Emotional neglect in children of parents with social problems.

Child abuse is a serious social problem, with many adverse consequences for the development of children. However, child abuse is often under-recognized in hospitals. To improve the identification of child abuse, hospitals in Amsterdam introduced a new protocol for the Emergency Department. This protocol implies that all adults who visit the Emergency Department because of domestic violence, substance abuse or a suicide attempt, are asked whether they have children in their care. If so, the children are referred to the pediatric outpatient clinic. During this visit a pediatrician screens for child abuse. A study in which this protocol is being evaluated, shows that pediatricians often do not recognize emotional neglect (one of the types of child abuse), while emotional neglect is the most frequently occurring type of child abuse. Especially in (very) young children emotional neglect is difficult to recognize, because these children lack the capacities to talk about how they are doing. From literature we know that the consequences of emotional neglect may be worse than the consequences of other types of child abuse. If pediatricians would be better able to identify emotional neglect, it would be possible to intervene timely and to prevent adverse outcomes for children. However, short tests to identify emotional neglect are lacking. Furthermore, literature shows no starting points for identification, because the indicators of emotional neglect on children of parents with psychosocial problems are under-studied. Research on emotional neglect in other populations shows that language delay and a disturbed parent-child interaction are indicators of emotional neglect in young children. In case this also applies to children of parents with psychosocial problems, this might offer leads for the identification of emotional neglect by pediatricians.
The primary goal is to examine if language delay and a disturbed parent-child interaction are indicators of emotional neglect in young children of parents with psychosocial problems. The secondary goal is to explore if a short test on language development is a suitable instrument to identify emotional neglect.
Two groups of children will be included. The first group consists of children age 2 to 7 years who are referred to the pediatric outpatient clinic, because at least one of their parents visited the Emergency Department because of domestic violence, substance abuse or a suicide attempt (cases). The second group is a control group (controls), consisting of children age 2 to 7 years who are not a victim of child abuse (present or past). In both groups, also one of the parents will be asked to participate.

Emotional neglect is a serious social problem, with many adverse consequences for the development of children. However, emotional neglect is difficult to identify for pediatricians. Indicators of emotional neglect in children of parents with psychosocial problems are under-studied and short tests to identify emotional neglect are lacking.
The primary goal is to examine if language delay and a disturbed parent-child interaction are indicators of emotional neglect in young children of parents with psychosocial problems.
We hypothesize that children of parents with psychosocial problems have a language delay more often than children of parents without psychosocial problems.
Furthermore, we hypothesize that the parent-child interaction is disturbed more often in families with psychosocial problems, than in families without psychosocial problems.

Shortly after the hospital visit a language test (Peabody Picture Vocabulary Test-III-NL), a play observation and questionnaires on posttraumatic stress disorder (CRIES) and on behaviour problems (CBCL) are administered.

Not applicable