The Experience of Neglect

(Originally published February 2013)

Some scholars and advocates have commented on the “neglect of neglect” for decades and these lamentations appear to have had some effect on other scholars. Certainly, there has been an increase in research regarding the effects of neglect on child development (and brain development) during the past decade. However, policymakers and child welfare managers are less effected by scholarly concerns and research than by the social and political milieu in which agencies function; and in these milieus discussions of neglect and the impact on children do not elicit the same outrage and public protest as stories about severe physical abuse and sexual abuse of children.


Neglect includes a wide range of parental omissions. A neglected child can be poorly fed, clothed or supervised; provided inadequate medical attention; exposed to a variety of safety threats such as extremely unsanitary home conditions or meth labs, or dangerous persons in the home. In very extreme situations, babies and toddlers may be cared for in institutional environments without a parent figure, or be virtually ignored by parents with substance abuse or mental health problems. “Neglected child” may not mean anything specific to persons outside agencies that work with abused and neglected children and their parents, while physical abuse evokes images of battered babies or severely beaten children (actually quite rare forms of abuse among CPS cases), and sexual abuse calls to mind adult predators who have sexual contact with large numbers of young children.


One of the few scholars who has provided vivid accounts of neglected children is Bruce Perry, a psychiatrist and trauma expert who, along with Maia Szalavitz, in The Boy Who Was Raised As A Dog (2006) combines stories of severely abused and neglected children with scholarly explanations of their behavior and recovery process. In the chapter from which the book’s title is taken, Perry and Szalavitz describe a 6 year old boy whom Perry encounters in a hospital emergency room. When Perry first meets 6 year old Justin, the child is naked in a cage in the emergency room, covered in food and feces which he is throwing at passers-by while uttering guttural sounds. Justin cannot walk or talk, and the emergency room doctors and nurses assume he is profoundly brain damaged.


 Perry takes an early history of the child’s caregiving arrangements and discovers that Justin had been raised by an unrelated dog kennel operator since age 1, mostly in a cage next to dogs. Perry quickly understands that Justin has been traumatized by severe neglect and is terrified; and that he must feel safe before being able to benefit from standard services available in the hospital. Much of the chapter is an account of how Perry and other hospital staff change the conditions in which Justin is being cared for in order to calm this child’s fears.


I have returned to Justin’s story in these commentaries over the years because Perry and Szalavitz have some important lessons to impart about working with traumatized and severely neglected children: (a) at first glance they may appear brain damaged and beyond help, (b) even professional medical staff (most of whom disliked this boy) may jump to conclusions and fail to take a careful early history, (c)  terrified children must feel safe before they can benefit from services and, (d) some of these children may, like Justin, make extraordinarily rapid developmental progress once they are well cared for by sensitive and astute caregivers, especially (like Justin) when they have had early experiences of being loved and nurtured.


For the purpose of this discussion, perhaps the most important lesson is that when responsive parenting and care are almost completely absent, young children are not socialized in basic ways, if indeed babies do not die. Every phase and domain of development, i.e., motor skills, cognitive skills (including language development) and social skills is profoundly compromised. Any abused or neglected child who has moderate developmental delays has received some level of appropriate parenting, an important point to remember when practitioners are working with less extreme neglect cases.


In doing neglect training for child welfare staff during past years, I have discovered that many caseworkers and supervisors have never been informed that one of the most common and serious effects of severe early neglect is a compromised immune system. In the 1940s, Rene Spitz found that babies placed for months or years in foundling homes often died of common childhood illnesses.  In one of Spitz’s studies, more than one third of infants cared for in an institutional setting for an extended period of time died. Young children being raised in chronically neglectful homes are likely to have a variety of serious health problems due to both erratic physical care and deprivation of nurturance.


However, neglect comes in many forms, and its developmental effects may not be apparent until adolescence or young adulthood. A profound and deeply distressing story about social isolation and lack of intimacy of a young Chinese woman emotionally neglected by her distant and (possibly) mentally ill adoptive mother is contained in the short story, Kindness in Yiyun Li’s Gold Boy, Emerald Girl (2010). Yiyun Li is Chinese; she was raised in Beijing but lives in California where she teaches at the University of California, Davis. She writes in English. The New Yorker once named her as one of the top 20 fiction writers under age 40.                    


In Kindness, 18 year old Moyan is serving a year in the Chinese Army. Unlike the other young women in her unit, she rarely receives mail from her parents (never from her mother), returns from home leave early, has no friends or boyfriend, seems to have little or no interest in romance, sex, career opportunities, social approval, or anything else which interests her peers. She accepts her isolation and lack of intimacy in the way she might accept a birthmark, i.e. there’s nothing that can be done so it’s not worth thinking about. Moyan (nay OM?) reacts to the punishment and humiliation of army life without defiance but also without any need to win the approval of her superiors. At one point, an officer who finds her inebriated asks “Is anything the matter?” … Anything the matter? I laughed and said that the trouble was, I did not know a single thing that could be called the matter.”


Moyan seeks indifference to human affections and she fends off the kindly overtures of the Lieutenant in charge of her unit. At one point the Lieutenant, recognizing that Moyan is a deeply unhappy person, says to her “Tell me, how can we make you happy?” to which Moyan replies “Why don’t you give me a happiness drill right at this moment? …There is nothing we can’t achieve in the army, right Lieutenant?” Li’s story can be read as a not so gentle mockery of the Buddhist ideal of desirelessness as a path to Nirvana.


Moyan describes herself as an indifferent person, yet she acknowledges “I have never forgotten any person who has come into my life.” Despite her best efforts, she is profoundly affected by kindness. When she is a young adolescent, a Professor befriends Moyan and begins to read to her from the novels of English masters:  Dickens, Hardy, and Lawrence. Moyan breaks off this relationship as an adolescent and then renews it in her adult life. She never forgets the Lieutenant who reached out to her, or a soldier who chases down a train for her to catch after her mother’s suicide.


Moyan is deeply affected by concrete actions of concern and interest, the only form of love she can tolerate. Moyan acknowledges that “Kindness binds one to the past as obstinately as love does, and no matter what you think of Professor Shan or Lieutenant Wei, it is their kindness that makes me indebted to them.” When Moyan remembers the soldier who demonstrated so much concern for her welfare by chasing a train in a vehicle for miles and the salute the soldier gave her as she entered the train, she says “I did not know the driver’s name, nor had I gotten a close look at his face – but for years to come, I would think of his salute, a stranger’s kindness always remembered because a stranger’s kindness, like time itself, heals our wounds in the end.”


This is a story of astonishing insight and depth, and I have only touched on a few of Li’s major themes. On first reading, the story describes a bleak and painful emotional landscape, but a deeper reading reveals a young woman with a rich inner life and absence of pretense who retains a capacity for happiness even as she uses every strategy at hand (numbness, detachment, cultivation of indifference) to cope with the hopelessness and loneliness she accepts as her fate.


After Kindness, Jeannette Walls’ The Glass Castle (2005) may seem lighthearted. This memoir of childhood is a very funny book because of seemingly endless stories about her parents’ outrageous behavior and their glib rationalizations for bad behavior. Nevertheless, Jeannette and her three siblings had a difficult time of it growing up, and I doubt these children found it amusing to frequently be without adequate food (or any food), clothing, hygiene, safe housing or heat. However, Rose and Rex Walls did not fit any stereotype of neglecting parents. Rose was an artist and would be writer who occasionally worked as a teacher, while Rex Walls was a sort of mad scientist with more than a smattering of scientific knowledge. Nevertheless, as a mother Rose could be remarkably detached from and indifferent to her children’s suffering. According to Rose, “Suffering when you’re young is good for you …It immunized your body and your soul and this is why she ignored us kids when we cried.”  Rex Walls was a violent alcoholic much of the time and determined to use the family’s limited resources to feed his alcoholism and smoking habit. Still, the father did not physically abuse his children though during one marital fight he chased down his wife in the desert in a speeding car and in another fight hung Rose out of a second story window.   


The Walls family frequently was forced to “skedaddle” out of town to escape the law or angry neighbors, or to find employment and, until Jeannette was well along in elementary school, they moved frequently from small town to small town in or around the desert as the father found jobs in mining towns. They also lived in a few large cities for periods of time, but were always forced to leave wherever they were living due, usually, to the father’s misadventures. Even after Rose inherited a home and land that might have been valuable, the family was not able to maintain a residence for very long. Rex Walls could never hold a job, and Rose disliked teaching which took her away from her artistic pursuits. The parents were too proud to accept welfare or charity (except from relatives) but not too proud to shoplift, or engage in other illegal activities that eventually would require the family to leave most of their belongings behind, and “skedaddle” to a new location.      


As The Glass Castle makes clear, it was no small feat for the Walls children to survive into middle to late adolescence without disabling injuries. The book begins with 3 year old Jeannette suffering serious burns requiring a skin graft while standing on a chair at the stove cooking a hot dog. After the father took Jeannette out of the hospital prematurely due to his hostility to doctors, Jeannette continued the same behavior that resulted in her burns; “Good for you, Mom said when she saw me cooking. You’ve got to get right back in the saddle. You can’t live in fear of something as basic as fire.” When Jeannette was 4 or 5, she fell out of a moving car without her parents being aware of what had happened. Jeannette sat in the desert wondering if her parents would return for her. They did.  


The Walls family had a troubled relationship with fire. After Jeannette’s accident, she courted disaster by playing with matches and starting fires in toilets. The family barely escaped from a burning home. Jeannette and her brother burned down a shed in which they were conducting chemical experiments, and Jeannette’s older sister Lori was seriously burned while using kerosene to start a wood fire. 


Despite childhood experiences that could easily have led to death or disability, and frequent hunger and cold, and beatings by peers and social humiliation, Lori and Jeannette were precocious. Lori helped her mother prepare lesson plans before she was a teenager. Jeannette became editor of the school paper when she was a junior in high school, a position that allowed her to forage through the cafeteria’s garbage for food. Lori, Jeannette and Brian, the younger brother, learned to stick together and fend for themselves at an early age. They foraged for food wherever they could find it, figured out how to survive during the winter in a home in West Virginia with very little heat and with holes in the roof, and found jobs when they were in their early teens.


However, the key to their emotional resilience came from a surprising source: their parents. Rose and Rex, despite their many failings, were able to engage their children’s imaginative worlds in a way that is both funny and heartbreaking. Rex Walls captured his children’s imagination and their loyalty with his grandiose plan to build a fantastic glass house in the desert with state of the art solar technology and its own water purification system. When Jeannette and Brian were in elementary school they decided to kick start the Glass Castle by digging a deep hole for its foundation. When the father discovered what his children were doing, he forced them to fill the hole with garbage. This may have crushed most children but not Jeannette who continued to believe in her father, as Lori appeared to remain loyal to her mother.


The Glass Castle has a deep lesson to teach about children’s resilience, i.e., children can absorb large amounts of physical suffering without crushing their spirits when their curiosity, intelligence and imaginations are activated by a sense of adventure.




Spitz, Rene, The First Year of Life ,1965.


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