The absence of responsive relationships poses a serious threat to a child’s development and well-being. Sensing threat activates biological stress response systems, and excessive activation of those systems can have a toxic effect on developing brain circuitry. When the lack of responsiveness persists, the adverse effects of toxic stress can compound the lost opportunities for development associated with limited or ineffective interaction. This complex impact of neglect on the developing brain underscores why it is so harmful in the earliest years of life. It also demonstrates why effective early interventions are likely to pay significant dividends in better long-term outcomes in educational achievement, lifelong health, and successful parenting of the next generation.

Chronic neglect is associated with a wider range of damage than active abuse, but it receives less attention in policy and practice.

Science tells us that young children who experience significantly limited caregiver responsiveness may sustain a range of adverse physical and mental health consequences that actually produce more widespread developmental impairments than overt physical abuse. These can include cognitive delays, stunting of physical growth, impairments in executive function and self-regulation skills, and disruptions of the body’s stress response. With more than a half million documented cases in the U.S. in 2010 alone, neglect accounts for 78% of all child maltreatment cases nationwide, far more than physical abuse (17%), sexual abuse (9%), and psychological abuse (8%) combined. Despite these compelling findings, child neglect receives far less public attention than either physical abuse or sexual exploitation and a lower proportion of mental health services.

Studies on children in a variety of settings show that severe deprivation or neglect:

Disrupts the ways in which children’s brains develop and process information, increasing the risk for attentional, emotional, cognitive, and behavioral disorders.

Alters the development of biological stress-response systems, leading to greater risk for anxiety, depression, cardiovascular problems, and other chronic health impairments later in life.

Correlates with significant risk for emotional and interpersonal difficulties, including high levels of negativity, poor impulse control, and personality disorders, as well as low levels of enthusiasm, confidence, and assertiveness.

Is associated with significant risk for learning difficulties and poor school achievement, including deficits in executive function and attention regulation, low IQ scores, poor reading skills, and low rates of high school graduation.

The negative consequences of deprivation and neglect can be reversed or reduced through appropriate and timely interventions, but merely removing a young child from an insufficiently responsive environment does not guarantee positive outcomes. Children who experience severe deprivation typically need therapeutic intervention and highly supportive care to mitigate the adverse effects and facilitate recovery.