nydia y. monagas, psy.d. - nursingfy.com
TRANSCRIPT
Nydia Y. Monagas, Psy.D.
In 2011, an estimate of 3.4 million child abuse referrals made involving over 6 million children
681,000 children found to be maltreated 78.5% neglect
17.6% physical abuse
9.1% sexual abuse
10.3% “other,” including psychological maltreatment,abandonment and congenital drug addiction
Estimated that less than one-third of cases reported
In 2011, it was reported that 1,545 children died from abuse/neglect
http://www.acf.hhs.gov/sites/default/files/cb/cm11.pdf
“Neglect is the failure, whether intentional or not, of the person responsible for the child's care to provide and maintain adequate food, clothing, medical care, supervision, and/or education.
A child may be found neglected who:
1. has been abandoned
2. is being denied proper care and attention physically educationally, emotionally, or morally
3. is being permitted to live under conditions, circumstances or associations injurious to his well- being
4. is being abused.”
(Retrieved from http://www.ct.gov/dcf/cwp/view.asp?Q=316956&a=2556)
Food, nutrition
Clothing
Shelter
Inadequate hygiene
Abandonment Not picked up within two days
Kicking child out of the home; leaving child with various caregivers due to disinterest in caring for child
Is it neglect if parents cannot provide for their child’s basic needs? If neglect is not intentional?
Physical Neglect
Medical Neglect
Educational Neglect
Emotional Neglect
Supervisory
Environmental
Emotional
Often occur together, and with other types of abuse
Immunizations and preventive care (e.g., dental)
Failure to seek timely medical/mental health care
Failure to comply with medical/mental health care
Is it neglect if recommended treatment is refused because of religious beliefs?
Truancy
Failure to enroll a child in school
Refusing or not seeking needed special education services
Is homeschooling a form of neglect?
Lack of supervision
Inappropriate caregivers
Exposure to hazards
Guns, poisons, drug paraphernalia, second-hand smoke, unsanitary household conditions, car seats
Is it neglect if cultural values support early responsibilities for children (e.g., leaving a toddler in the care of a 10-year-old
Neighborhood factors
Do you consider this neglect? Who is responsible?
Lack of safety
Part of psychological maltreatment
Inadequate nurturing or affection
Psychological unavailability can lead to deficits in multiple areas (e.g., attachment, language and cognitive development, motor skills)
Exposure to extreme/chronic domestic violence
Permitted drug or alcohol use
How bad does this have to be to be considered neglectful?
<5% in weight and height
Baby was once of normal weight and height
Delay in psychomotor development
Flat affect; passivity
Poor ability to suck
Lack of interest in food; vomiting
Unwilling to be held
Lack of eye contact
Delay in language
Affects children 18 months to 16 years of age Often associated with emotional deprivation <5%ile in weight and height Retarded skeletal maturation Bizarre eating patterns (e.g., overeating, stealing,
hoarding) Sleep problems and night wanderings Hyperactivity Extreme fatigue Enuresis and encopresis Delayed development (e.g., speech, social skills)
Self-stimulating and self-calming (e.g., rocking, thumb sucking)
Delays in motor skills
Delayed cognitive development, including expressive and receptive language
Delayed social skills
Lack of prosocial behavior
Lack of delayed gratification due to unpredictability
Others?
Wears dirty or inappropriate clothing
Shows poor hygiene; dirty or decaying teeth
Always seems hungry; hoards, steals or begs for food; comes to school with little food
Often appears listless and tired
Frequently reports caring for younger siblings
Unaddressed medical or dental problems
Homeless families are approximately 1/3rd of homeless population
More than one million children are homeless
On any given day, an estimated 200,000 children have no place to live
Among all homeless women, 60% have children, but only 65% live with at least one of their children
Should parents be charged with neglect if their children are homeless?
http://www.familyhomelessness.org/media/306.pdf
http://video.msnbc.msn.com/rock-center/50020452#50020452
What are some of the causes of family homelessness?
What is the impact on children?
What can we do?
http://www.familyhomelessness.org/media/306.pdf
Critical to psychological and interpersonal health
Characteristics of securely attached children: Explore freely while primary attachment figure is
present
Respond differently to strangers (may exhibit fear of strangers
Upset at departure of attachment figure
Comforted by reappearance of attachment figure
www.youtube.com/watch?v=36GI_1PBQpM&NR=1
Ensures survival of the individual and humans
Infant is biologically programmed to seek proximity to a caregiver
Critical period: developmental phase during which there is a heightened sensitivity for a stimulus to occur
Critical period: 6 months – 3 years
Behaviors subside, but reappear in crisis situations throughout life
Styles are developed in first few years of life
Parent engaged, but in response to own needs
Child is anxious about exploring, even when mother is present
Child is highly distressed when mom leaves
Child is ambivalent upon mom’s return (stays close , but is resentful and resistant to being reengaged)
Mom is more engaged
Child avoids or ignores mom
Child does not explore much
Child does not respond differently to strangers
Child shows little emotional response when parent departs or returns
Caregivers are either frightened or frightening
Caregiver is source of alarm to child, but also source of safe haven
Creates an approach-avoidance conflict for the child: child freezes
No coherent pattern for coping
Often associated with abuse
Changes in brain structures are due to experience
In critical period, energy is high in infant and parent for receptivity to each other’s cues
Secure and insecure attachment patterns result in differences in brain development