR NEGLECT

child (Schumacher, Smith Slep, & Heyman, 2001).

Due to the reliance and dependence of infants and toddlers on adults for survival, it is not
surprising that there is higher incidence of neglect seen with this age group. Maltreatment of
children is most prevalent from ages 0-3 years old, with a substantial portion of maltreatment
encompassing neglect (Barkley & Mash, 2003), of this, infants comprise the highest risk group
(Child Maltreatment, 2011). In addition, younger children show an increased risk for more
severe child neglect up to and including death (Slack, Berger, DuMont, Yang, Ehrhard-Dietzel, &
Holl, 2011). As children age, the dimensions of adolescent neglect are less concretely identified.
Throughout later child development, parental involvement shifts from protection of immediate
harm to emotional support, supervision and monitoring, although the need for control and
nurturance is consistent throughout (Clark, Thatcher, & Maisto, 2004).
As a result of neglect, particularly in children under the age of two, the most likely
outcome is failure to thrive (FFT) or inadequate physical growth (Barkley & Mash, 2003). For
children who experience failure to thrive as a result of neglect, even after intervention these
children display lower cognitive abilities and struggle to keep up with their peers educationally
and emotionally (Black, Dubowitz, Casey, Cutts, Drewett, Drotar, Frank, Karp, Kessler, Meyers,
& Wright, 2006). Older children and adolescents who experience neglect often present with life
long cognitive deficits as well as an increase in alcohol consumption compared to similar aged
peers (Clark, Thatcher, Maisto, 2004; Barkley & Mash, 2003). It is also frequently noted that
neglected children develop insecure attachments with caregivers and as a result have difficulties
with attachments with others as they age. Throughout the neglected years the exposure to typical
attachments and emotional learning opportunities is limited and strategies to engage peers and
adults in typical manners are largely foreign (Barkley & Mash, 2003).

Running head: SES AND RISK FACTORS FOR NEGLECT

Within the United States and Canada, neglect is the most frequently reported and
documented form of child maltreatment, comprising of 54-58.4% of cases (Barkley & Mash,
2003; Schumacher, Smith Slep, & Heyman, 2001), although many children suffer from multiple
forms of child maltreatment (Child Maltreatment, 2001). As per Barkley & Mash (2003), the
mortality rate is 1.62 deaths per 100,000 children. More recently in 2011, the United States
national estimate indicated 1,570 children died from child maltreatment, with 895 resulting from
neglect solely or paired with another type of maltreatment (Child Maltreatment, 2011). Of these,
81.6% of child fatalities were under the age of 4 years old. Canadian Child Welfare Statistics
(2013) identified rates of child maltreatment per province in 2003, with information specific to
neglect for both Ontario and Alberta. During 2003, Alberta possessed a total child population of
752,005, with 6,064 substantiated child investigations of neglect (Canadian Child Welfare
Statistics, 2013). Ontario, with a much larger child population of 2,382,035 experienced 11,894
cases of neglect (Canadian Child Welfare Statistics, 2013) comprising 31% of all of Ontarios
child maltreatment cases. Despite the fact that child abuse and neglect appears to be on a decline
over the past 20 years, the prevalence rate still remains high and continued research into the
factors which predict or pose an increased risk for neglect are crucial. One factor, socioeconomic
status, is frequently investigated as having a direct link towards the likelihood of neglect.
Socioeconomic Status and Neglect
Socioeconomic status, which typically addresses an individuals income, education
and/or occupation, can be broken into categories identified as high socioeconomic status, middle
socioeconomic status and low socioeconomic status. Families within the low socioeconomic
status bracket typically have very low income, experience poor health, poor environmental
conditions, and hold less valued occupations.

Running head: SES AND RISK FACTORS FOR NEGLECT

It has been identified through numerous studies that poverty ranks within the most
important predictors of child maltreatment (Jonson-Reid, Drake, & Zhou, 2013). When
investigated by the National Incidence Study of Child Abuse and Neglect, families with a total
income under $15,000 were 18-26.5 times more likely to neglect their children than compared to
higher income families (Ondersma, 2002; McSherry, 2004; Schumacher, Smith Slep, & Heyman,
2001). Identified through a 17-year study, subjects who were maltreated showed likelihood to be
from low income who accessing public assistance at a rate of 5.11-11.01 times higher than those
who were not maltreated (Ondersma, 2002). It has been consistently determined that risk of
neglect in children is closely related to low socioeconomic status with both physical and
educational neglect ranking as the most common forms of neglect seen in these families
(Schumacher, Smith Slep, & Heyman, 2001).
It is important to note that socioeconomic status frequently remains static throughout
generations, particularly for those in the lower socioeconomic status category. This potentially
means that parents themselves have been raised in poverty; they were recipients of neglectful
parenting and are perpetuating the process of neglect based on learned parenting skills
(McSherry, 2004). Despite the widely supported notion that low socioeconomic status correlates
with neglect, it is important to acknowledge that a substantial portion of families living within
the low socioeconomic status range do not neglect their children (McSherry, 2004). Ondersma
(2002) identified more than 940 children per 1,000 in families with low incomes were not
maltreated. If low socioeconomic status was solely the risk factor, then providing families with
increased income and employment would resolve the risk of neglect. It appears obvious that this
is not the case so it is important to consider what other correlates or factors when paired with low
socioeconomic status increase the risk of neglect.

Running head: SES AND RISK FACTORS FOR NEGLECT

Socioecononmic Status Correlates and Neglect

Many additional factors combined with poverty may potentially have influence and
increased risk for neglect in families. Some of which consist of the degree family and community
supports, familial psychopathy and ethnicity. It is important to identify these correlates when
paired with low socioeconomic status as a unifying commonality that may play a larger role in
influencing risk of neglect.
Community Supports. Community plays a large role in the prevalence of neglect. An
increased rate of physical and educational neglect can be seen in children who were living in
large urban communities, particularly in areas of poverty. These children were also identified to
be at an increased risk of school drop out and, as will be addressed later, displayed lower rates of
two parent families (Schumacher, Smith, Slep, & Heyman, 2001). Families showing an increased
risk of neglect tend to also lack social supports within their community. Neglectful mothers
report lower levels of support in regards to advice and counseling, positive views of self as a
provider, and lower levels of belonging, particularly within community activities (Schumacher,
Smith Slep, & Heyman, 2001). Similarly, an increased risk can be seen in parents who feel as if
they have little influence over the events of their live, and those who show a tendency to feel
incompetent and helpless within their environments and current life situations (McSherry, 2004).
The more a family has access to community supports, quality education and opportunities as well
as other resources such as positive adult figures, the lower risk for neglect is present. (JonsonReid, Drake, & Zhou, 2013).
Family Dynamics. Looking into the dynamics of a family shows potential insight into the
prevalence of neglect. Both age of parents and age of children exist as predictors of neglect when
paired with living in low socioeconomic status. Schumacher et al, (2001) identified that

Running head: SES AND RISK FACTORS FOR NEGLECT

neglectful parents were generally younger in age than the non-neglectful sample. It has also been
identified that children who were older in age (15-17 years) show an increased risk for
educational neglect. Father only families run an increased risk of physical neglect for their
daughters, while a link between female only run families and neglect is also seen as a risk factor
(Schumacher, Smith Slep, & Heyman, 2001; Barkley & Mash, 2003). As one could assume,
unstable marriages or single parent households tends to be more prevalent in families that are
neglectful and living in poverty (Schumacher, Smith, Slep, & Heyman, 2001). Despite the
increased risk associated in one-parent families, it is important to note that evidence for
increased neglect is also associated with a greater number of people living in one household
(Schumacher, Smith, Slep, & Heyman, 2001). For families who experience additional stressors
such as those listed above (young age of parents, several children within the family, and poor
social supports within the community) as well as living a life of low income the risk is increased
when compared with those who experience only poverty (Ethier, Couture, & Lacharite, 2004).
The next major factor to be considered that poses increased risk looks into familial psychopathy.
Family Psychopathy. A large portion of the efficacy of parenting relies on parental
psychopathy. A parent must be aware of the needs of a child throughout their development, and
be able to provide them nourishment as well as a safe secure and nurturing environment where
the children can grow and explore themselves. Stable relationships help to guide children in
creating relationships themselves, and a parental ability to problem solve and guide children
through the problem solving process is also important as children start to develop. Many times
these basic parenting responsibilities can be clouded when the parents themselves have had
unstable childhoods or if parents experience obstacles themselves. Particular parental
characteristics such as psychopathy are seen more frequently in families living in poverty.

Running head: SES AND RISK FACTORS FOR NEGLECT

McSherry (2004) identified that because functional interpersonal relationships are needed to
maintain families and employment and to obtain assistance from others, poor relationships may
lead to economic poverty, particularly the sort of poverty that is enduring across generations in
spite of opportunities for economic success. Parental cognitive abilities has also been linked
with an increased risk of neglect in several cases. When looking into differences between
neglectful and non-neglectful parents, as many as 75 percent of mothers who neglected their
children had been identified as having learning disabilities, particularly with reading and writing
(McSherry, 2004). As well, a large portion (78%) of parents who experience intellectual
functioning below the 25th percentile have displayed chronic maltreatment of their children
(Ethier, Couture, Lacharite, 2004). Adults who show large cognitive deficits typically also show
deficits in ability to adapt to daily situations that require problem solving or change. Even though
the intellectual capacity of parents poses a risk for neglect, when lower functioning parents are
paired with diminished social supports, difficult living situations and additional psychopathy this
poses a much greater risk (Ethier, Couture & Lacharite, 2004). Parents who experience mental
health disorders such as depression, as well as stress and a decreased sense of self-efficacy were
more likely to be reported to child protection services for neglect (Slack, Berger, DuMont, Yang,
Ehrhard-Dietzel, & Holl, 2011). Lastly, substance abuse in parents of low-income families
shows increased risk of neglect when compared with low-income families without substance
abuse (Ondersma, 2002; Slack, Berger, DuMont, Yang, Ehrhard-Dietzel, & Holl, 2011).
Similarly, for infants who were exposed to illegal drugs in utero, as well as maternal use of
drugs, alcohol and police involvement have been identified as one of the strongest predictors of
childhood neglect after socioeconomic status (Ondersma, 2002). It appears that when looking at
struggles parents in poverty have to overcome, psychopathy plays a substantial role in predicting

Running head: SES AND RISK FACTORS FOR NEGLECT

the likelihood of neglect. In addition, the more risk factors parents experience, the greater the
likelihood that chronic child maltreatment will continue (Ethier, Couture, & Lacharite, 2004).
Ethnicity. The final factor to be discussed that typically correlates with low
socioeconomic status is race. Ethnicity has been of great interest in regards to identifying risk
factors of child maltreatment. As ethnicity of the non-white background, particularly African
American, appears across the literature to be paired with increased risk of neglect (Jonson-Reid,
Drake, & Zhou, 2013), it is important to delve into the reasoning around that. In a self-reported
study of neglect, adults who were identified as neglectful were more likely to state their race as
non-white than those who were deemed non-neglectful (Schumacher, Smith, Slep, & Heyman,
2001). Both African American and Latino parents have been proven capable to expand on the
dynamics that constitute harmful or neglectful behaviours (Elliott & Urquiza, 2006), so it is
improbable that the increased rates were driven by a lack of knowledge. Although families of
African American decent are three times more likely to experience poverty than white families, it
is also critical to note that these families are twelve times as likely to live in communities of
concentrated poverty (Jonson-Reid, Drake, & Zhou, 2013). Areas of concentrated poverty show
an increased likelihood of exposure to violent neighborhoods and substance abuse, untreated
parental mental health issues or criminal behaviour (Elliott & Urquiza, 2006). Caucasian children
who have been identified as having low socioeconomic status are more likely to live throughout
non-poor communities, so therefore may have less exposure to negative life events as a result of
their community environment (Jonson-Reid, Drake, & Zhou, 2013). Within the United States
13.7% of white and 61.9% of black children lived in communities of concentrated poverty with
same race individuals (Jonson-Reid, Drake, & Zhou, 2013). The fact that non-white poverty
stricken individuals tend to have increased exposure to risk in life may have lead to the

Running head: SES AND RISK FACTORS FOR NEGLECT

10

overrepresentation of ethnicity as a risk factor in neglect. Some may go as far as to state that
African American children may be at a lesser risk for maltreatment if exposed to similar levels of
risk throughout their life as white children experience (Elliott & Urquiza, 2006). This emphasizes
the importance of considering not one but multiple factors that may pose an increase in risk for
neglect. Looking into the increased rates of African American families who live with little
income, are raised in single parent environments (54% mothers only), and who due to cultural
and language barriers are unable to access, or are unaware of supports, it is easy to see how being
an African American child can increase risk of neglect within the family environment.
In conclusion, neglect has been identified as the most common form of child
maltreatment, often times creating life long deficits within the children who experience it. Many
studies are quick to identify that low socioeconomic status is a predictor of neglect but despite
this, the drive for change must address many of the underlying associated factors of a life in
poverty. Income plays a large role in quality of care given to children, but looking into the
family make up, psychopathy, community supports and general overview of individuals living in
poverty may pose a more in depth conception of why these families are neglectful when so many
poverty stricken families manage to provide adequate care for their children. It is also important
to stress that many of these risk factors coincide with one another. Simply being raised in an
African American family does not provide enough evidence that the children will be neglected.
The multifaceted look on the dynamics of poverty gives a greater look into the likelihood of
neglect than simply identifying that low socioeconomic status increases the risk of such an
occurrence.

Running head: SES AND RISK FACTORS FOR NEGLECT

11

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