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Other useful references


The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Faltering growth

  • One study assessed the catch-up growth of long term physically neglected and emotionally abused pre-school children and determined that the growth failure was reversible after one year in foster care 1

Incidence of child neglect

  • A Canadian incidence study during 1998 noted that 40% of investigations were due to neglect and 19% emotional maltreatment 2
  • Another Canadian incidence study from 2003 recorded the prevalence of neglect and emotional abuse with relevant associated risk factors 3,4
  • The UK Framework for the Assessment of Children in Need and Their Families identifies the statutory basis for assessment in the UK (+ working together to safeguard children) 5
  • An American statement on screening for family and inimate partner violence 6
  • For the period 2008-9 the incidence of neglect was 48% and emotional abuse 24% in Wales, UK 7

Prevalence of Emotional Abuse

  • A meta-analysis of 29 studies determined the prevalence of emotional abuse of 3/1000 children for studies using an informant versus 363/1000 using self-report measures 8

Consequences of extreme early neglect

  • MRI studies of children experiencing severe institutional neglect demonstrated reduced cerebellar volume 9

Long term consequences

  • Early adverse childhood experiences (including emotional abuse) are associated with an increased risk of premature death 10
  • Overarching study summarising the conclusions of the Minnesota Study (The Mother Child Interaction Research project) identifying the developmental sequelae of infant maltreatment 11
  • Early childhood neglect (aged 0-2 years) is associated with aggression at age 4-8 years 12
  • There has been an increase in animal data to suggest that early maltreatment including neglect can affect methylation of brain-derived neurotrophic factor (BDNF) which may lead to altered BDNF gene expression in future offspring. This has been association with perpetuation of abnormal care taking behaviour 13


  • The Cleveland Child Abuse Potential Scale (C-CAPS) was piloted to determine if it could effectively distinguish between children who were maltreated, at risk, and controls. The instrument was able to correctly classify 85% of control cases and 76% of Maltreatment cases 14



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  1. Oliván G. Catch-up growth assessment in long-term physically neglected and emotionally abused preschool age male children. Child Abuse and Neglect. 2003;27(1):103-108 [Pubmed]
  2. Trocmé NM, Tourigny M, MacLaurin B, Fallon B. Major findings from the Canadian incidence study of reported child abuse and neglect. Child Abuse and Neglect. 2003;27(12):1427-1439 [Pubmed]
  3. Chamberland C, Fallon B, Black T, Trocme N. Emotional maltreatment in Canada: prevalence, reporting and child welfare responses (CIS2). Child Abuse & Neglect. 2011;35(10):841-54 [Pubmed]

  4. Chamberland C, Fallon B, Black T, Trocmé N, Chabot M. Correlates of substantiated emotional maltreatment in the second Canadian Incidence Study. Journal of Family Violence. 2012;27(3):201-213 [Abstract available from Springer Link]

  5. Department of Health, Framework for the Assessment of Children in Need and Their Families. 2000:1-109 [Framework provided by Department of Health]
  6. U.S. Preventive Services Task Force. Screening for family and intimate partner violence: Recommendation statement. Annals of Internal Medicine. 2004;140(5):382-386 [Pubmed]
  7. Local Government Data Unit, Wales. Local authority child protection registers. 2009 [Summary provided by the Welsh Government]
  8. Stoltenborgh M, Bakermans-Kranenburg MJ, Alink LRA, van IJzendoorn MH. The universality of childhood emotional abuse: a meta-analysis of worldwide prevalence. Journal of Aggression, Maltreatment & Trauma. 2012;21(8):870-890 [Abstract available from Taylor and Francis]

  9. Bauer PM, Hanson JL, Pierson RK, Davidson RJ, Pollak SD. Cerebellar volume and cognitive functioning in children who experienced early deprivation. Biological Psychiatry. 2009;66(12):1100-1106 [Pubmed]
  10. Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine. 2009;37(5):389-339 [Pubmed]
  11. Egeland B, Sroufe A. Developmental sequelae of maltreatment in infancy. New Directions for Child and Adolescent Development. 1981(11):77-92 [Abstract provided by Wiley]
  12. Kotch JB, Lewis T, Hussey JM, English D, Thompson R, Litrownik AJ, Runyan DK, Bangdiwala SI, Margolis B, Dubowitz H. Importance of early neglect for childhood aggression. Pediatrics. 2008;121(4):725-731 [Pubmed]
  13. Roth TL, Lubin FD, Funk AJ, Sweatt JD. Lasting epigenetic influence of early-life adversity on the BDNF gene. Biological Psychiatry. 2009;65(9):760-9 [Pubmed]

  14. Ezzo F, Young K. Child maltreatment risk inventory: Pilot data for the Cleveland child abuse potential scale. Journal of Family Violence. 2012;27(2):145-155 [Abstract available from Springer Link]



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