Child Neglect Often Ignored by Society, Experts Warn

She has seen a lot of horrendous things in her six years on the Baltimore City police force, but Officer Donna Gleason says nothing prepared her for what she found in the house on Cedardale Road. It haunts her still, the memory of that awful moment when she opened the door and discovered the five abandoned children.

“The entire house was filthy and smelled of garbage,” Gleason said. “There was no sink in the kitchen, and the refrigerator was broken and empty. All of the kids were half-naked, hungry and filthy. The 3-year-old boy was running around with an empty peanut butter jar, trying to scrape peanut butter out of the jar with his finger. The 1-year-old baby was just sitting there, staring.”

Dirty Mattresses

The house had a few dirty mattresses on the floor but very little else. No sheets, no blankets, no towels, no running water. The children--ranging in age from 12 months to 12 years--were frightened and confused; they told Gleason that they had not seen their mother for four days.

“What I saw was so unbelievably bad, I wanted to have them take photographs so I could show the pictures in court,” she said.

The next step was to get the children to the hospital for medical examinations. “The two older kids were afraid of the police and of getting Mommy in trouble,” Gleason said, “but the younger ones were real friendly and wanted attention.”

She piled the children into the back seat of the patrol car and then, as she drove them to a hospital, something happened: Donna Gleason, who is rearing three children of her own, lost it.

“I just broke down and cried,” she said. “I was in the front seat, and I tried to hide it from the kids, but I just cried. I went home that night and I’m crying and telling my kids, ‘You just wouldn’t believe how some kids have to live. It’s unbelievable.’ ”

Unbelievable.

Casual Attitude

Gleason said the word over and over again, but now it is the system she is talking about--and the casual way child neglect is often viewed by society at large and by the legal system in particular.

The officer was in court when the mother was found guilty on three counts of leaving a child unattended and sentenced to serve 30 days in jail for each count. Two children were over the age of 8 and therefore not covered under Maryland law. Before the sentencing, the five children had been placed with various family members.

Gleason is aware that perhaps the answer to the question of child neglect, in the long run, is not criminal prosecution. But this case, and others like it, elicit a tangled web of responses in her. “I’ve been involved in physical abuse cases too. And to me this is a type of abuse. If I had to live in conditions like that, I would literally just give up. It’s a wonder these kids survived.”

She paused, this 35-year-old plain-spoken policewoman and parent who knows--without having to see the psychologists’ evaluations--something about what can happen to children who come from neglectful parents. “You know what the worst part is? You know what these kids are going to grow up thinking?” she asked. “That they’re nothing. And that they mean nothing to no one.”

Increasingly, the public has glimpsed the nightmarish world of children who die from physical abuse administered by parents or caretakers. The horror endured by these child victims was driven home by such headline-making cases as that in 1987 of 6-year-old Lisa Steinberg in New York.

Similarly, much attention has been focused on child sexual abuse. The national publicity given, for example, to Elizabeth Morgan, the Washington plastic surgeon who believes that her ex-husband sexually molested their young daughter, has made Morgan a celebrity.

While experts involved in the serious issues of child maltreatment welcome the attention being paid to the horrendous social problems of physical and sexual child abuse, they also express concern that society has failed, in large part, to recognize the most prevalent of all forms of child maltreatment: neglect.

“Child neglect is not as dramatic as something like the Lisa Steinberg case,” said Baltimore pediatrician Howard Dubowitz, who is involved in clinical and research issues of child maltreatment. “That was a violent death that made headlines. But the numbers of kids involved in neglect is greater. In fact, the data we have on childhood mortality suggests that neglect is as much a factor as abuse.”

The statistics on neglect are staggering.

A recent study prepared by the American Humane Assn. states that, nationwide, neglect consistently has accounted for the greatest number of maltreatment reports; in 1988 it represented 63% of the approximately 2 million cases of reported incidents of the three predominant forms of child maltreatment--physical abuse, sexual abuse and neglect.

And because the figures represent only those cases that come to the attention of various protective agencies, the researchers say, the actual number of all maltreated children is probably considerably higher, perhaps three to seven times greater than the reports. This may be especially true of child neglect.

“Neglect is far more prevalent than physical and sexual abuse. (But) people are probably a lot more likely to report physical abuse and sexual abuse than they are to report neglect,” said Susan Zuravin, a research assistant professor at the University of Maryland School of Social Work who has been studying child maltreatment for more than 20 years. “People probably think of sexual abuse and physical abuse as more important.”

Neglect Harder to Define

Another deterrent to recognizing and reporting neglect, Zuravin said, may be that neglect is often harder to define and more invisible than physical or sexual abuse.

“One of the problems in defining neglect is you’re talking about omissions in care rather than an act of commission. But I would say the accepted standard definition of child neglect is the failure of the child’s parent or caretaker, who has the material resources to do so, to provide adequate physical types of care for the child.”

The average age of children who die as a result of neglect, according to a paper released by the National Center on Child Abuse and Neglect, is 3 years of age.

Of course, statistics never tell the whole story. Behind them lie the small human tragedies: the individuals who suffer. And in the case of neglect, the individuals who suffer are powerless children.

“The problem in dealing with neglect is that there’s always the connotation of blame associated with it,” said Dubowitz, a pediatrician who oversees a home-intervention program in Baltimore that helps neglectful, or potentially neglectful, families with young children. “And I think that assigning blame is not always accurate and not always constructive.

Often Too Needy

“What I try to do in my work with neglectful families is to move away from the framework of ‘good’ parents and ‘bad’ parents and come up with some assessment as to what are the abilities of a family--with good help--to take care of a child. And what I often see with neglectful families is parents who would like to be good parents but cannot. Often they’re too needy themselves.”

In dozens of interviews with pediatricians, psychologists, social workers and others involved in issues of neglect, two points were made over and over again concerning the root causes of neglect:

*That although there is a close link between neglect and poverty, the overwhelming majority of families living in poverty do not neglect their children.

*That many, if not most, neglectful parents were neglected themselves as children and therefore have little firsthand knowledge of the parenting required to meet the physical, social and emotional needs of children. They often have unrealistic expectations concerning a child’s developmental skills at a given age.

“In a sense, the neglecting parent needs to be cared for just as much as the neglected child needs caring for,” said Dr. Jay Belsky, a professor of human development at Pennsylvania State University and an expert on child maltreatment. “These are people who have not been nurtured and who have not learned to trust others. They are unable to express their own emotions, unable to get close to others.”

Perpetuate the Problem

And, Belsky said, unless such people experience a nurturing relationship somewhere along the way to adulthood, they may be at risk of perpetuating this kind of parenting with their own children.

Experts point out that regardless of a family’s socioeconomic status, child neglect is difficult to identify. Typically, they say, child neglect is “insidious, chronic and terribly private.”

There is milk and mayonnaise in the refrigerator, dry cereal on the shelf and little else to eat as lunchtime approaches and Angela rises from bed to face the day. It is almost 1 p.m. and Angela, 24 and the mother of four children, is still in her robe, not fully awake. There are the sounds of babies upstairs; two older children are in school.

Angela lives with her boyfriend in a small house not far from an upscale Baltimore neighborhood. The house appears neat and clean but is almost empty of furniture. The first floor contains only a kitchen table, four chairs and a fancy glass curio cabinet that holds a crystal decanter, some wine glasses and photographs of Angela with her children: Denise, 9; Calvin, 6; Reggie, 16 months; and Tanya, 6 months. Angela’s boyfriend, Reggie Sr., is the father of the three youngest children. (Names of the family have been changed to protect their privacy.)

Both parents have drug problems, and 6-month-old Tanya was born with drug-withdrawal symptoms.

Angela admits that she has had some difficulties in parenting but said that she is determined to turn her life around. In fact, she has an array of people trying to help her recognize and solve her problems: a therapist, a protective services worker, a parent aide. She has enrolled in parenting classes and an outpatient drug rehabilitation program.

One of the people working with Angela is Karen Shavers, a social worker who is part of a family support program run by the Waverly Family Center. Her job--she is technically an in-home intervention specialist--consists of solving family problems with mothers in their own homes, hoping eventually to bring them into the center itself and the many support programs offered there.

Prepare for Hearing

Today she will visit Angela to help her prepare for a court hearing to determine whether the children need to be removed from the home. Shavers is worried about the outcome.

“I personally have concerns about these children being left with Angela,” she said. “I see she has made some effort, but I think the family may be in some type of trouble. She leaves them alone from time to time, and Denise, the oldest, is basically the mother for all the children.”

Shavers has learned of a recent incident that upset Denise tremendously. It seems Angela got high and, in the middle of the night when the younger kids needed attention, Denise could not awaken her mother. She became quite frightened and did not know what to do. She was up all night, crying and doing what she could to take care of the situation.

Because of incidents like this, Denise has missed quite a few days of school. Recently her grades have slipped.

When Shavers arrives at Angela’s house at 12:30 p.m., Angela is still asleep. She has forgotten her appointment even though a phone call was made the day before reminding her of it. She pays little attention to 16-month-old Reggie, who has been brought downstairs from his crib and clearly is hungry. Twice, Angela rises to pour some dry cereal into a bowl for Reggie, but both times she gets sidetracked and forgets to give him the food.

Child Unsupervised

An appealing child, Reggie seems to be on his own; he runs around the two-story house with no supervision. Not once does Angela get up from the kitchen table to see where he is. She does not attempt to move him or warn him about falling when he stands on a chair in front of the table, holding his bottle.

“He’s spoiled,” said Angela of Reggie when he climbs onto Shavers’ lap. “He likes being held.” Angela tells Shavers that her parenting classes are ending but “I’ve still got my active parenting books and I’m still reading them.”

In a way, all that Angela will ever know about mothering may come from books; her own childhood seemed never to have existed. When asked about it, she tells you in an emotionless voice:

“Well, I never really did the things that other little children did. When they were out playing, I was washing dishes and combing hair. . . . I was the oldest, and I raised my sisters and my brother.

“My mother ran the street all the time. . . . There were times when she might leave us in the house for three days or even four. I’d call my grandmother, and she’d tell me to get all the kids together and bring them up to her house. But sometimes my mother would come home before we’d leave and she was drunk. I was 7 years old. . . . I want to get myself together while my kids are still young. So they don’t go through the same thing.”

‘I Love All of Them’

Denise and Calvin arrive home from school. They are polite and attractive children, clean and nicely dressed. But they seem uncertain and on guard about what might happen next. Denise immediately takes charge; she gets the baby, Tanya, from her crib and feeds Reggie. It is clear the younger children love her; Reggie responds with joy at the sight of Denise. It’s reciprocal: “I love all of them,” says Denise softly.

Denise is very guarded when answering Shavers’ questions about her life at home. She knows that there is a hearing coming up to determine whether she will be taken away from her mother, and her answers reflect an intelligent mind working to forestall such an event.

The next week, at the hearing to determine the best course of action for the family, Protective Services recommended that the family stay together based on a program stipulating that both parents continue in drug rehabilitation programs, that summer activities are found for the two older children, that the whole family begin intensive counseling, and that the two older children, who have missed a substantial number of school days, be transferred to a school closer to home.

“Is all this going to change anything?” asked Shavers. She sighed. “I can’t say I’m totally optimistic, but I do feel somewhat optimistic. Because if Angela doesn’t follow through with this, it will go back to court.”

Psychologists, pediatricians, educators and other experts who have worked with and studied children from neglectful families warn that society will continue to pay a high price if it fails to deal with this major social challenge. So, of course, will the children themselves.

“There is no question these kids have big-time problems and that there are serious consequences if we don’t intervene early,” said psychologist Dante Cicchetti, director of the Mount Hope Family Center, a highly regarded facility at the University of Rochester in New York, where kids at high risk of neglect and abuse are treated with their parents.

More at Risk for Drug Abuse

A nationally recognized authority on the long-term consequences of neglect, Cicchetti said such children are more at risk for delinquency, for alcohol and drug abuse and for serious psychiatric problems. And neglected children, he said, demonstrate the most severe difficulties in the school setting. For example, a study he conducted found them to be more anxious and inattentive than other children, to rely more heavily on the teacher for encouragement and approval, to be much more uncooperative with adults and to be more likely to be unpopular with their peers.

At the Mount Hope Family Center, considered by many to be a model program, the basic philosophy, he said, is to intervene early and to treat the entire family in one comprehensive location. Funded by private and public agencies, all of the services, from therapy to summer camp, are free.

One of the most comprehensive assessments of how maltreated children function in school is a recent study done at the University of Minnesota. It found that of all the maltreatment groups, neglected children have the most difficult time coping with the academic and social demands of school.

“By the time these kids get into kindergarten, they have generally got serious academic problems,” said Byron Egeland, a psychologist involved in the study. “They just can’t cope. They’re not very well organized, partly because they’ve never been in an environment where they’ve had an opportunity to gain confidence about mastering their surroundings.”

Egeland’s research finds that among this group of children, 65% were referred for special help in kindergarten and 58% were retained in their first two years of school. So many children entering school with such difficulties, he said, may add substantially to the public school crisis.

Unfortunately, he said, few programs in this country offer on a large scale the kind of continuing, comprehensive approach needed. “Government is going to have to take the initiative to make that happen.”