Emotional abuse and neglect

Certain parenting or childcare styles entail passive neglect or active emotional abuse of infants and children (Browne, 2002; Dubowitz & Black, 2002; Erickson & Egeland, 2002; Glaser, 2002a; Hart, Brassard, Binggeli & Davidson, 2002; Hildyard & Wolfe, 2002; Iwaniec, 1995, 2004; Jones, 2000; MacDonald, 2001; Reder & Lucey, 1995; Smith & Fong, 2004; Wekerle & Wolfe, 2003). There is not an international consensus in this area. Some Eastern countries endorse institutional practices for orphans that are considered neglectful in the West. In contrast, some Western practices, such as infants sleeping in separate rooms from their parents, are considered neglectful in some Eastern cultures. Neglect and emotional abuse may lead to negative physical, cognitive and social outcomes for the child. Negative physical outcomes include non-organic failure to thrive and psychosocial dwarfism. Relationship difficulties and attachment problems are the principal negative social outcomes for children who suffer neglect or emotional abuse. Developmental delays are the principal cognitive sequelae of these aversive parenting practices. A typical case characterized by neglect, nonorganic failure to thrive, developmental delay and attachment problems is presented in Box 20.1. After considering the definition of neglect, emotional abuse and related conditions, this chapter describes an approach to assessing risk and protective factors in these cases. Treatment and prevention are then discussed.