The Effects of Abuse and Neglect on Child Development
Section 3: From Three to Five Years
Case Scenario: Kendra
An Expert’s Opinion
Physical Development
Her awkward gait and general lack of coordination are not normal for children of her age. It is unknown
whether this indicates a developmental delay or some type of neurological problem, perhaps caused by
pre natal exposure to drugs.
Social Development
Problems with social and emotional development can be considered along a continuum of mild to
severe. Some problems result when children attempt to engage in age-appropriate activities when they
haven't mastered the pre- requisite social skills. Other social or behavioral problems can be children's
attempts to adapt to their abusive or neglectful environment; and some problems result from damage
done to the child (i.e.: complex trauma). At the severe end of the continuum are emotional
disturbances. Kendra has some severe problems which are common in children who have been
traumatized by chronic abuse.
Kendra’s attachment with her aunt appears to be insecure. She follows her aunt constantly, and
frequently seeks proximity and reassurance from her aunt.
Kendra is delayed socially. She engages in parallel play and does not engage in imaginative or
cooperative play typical of preschoolers. She fights with peers whenever frustrated rather than trying to
resolve disagreements verbally.
Emotional Development
Her frequent, violent temper tantrums and emotional outbursts are outside of normal behavior for
preschool children. These are common outcome for children who have been traumatized by abuse. This
may indicate emotional disturbance,
Night terrors may indicate anxiety or fear.
Cognitive Development
Kendra appears delayed in speech and language. Her aunt often cannot understand her. At this age;
most children are understood by their caretakers. Also, her use of very simple sentences is more typical
of 2- to 3-year-olds.
Her short attention span may be a reaction to the chronic stress of abuse. Children who are constantly
alert to danger in the environment, or who are constantly poised for "flight or fight" are often unable to
concentrate in school. Her short attention span could also indicate attention-deficit concerns.
Case Planning & Interventions
Case planning for Kendra should include the following interventions:
- Comprehensive developmental and psychological assessment of Kendra to determine the extent
of her developmental delays and emotional disturbance.
- Evaluation by a physician for her awkward gait. The family doctor may refer her for a
neurological evaluation.
- Kendra’s behavior may be too extreme for Head Start or other preschool programs. She may
need a more intense program which has specialized staff prepared to help children with
emotional and behavioral problems. If a specialized program is not available, then a Head Start
program that has some capacity to manage Kendra’s behaviors could be considered.
- Speech Therapy would improve Kendra’s speech and language, which would likely decrease her
frustration, and improve her peer interactions.
- Mental health therapy could help Kendra to do the following:
- Learn to appropriately express and regulate her emotions;
- Develop social skills appropriate to her age;
- Understand that her past maltreatment is not her fault, and develop a more positive,
adaptive view of herself in her present situation; and
- Develop effective problem-solving skills.
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