DEE WILSON CONSULTING

(Originally published March 2017)

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(This commentary is a revised version of a paper I wrote for Upbring, a private agency in Texas, during the spring of 2016. Click here to read the full article)

 

Modern CPS systems in the U.S. were created in state and federal law during the 1960s and early 1970s due to intense public concern with the severe physical abuse of young children.  It appears that definitions of child neglect were added to state statutes almost as an afterthought or because of federal CAPTA requirements or in response to model statutes developed by advocacy groups.  Nevertheless,  reports of child neglect have far outnumbered reports of physical abuse and sexual abuse from the early years of the modern child protection system.  In recent annual Child Maltreatment reports based on NCANDS data, almost four-fifths of victims of child maltreatment were neglected compared to about one-fifth of victims who were physically abused and less than one in ten victims who were sexually abused.

 

Neglect is a more recurrent type of maltreatment than physical abuse or sexual abuse as indicated by rates of CPS re-reports and multiple substantiations.  In families with 3 or more CPS reports, cross type recidivism in which allegations of neglect and different types of abuse are combined is the rule rather than the exception, according to research published by Melissa Jonson-Reid and Brett Drake. Neglect is also enmeshed with poverty to a greater extent than physical abuse or sexual abuse.

 

Early Research on Intergenerational Transmission (IGT) of Child Abuse

 

From the 1960s until about 1990 the most widely shared hypothesis regarding the cause of physical abuse among scholars and advocates was that parents who were abused in their own childhoods often became physically abusive parents.  The simplest version of the IGT hypothesis was that abusive behavior was the result of social modeling,  i.e., abusive parents raised their children as they were raised. There were also psychodynamic explanations of IGT offered by some theorists.

 

Numerous research studies of the IGT hypothesis produced mixed results, possibly due to different definitions of physical abuse, along with varying samples, research designs and measures, along with the questionable assumption that physical abuse was a homogenous phenomenon.  In 1987, Kaufman and Zigler published an influential summary of studies that concluded the rate of IGT was about 30%.  Other studies found that physical abuse in childhood often resulted in neglectful parenting rather than abusive parenting.  These research findings complicated the simple explanation of how the experience of childhood abuse often led to child maltreatment.  I remember reading an opinion piece in Newsweek in the late 1980s or early 90s in which the author assured readers that adult victims of child abuse were not doomed to be abusive parents!

 

Following the publication of Kaufman’s and Zigler’s 1987 article, child welfare scholars appeared to lose interest in figuring out the causes of child maltreatment,  choosing instead to focus on risk assessment issues, i.e., prediction and/or classification of risk profiles or on other child welfare subjects such as substance abuse,  mental health problems, domestic violence, etc.  

 

New Research regarding Intergenerational Transmission of Child Neglect

 

During recent years there has been a resurgence of scholarly interest in the IGT of child maltreatment and renewed interest in the causes of child maltreatment,  in part because of a heightened interest in prevention and perhaps due to research findings regarding the devastating effects of severe and chronic neglect on early childhood development.  Carolyn Widom and Valentia Nikulina, Jessica Bartlett and Melissa Easterbrooks, Emily Putnam-Hornstein and other scholars have used longitudinal studies, administrative data bases, surveys of young mothers in prevention programs and other creative sampling strategies to explore the extent of IGT of both child abuse and neglect.  Some of their research findings are surprising and have yet to be adequately explained:

 

• In Widom’s and Nikulina’s longitudinal study of children made legally dependent due to abuse or neglect between 1967-71 in a Midwestern city,  a history of child maltreatment was associated with elevated rates of neglect and sexual abuse, but not physical abuse, when these children became parents.  This longitudinal study compared adults with childhood histories of maltreatment to a non-maltreated control group who grew up in the same neighborhoods and whose families had similar socioeconomic profiles.

• In Bartlett and Easterbrooks' study of infant neglect among young mothers enrolled in a home visitation program, more than three quarters of mothers (77%) who were maltreated in childhood had not maltreated their child by age 30 months, according to CPS records.  However, “a history of substantiated intergenerational transmission was common;” 60% of mothers of neglected infants were maltreated in their childhoods.

• Widom and Nikulina found that rates of IGT of neglect were dependent on the measures utilized: CPS reports (about 20%), self report of parents (about 40%), reports of children (almost 60%).  Parents who self reported maltreatment of their children were more likely to have been reported to CPS if they had been made legally dependent due to abuse or neglect themselves.

• Bartlett and Easterbrooks found that history of physical abuse in childhood was more likely to lead to neglectful parenting than abusive parenting. Mothers who were abused in childhood were four times more likely to be substantiated for neglect than mothers who had not been physically abused as children.

•  In Bartlett’s and Easterbrooks' study of infant neglect, the frequency and dependability of social support moderated the relationship between maternal histories of childhood maltreatment and parenting, whereas positive relationships in childhood did not have a significant influence. However, in their study of adolescent mothers Bartlett and Easterbrooks found that “positive early bonds help to counteract adversities.” 

• In Bartlett’s and Easterbrooks' study of infant neglect,  the experience in childhood of multiple types of child maltreatment was associated with highly elevated rates of neglect in the next generation.

 

In these studies, rates of intergenerational transmission of neglect were 18-44%; discontinuity of IGT was the rule; continuity (of IGT) the exception. The question these studies suggest is not “how do some children break the cycle of child maltreatment?” A better question is “why do many children fail to break the cycle of child maltreatment”? What is different about the 20-40% of parents with histories of childhood maltreatment who become neglectful parents? Possible answers include: 

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1)  the severity and chronic nature of early maltreatment

2)  histories of multiple maltreatment that include physical abuse or sexual abuse

3)  the early effects of child neglect on childhood development and emotional functioning

4)  low levels of academic achievement

5)  characteristics of the social environment in which parents grew up or currently live

6)  mental health conditions and substance abuse in late adolescence and early adulthood, for example rates of co-occurring
     disorders

7) presence or absence of domestic violence in intimate relationships and

8)  negative experiences in foster care.

 

 Mechanisms for Intergenerational Transmission

 

1.     One plausible hypothesis is that severe early neglect of children is associated with multiple adversities, including poverty, co-occurring substance abuse and mental health disorders, domestic violence and parental incarceration.  Adverse Childhood Experiences (ACE) studies have consistently found that it is the number of adversities, rather than any one specific adversity, that has the greatest effect on health and mental health throughout the life course.  IGT of neglect may be associated with a parent’s ACE score, that is with a higher “dose” of adversities in childhood for parents who are unable to break the IGT cycle.

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2.     Nikulina, Widom and Czaja have published articles based on the longitudinal study described above indicating that both poverty and neglect were associated with elevated rates of PTSD and arrests in young adulthood and with lower levels of academic achievement. Poverty, but not neglect, was associated with an elevated rate of Major Depressive Disorder. Children who experience both chronic neglect and long term poverty as children are at risk for low academic achievement and for the combination of PTSD and depression, conditions that undermine self efficacy, i.e., personal agency.  Young adults with these childhood histories may be stuck in low wage jobs or be dependent on welfare due to low academic achievement and lack of job skills.  The combination of poverty with chronic mental health disorders often has a devastating effect on parents' belief that they can exercise a reasonable degree of control over their life circumstances.

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3.     Severe and chronic early neglect may undermine the capacities that create the foundation for resilience in childhood and across the life course. Resiliency seems to crucially depend on:

 

• the capacity for friendship and positive intimate relationships and for affiliation with others when experiencing stressful and dangerous conditions,

• the ability to control emotional reactions and avoid “meltdowns,”

• self reliance and persistence in problem solving rather than being quickly defeated by frustrating circumstances or events, and

• development of socially valued talents.

 

It is likely that differences in these resiliency factors are as important as the presence or absence of chronic mental health conditions.  Of course, there may be a strong relationship between children’s mental health conditions and their ability to develop friendships, control emotions, struggle persistently with challenges and work hard at developing socially valued talents.

 

Stopping Intergenerational Transmission of Child Maltreatment

 

It is highly likely that IGT of child neglect depends on the effects of neglect on child and adolescent development.  During the past two decades there has been a large body of research that describes how early neglect that includes lack of emotionally responsive parenting undermines children's capacity for secure attachment and trust in adults, leads to emotion dysregulation and discourages persistent problem solving efforts when learning new tasks.  In extreme cases, neglected children may come to believe that “it would have been better if I was never born.”

 

Prevention of IGT of neglect must begin with undoing the attitudes and belief undermining the capacity for supportive relationships, the ability to calm down when upset or frustrated, the confidence in oneself to overcome difficulties and opportunity to develop socially valued skills.  First and foremost, children need nurturing caregivers who understand the effects of trauma and severe neglect.  These caregivers need the skills to develop close relationships with children who are oppositional or withdrawn, and out of control when upset.  The earlier children receive the trauma informed care they need, the better.  It is not enough to fund prevention programs that intervene when older adolescents or young adults are on the verge of becoming parents. 

 

Arguably, the same conditions that lead to severe and chronic neglect (poverty, substance abuse, mental health conditions and domestic violence) lead to IGT of neglect.  For this reason, it is worth considering how to prevent the inter-generational transmission of drug/alcohol abuse, mood disorders, DV and poverty.  States need to develop the capacity to offer prevention and early intervention services to vulnerable families before a CPS report occurs. CPS systems are not designed for this purpose, and it is not obvious how the design flaws of current child protection systems will be overcome.  Currently, home visitation programs are reaching only a small percentage of families at highest risk for child maltreatment.  One possible approach is to strengthen the capacity of public health systems to reach out to high risk parents as determined by “big data” regarding birth cohorts,  or through neighborhood family support centers located in areas of concentrated poverty.

 

In addition,  the plain fact that severe and chronic neglect of children is grounded in poverty, often extreme poverty, needs to be taken seriously.  I continue to encounter prevention initiatives that have “work-arounds” for child poverty, for example early childhood education or home visitation programs offered to low income parents, absent any poverty related services.  Any wealthy country that tolerates a child poverty rate of 20-25% and leaves almost 10% of children growing up in families with annual incomes less than $10-11,000 will have child welfare systems inundated with neglect reports and with large numbers of babies and other preschool children entering foster care.  Both states and the federal government should adopt the goal of eliminating severe poverty and child homelessness.  There is no prevention oriented “work around” for destitution and its effects on family life.

 

Advocates, policymakers and practitioners should review research of foster care outcomes that has found high rates of PTSD and depression among young adults who spent considerable time in foster care as adolescents.  Foster care systems for behaviorally troubled school age children seem to be reproducing the conditions that lead to intergenerational transmission of child maltreatment, i.e., high rates of mood disorders and substance abuse combined with low levels of academic achievement.  Policymakers, advocates and practitioners should engage in a potentially painful discussion regarding how foster practices and services for behaviorally troubled children are contributing to the inter-generational transmission of child maltreatment. 

 

References

 

Bartlett, J. & Easterbrooks, M. (2012). “Link between physical abuse in childhood and child neglect among adolescent mothers”.  Children and Youth Services Review, 34(11), 2164 – 2169.

 

Bartlett, J. & Easterbrooks, M. (2015).  “The moderating effect of relationships on intergenerational risk for infant neglect by young mothers.” Child Abuse and Neglect, 45, 21-34.

 

Kaufman, J. & Zigler, E. (1987). “Do abused children become abusive parents?”  

 The American Journal of Orthopsychiatry, 57(2), 186-192.

 

Nikulina, V., Widom, C. & Czaja, S. (2011). “The role of childhood neglect and childhood poverty in predicting mental health, academic achievement and crime in adulthood.” American Journal of Community Psychology, 48(3-4), 309-321.

 

Widom, C., Czaja, S. (2015, March 27). “Intergenerational transmission of child abuse and neglect.” Science, 347 (6229), 1480-1485.

 

Widom, C. & Nikulina, V. (2012). Long Term Consequences of Child Neglect in Low Income Families. In V. Maholmes & R. King (Eds.) The Oxford Handbook of Poverty and Child Development. Oxford University Press, 68-85.

  

deewilson13@aol.com

    

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