Chapter 5 - Neglect Test Items

1. If parents fail to provide for their children because they are unable to afford food and shelter a. they are guilty of neglect b. they are not guilty of neglect c. it depends on which state they live in

Answer: C a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

2. Which type of neglect is defined as the failure to meet the child’s needs for food, shelter, clothing, and protection from harm?

Answer: A a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

3. What subtype of neglect includes the failure to provide adequate affection.

Answer: B a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

4. Beth did not want a child and was upset when she became pregnant. After the baby was born, she attended to his physical needs, but did not talk to him or cuddle him. What type of neglect is her son experiencing?

Answer: B a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

5. What subtype of neglect is defined as the failure to provide prescribed medical treatment?

Answer: C a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

6. What subtype of neglect is defined as the failure to comply with recommended psychological treatment?

Answer: D

7. Bobby has been diagnosed with anxiety by the school psychologist. The school psychologist recommends counseling and gives Bobby’s parents a referral to a local, low-cost psychologist with experience in working with young children who suffer from anxiety. Bobby’s parents think he will simply grow out of his anxiety, so they do not contact the psychologist. What subtype of neglect is this?

A. Physical neglect

B. Emotional neglect

C. Medical neglect

D. Mental Health Neglect

E. Educational Neglect

Answer: D

8. Which subtype of neglect includes the failure to enroll a child in school?

A. Physical neglect

B. Emotional neglect

C. Medical neglect

D. Mental Health Neglect

E. Educational Neglect

Answer: E

9. Jane’s mother does not enroll her in school because she has decided to provide home-schooling for Jane. However, due to the presence of her infant twins, she never gets around to starting Jane’s curriculum. What subtype of neglect is this?

A. Physical neglect

B. Emotional neglect

C. Medical neglect

D. Mental Health Neglect

E. Educational Neglect

Answer: E

10. The most common type of reported maltreatment is: a. sexual abuse b. neglect c. physical abuse

Answer: B

11. Which of the following is the most common type of neglectful behavior?

A. Supervisory neglect

B. Environmental neglect

C. Both are equally common

Answer: A

12. What is the strange situation designed to measure?

A. child neglect

B. child abuse

C. intelligence

D. attachment

Answer: D

13. Examining a parent’s emotional expression for cues about a situation is

A. Social referencing

B. A symptom of insecure attachment

C. A symptom of neglect

Answer: A a. secure b. avoidant c. resistant

15. In the strange situation task, William clings to his mother prior to separation. After separation, William appears to be angry with his mother when she returns and he resists her attempts to comfort him. This pattern of behavior illustrates a(an) attachment.

Answer: C a. secure b. avoidant c. resistant

16. In the strange situation task, Rachel is generally unresponsive to her mother. She is not upset when her mother leaves and she does not rush to greet her when she returns. This pattern of behavior illustrates a(an) attachment.

Answer: B

17. Sandra keeps to herself. When her peers fill out a peer rating form she is not listed as a person they would most like to play with nor is she listed as a person they would least like to play with. Sandra is: a. peer rejected b. peer neglected c. peer accepted d. peer reinforced

Answer: B

18. When the children in a class fill out peer rating forms, many of them list Joseph as a person they wish to avoid. Nobody lists Joseph as a child they would like to play with. Joseph is a. peer rejected b. peer neglected c. peer accepted d. peer reinforced

Answer: B

19. Adults with a history of neglect are more likely than their non-maltreated peers to a. drink heavily b. engage in risky sexual behavior c. have a psychological problem d. all of the above

Answer: D a. neglected mothers are NOT more likely to neglect their own child b. maternal neglect is a significant risk factor for neglect of her children c. all mothers who were neglected as children go on to neglect their own children d. the majority of mothers who were neglected go on to neglect their own children

20. Which of the following is true regarding the intergenerational transmission of neglect?

Answer: B a. the presence of a supportive adult during childhood b. having a supportive, competent partner c. therapy to address the maltreatment d. dissociating the abuse experience

21. Which of the following is NOT associated with breaking the cycle of abuse?

Answer: D

True/False

1. Child neglect is an act of omission.

Answer: True

2. Fetuses are covered by the neglect laws in all 50 states.

Answer: False

3. Childhood obesity is never considered a form of medical neglect.

Answer: False

4. State laws clearly and precisely describe what constitutes a suitable place of abode.

Answer: False

5. Parents can be charged with neglect if their home is filthy.

Answer: True

6. In some states, witnessing Criminal Domestic Violence is considered a form of child maltreatment.

Answer: True

7. Parents cannot be charged with medical neglect if they refuse treatment for their child based on religious grounds.

Answer: False

8. Failure to vaccinate your child is always grounds for medical neglect.

Answer: False

8. Neglect is the most common form of child maltreatment. Answer: True

9. Neglect is the leading cause of fatalities from child maltreatment.

Answer: True

10. In cases of neglect, the perpetrator is almost always the father.

Answer: False

11. Neglect alone may lead to symptoms of Post-Traumatic Stress Disorder.

Answer: True

12. The consequences of neglect do not appear to persist into adulthood. Answer: False

Short Answer Questions

1. What does it mean to say that neglect is chronic in nature?

Answer: With neglect, we are defining a pattern of parental behavior rather than just a few instances.

2. Define medical neglect.

Answer: Failure to provide prescribed medical treatment or failure to secure medical treatment in a timely fashion (when a reasonable person would have known treatment was needed).

3. List 3 arguments for the prosecution of childhood obesity as medical neglect.

Answer: Any 3 of these:

- Obesity is associated with health concerns

- Obesity can be fatal (although very rare)

- Obesity is associated with social problems

- Obesity is associated with future harm; including a shortened life-span

4. List 3 arguments against the prosecution of childhood obesity as medical neglect.

Answer: Any 3 of these:

- Obesity may be due to genetics or endocrine problems

- Harm of obesity is rarely imminent

- No evidence that obese children will do better in protective care

- Removing the child from the home may pose a risk that outweighs any health benefit

- Parents do not have total control over what their children eat

5. Define child endangerment.

Answer: Child endangerment is unnecessarily exposing a child to possible harm.

6. Define nonorganic failure to thrive.

Answer: Infants, who were once in the normal range, now fall below the fifth percentile for height and weight in the absence of any organic explanation may be diagnosed with nonorganic failure to thrive.

7. List 4 possible signs of neglect in infancy.

Answer: Any 4 of these:

- Nonorganic failure to thrive

- Insecure attachment

- Poor muscle tone

- Flat, bald spot on the back of the head

- Lack of smiling, babbling

- Rashes/infections

- Lower intelligence

8. List four explanations for the academic deficits seen in neglected children.

Answer: First, neglected children may be less persistent and less enthusiastic than their peers. Second, students may have delays in cognitive abilities related to language, Third, students may struggle due to poor attendance at school. Fourth, neglected children have lower IQs than their peers.

9. What is the most likely explanation for why neglected children are peer neglected?

Answer: The most likely explanation is that neglected children tend to be aggressive and aggression is linked to peer rejection.

10. List 3 possible effects of neglect seen in adolescents.

Answer: Any 3 of these:

- socially isolated

- intellectual/academic problems

- higher rates of delinquency

- increased problems with substance use and abuse

- increased rates of risky behavior

- higher rates of psychiatric disorders

11. List 3 possible effects of neglect seen in adulthood.

Answer: Any 3 of these:

- An increase in sexually transmitted diseases

- More likely to engage in risky sexual behavior

- More psychological problems

- Problems with alcohol

Additional Case Studies

1. Varness (2010) presents the case of a nine-year-old girl, Tiffany who is morbidly obese. When Tiffany’s mother is confronted by the pediatrician, she makes it clear that she does not intend to make changes. The doctor must then decide if this is a case of medical neglect. Varness goes over the criteria for medical neglect and then relates each criteria to Tiffany’s case. The article concludes with a suggested course of action.

Varness, T. (2010). Deos pediatric obesity indicate child neglect? Virtual Mentor, 12 (4), 263-267.

2. Cox (2009) reviews the case of a mother how is charged with neglect because her 14-year-old son weighed 555 pounds. This case received a great deal of media attention and many article, pictures, and video clips can be found on-line. The mother’s name is Jerri Gray and the case took place in South Carolina.

Cox, L. (2009, June 29). Courts charge mother of 555-pound boy. ABC News Medical Unit. Retrieved from: http://abcnews.go.com/Health/WellnessNews/story?id=7941609 https://www.youtube.com/watch?reload=9&v=FLxHmfXEf00

- 5 minute 10 second video from CBS overviewing case https://www.nydailynews.com/life-style/health/child-obesity-abuse-court-decides-mom-jerri-gray-neglected-555-pound-14-year-old-son-article-1.428096 https://www.wyff4.com/article/video-update-on-upstate-boy-who-weighed-555pounds/6503510 https://doi.org/10.1177/1077559510384983

- 4 minute 21 second clip from NBC news posted Dec.. 6, 2013 – Gives an update on the case when son is 18 years old.

3. Merrick et al. (2012) present 5 case examples. In each case a newborn screening reveals that the child has a disorder. The family is notified via phone, mail, or in person. The family is described as having no insurance, Medicaid, or private insurance. In all cases the family does not seek follow up services. The question is whether the doctor would report medical neglect. The article includes the results obtained when the vignettes were sent to 102 professionals in the field of pediatric medicine.

Merrick, M. T., Butt, S. M., Jent, J. F., Cano, N. M., Lambert, W. F., Chapman, A. V., Griffith, J. F., Ciener, D., Dandes, S. K., & Sanders, L. M. (2012). No follow-up after positive newborn screening: Medical neglect? Child Maltreatment, 15 (4), 315-323.

4. Green (1991) present a 13 page case description of a neglected child, Alan, aged 13-years. The commentary includes looking at medical and legal issues as well as family and social issues. It also covers the assessment of both the child and his mother. The description ends with treatment options.

Green, A. H. (1991). Child neglect. In R. T. Ammerman & M. Herson (Eds.). Case studies in family violence (pp. 139-152). Plenum Press.

Video Suggestions

1. A 45 minute video lecture with power point is available on-line at http://videos.med.wisc.edu/videos/7485. In the video Dr. Todd Varnes presents a lecture entitled Does Severe Childhood Obesity Constitute Medical Neglect? Dr. Varnes presents case studies from the U.K. and the U.S. He reviews the consequences of obesity and the criteria for medical neglect before discussing when childhood obesity might warrant removal from the home.

2. Video clip from CNN on obesity and medical neglect. See Case Example #2 above.

3. Broken Child: Case Studies of Child Abuse (2004). This 61 minute dvd is produced by HBO. Several real cases of child maltreatment are documented including a child who has Fetal Alcohol Syndrome and a mother who uses crack and works as a prostitute while pregnant. Warning: The language is very graphic.

4. http://www.youtube.com/watch?v=cMQirLFI2Q4 This 3:45 minute video clip covers the arrest of three adults for child neglect in Oklahoma City. A 5-year-old was being kept in a closet, beaten, and underfed. She weighed just 19 pounds. Interesting point: 5 other children in the home were not being maltreated. The child who was being maltreated had a different father than the other children.

5. http://www.youtube.com/watch?v=QZ1zXJVv9SQ This 2:48 minute video clip covers the arrest of four adults after two children aged 2-years and 3-years were found walking in the road. Another child, an infant was crying in an infant seat in the home. All four adults were passed out and the home was filthy.

6. This 2:23 minute video, Mom Charged with Child Neglect, from News Channel 9 describes the case of a 4-year-old girl who was found outside alone in only a shirt and underwear. Apparently, she left her home while her mother was sleeping. This was not the first time the child had been found unsupervised. The original air date was August 6, 2012.

http://www.youtube.com/watch?v=NlwClWNr2pE http://www.youtube.com/watch?v=mFzFCN9siug http://www.youtube.com/watch?v=vtR6svteJvw https://www.youtube.com/watch?v=_Baj5ka7t-s https://www.youtube.com/watch?v=EPWtRSX5VNY

7. This 2:39 minute video clip, Muncie Stepmom Found Guilty of Child Neglect in Death of 5-Year-Old, was produced by Fox News. It describes the jury verdict and reviews the case of severe neglect. Original air date – July 27, 2011.

8. This 2:06 minute video clip, NN Mother Arrested for Child Neglect, was produced by NBC News and first aired on July 20, 2012. It describes a case of felony child neglect involving teenage girls – 13 and 14-years-old.

9. This 2:01 minute video clip from NBC News presents a case of child neglect in Port St. Lucie based on extreme filth in the home.

10. This 2:25 minute video clip from NBC News presents the case of parents charged with child neglect after they were found to be living in a Walmart parking lot with their children.

Discussion Topics

1. Should child obesity be grounds for charging for parents with medical neglect? Have students debate this issue.

2. Have the students discuss the phrase “home or suitable abode.” Is it sufficient to live in a tent? A car? A camper? Does it depend on the environment (temperate versus very cold or hot)? Are electricity and indoor plumbing required? What if parent are providing as much as they can based on a limited income?

3. Many experts think that the consequences of neglect may be more severe than the consequences of physical or sexual abuse. Have your students discuss why neglect might have such a dramatic impact on development.

4. Have the students look up their state law on neglect and the laws in three other states for comparison. Ask them to note what, if anything, they like better about their state law and what, if anything, they are less pleased with. How would they write the child neglect law if it was up to them?

5. Seth Pollak has examined children who were raised in orphanages in Russia and Romania before being adopted by parents in the US. He assesses the deficits associated with extreme neglect during infancy. This can provide an interesting discussion of how to adequately prepare adoptive parents to meet the needs of their adopted children.

6. Kwak and colleagues found that neglect was associated with an increase in Smartphone addiction. Because so many students are very interested in cell phone use, they may enjoy discussing this article:

Kwak, J. Y., Kim, J. Y., & Yoon, Y. W. (2018). Effect of parental neglect on smartphone addiction in adolescents in South Korea. Child Abuse & Neglect, 77, 75–84. https://doi.org/10.1016/j.chiabu.2017.12.008