Neglect is the most commonly reported type of child maltreatment, affecting more than one in seven U.S. children at some point in their lives, and yet it is the least studied type of childhood adversity (Vanderminden et al, 2019). It is associated with a wide range of long-term negative health, mental health, and developmental outcomes. Some studies have found that quality of life in adulthood was lower for those who experienced emotional abuse and neglect than for those who were physically or sexually abused (Lippert & Nemeroff, 2023; Strathearn et al., 2020).
Neglect is often confused or conflated with poverty, sometimes leading to inappropriate child welfare interventions or child removals when the problem is a parent with financial or housing difficulties rather than a matter of intentional or unthinking neglect. Severe neglect and growing up in extreme poverty are both associated with disruptions to brain maturation and delays in cognitive development (Smith, 2025), but the dynamics and effects of child neglect are complex and damaging in ways that go beyond the harms of economic circumstances alone.
The definition of child neglect as a reason for state intervention varies from state to state, though there is broad agreement that it is the failure to adequately respond to the needs of a child. States place emphasis on a lack of supervision, exposure to unsafe conditions or people, or a lack of food, safe shelter, or medical attention. A few states with more expansive definitions include emotional neglect and failure to seek or get treatment for emotional problems (Smith, 2025).
Too often, neglect includes failure to meet the entire list of children’s physical and emotional needs, as I learned from the former juvenile offenders I interviewed for my book, Before Their Crimes: What We’re Misunderstanding About Childhood Trauma, Youth Crime, and the Path to Healing. The painful recollections of neglect were almost always associated with parents caught up in drug addiction.
Joshua’s mother developed an addiction after she moved in with a new boyfriend who was a cocaine addict. He offers a poignant picture of the disastrous turn his life took when he was seven years old:
“We went from a really nice neighborhood to living in some of the worst projects, and from then on, my mom was very neglectful. She spent her time locked in the bedroom with her new man. My brother and I had to take care of ourselves and cook for ourselves… My mom never washed our clothes, we always had dirty clothes. We had to wash them in the bathtub with a bar of soap. Sometimes we didn’t have food. We would jump the fence behind the project to the fields next door, where they grew cauliflower and broccoli. We’d boil it and eat it.”
Joshua started drinking at 14 and turned to methamphetamines soon after. He contemplated and made an aborted attempt at suicide. Eventually, he joined a gang.
The people I interviewed were living testaments to the fact that neglect and abuse are often interwoven in children’s lives, occurring simultaneously and inseparably. Despite the co-occurrence of neglect with physical or sexual abuse, neglect and emotional abuse have been found to predict greater severity of depression, even after controlling for physical and sexual abuse (Lippert & Nemeroff, 2023). Researchers have found elevated rates of suicidal ideation and higher rates of illicit drug use and underage alcohol use among youth who have experienced neglect (Vanderminden et al., 2019), and I saw this myself in my 29 interviewees.
The physical facts of neglect are hard on the body, potentially including impingement on neurobiological development, but there is also a powerful impact on mental health and the child’s developing sense of self and the world. Neglected children see and feel the lack of care from the adults closest to them. It is a piercing experience of being unloved. As with other forms of abuse that occur early in life, before the self is fully developed, before children can easily distinguish the meaning of the behavior of others, they most often attribute the reason or cause of ill treatment to something bad or lacking or unlovable about themselves.
The recollection and unpacking of early experiences of neglect with a trusted, caring adult in a safe space can make room for boundaries to become clearer and allow the self to flourish and healing to take place.
