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Treatment and Follow-up : Child Neglect

In New York State, neglect is defined by law as a form of maltreatment that refers to situations where a child's physical, mental, or emotional condition has been impaired, or is in imminent danger of becoming impaired, due to the failure of the parent or caretaker to exercise a minimum degree of care.

Neglect specifically refers to the failure of a parent or caretaker to provide for a child's basic needs, such as adequate food, clothing, shelter, medical care, education, or supervision, to the extent that the child's health, safety, and well-being are threatened with harm.

Examples of Neglect

  • Examples of Neglect
  • Failing to provide necessary food, clothing, or shelter
  • Failing to ensure or deliberately withholding necessary medical or mental health care for the child
  • Leaving a child unsupervised in situations inappropriate for their age or development
  • Exposing a child to domestic violence
  • Permitting chronic truancy or failing to enroll a child in school

In all situations where neglect is being considered, medical providers should also consider other factors that may be influencing a family’s inability to provide for basic needs. In situations of medical neglect, this may include barriers related to poverty, educational level and literacy, and cultural and/or religious beliefs. Other factors may be related to the child, such as challenging behaviors that may prevent cooperation with needed treatments. Healthcare providers should work to provide approaches and materials that meet the needs of their patient population.

Most incidences of neglect can be remedied with strong and continued support services for the family. However, some cases require medical intervention, particularly infants and children diagnosed with medical neglect or failure to thrive. For more information, see New York City - Administration for Children's Services - What is Child Abuse/Neglect?

Management of Child Neglect

For children with confirmed or suspected neglect, particularly those with disabilities, clinicians should coordinate a comprehensive, multidisciplinary treatment plan.

Plan of Care for Suspected or Confirmed Neglect
  • Medical care for any identified injuries, infections, or unmet health needs.
  • Dental care, as needed.
  • Developmentally appropriate mental health services, including trauma-informed therapy.
  • Family counseling to address contributing psychosocial factors and support the caregiving environment.
  • Integration with existing services, such as:
  • Counseling caregivers on the impact of neglect and the importance of adherence.
  • Establishing culturally appropriate written care agreements that define mutual expectations and consider family limitations. This could be provided as part of an after-visit summary in the electronic medical record.
  • Reporting to Child Protective Services (CPS) when a child’s health or safety is at risk due to unmet needs. For medical neglect and per the American Academy of Pediatrics, this includes “failure to heed obvious signs of serious illness or failure to follow a physician’s instructions once medical advice has been sought.”

In cases of medical neglect, medical providers should make use of the electronic medical record (EMR) to alert other providers or potential providers of concerns.

Routine screening for a history of neglect is recommended when evaluating children and adolescents with behavioral or psychiatric concerns. Children with challenging physical, behavioral, developmental, or mental health concerns are at higher risk of abuse, maltreatment, or neglect.

The above information is based on content found in Jenny C, Metz JB. Medical Child Abuse and Medical Neglect. Pediatrics in Review. 2020; 41 (2) : 49-60. (DOI) .

Treatment and Follow-up