Distinguishing Between Poor/Dysfunctional Parenting and Child Emotional Maltreatment - Executive Summary

Executive Summary

This paper was intended to distinguish between poor parenting and child emotional maltreatment (CEM), to inform child welfare and public health policymakers of the need for differentiated responses. The paper arose from a policy think tank conducted in 2009, in which a panel of experts drew attention to the difficulty defining or classifying child emotional maltreatment and raised concerns that the issue was not drawing the attention it deserves as a public health issue [The Public Health Agency of Canada (PHAC), 2009]. The panel recommended clarifying what is and is not (or should and should not be) included under the emotional maltreatment label, as well as distinguishing between emotional maltreatment and poor/dysfunctional parenting. Our strategy was to integrate scientific literature with current practice and assumptions relating to poor/dysfunctional parenting and child emotional maltreatment. We approached this task from a relationship perspective, as opposed to a disease model, which provides a useful framework for organizing the study of parenting methods and their effects on child development.

Child emotional maltreatment includes abusive or neglectful behaviours by the parents or caregivers that have caused, or could cause, serious behavioural, cognitive, emotional, or mental problems. Emotionally abusive behaviours include excessive and continuing criticism, denigration, terrorizing, repeated blaming, insults, and threats against children by their caretakers. Emotionally neglectful behaviours include gross indifference and inattentiveness to a child's developmental or special needs. Numerous factors that impinge on the distinction between these acts of emotional maltreatment and acts of poor or dysfunctional parenting were considered in this analysis, such as the child's age, the frequency and severity of behaviour shown by caregivers, cultural norms, and parental beliefs and goals in childrearing (among others). In addition, knowledge of healthy and secure parent-child relationships and normal child development was examined to inform our discussion of the literature on poor and maltreating parenting methods.

The findings highlight two complementary strategies for examining distinctions between poor/dysfunctional versus emotionally maltreating parenting. One strategy is based on a continuum of parenting behaviours from negative to positive, which serves as a conceptual framework for understanding the range of acceptable and unacceptable parenting practices. The other strategy is based on empirically derived criteria for poor parenting and for emotional abuse, culminating in a categorical, operationalized distinction between the two parental acts that can be readily applied by trained investigators (based on the work of Heyman & Slep, 2006).

Several important similarities in parental risk factors, childrearing behaviours, and potential harm to the child were found among parents described as poor/dysfunctional and those described as emotionally maltreating. These similarities include a) an imbalance of negative, harsh childrearing methods relative to positive ones; b) few compensatory factors or resources to counterbalance harsh or inappropriate parenting methods; c) poor fit of parenting methods with the child's particular needs; d) poor fit of parenting methods with minimal acceptable standards of care, accepted cultural norms, and childrearing expectations; and e) similar goals and expectations for parenting, i.e., an authoritarian parenting style that values control and demandingness rather than sensitivity and guidance. These similarities indicate that these two types of parenting behaviours cannot be clearly distinguished from one another on the basis of etiology or impact on the child alone. Rather, both are examples of relational disorders, which differ qualitatively in terms of their chronicity, severity, and potential harm to the child.

Despite similarities, two primary factors were identified that distinguish emotional maltreatment from poor/ dysfunctional parenting: a) the chronic, severe and escalating pattern of emotionally abusive and neglectful parental behaviour toward the child, i.e., parents defined as emotionally abusive typically have shown qualitatively more extreme, appalling, and disturbing behaviours towards a child (compared to those described as poor parents); b) the pattern of chronic and severe parenting methods is associated with a proportionate increase in the likelihood of psychological harm or developmental disruptions, presumably because the child is exposed to ongoing stress that interferes with his or her ability to establish emotion regulation.

These distinctions highlighted the conclusion that parental actions and relative risk of harm to the child are both important ingredients in defining child emotional maltreatment.

Conclusions focused on how similarities and distinctions between poor parenting and child emotional maltreatment can be turned into practical guidelines for assessing risk and activating appropriate prevention and intervention:

• Because of the relational context in which both of these negative parental actions occur, it is necessary to include dual criteria for emotional maltreatment pertaining to 1) specific parental behaviours shown, and 2) their potential impact on the child.
• Poor/dysfunctional parenting methods occupy a wide range along the hypothetical continuum of positive- to-negative parenting behaviours, whereas emotionally abusive or neglectful methods warrant a qualitative distinction from the other methods. Thus, specific criteria are necessary for child welfare decisions relating to allegations of emotional maltreatment and need for child protection; however, meeting specific criteria may not be necessary for determining poor/dysfunctional parenting, unless it is needed to obtain services or other assistance.
• Poor parenting methods fall within a population health mandate: most parents need to receive some level of assistance, education, and awareness to maximize their important role and reduce all forms of child abuse and neglect.
• Types of child emotional maltreatment fall within a more narrow yet qualitatively more extreme and potentially more harmful range (than poor parenting) that requires a more focused intervention response.
• Criteria for emotional maltreatment relating to parental acts and child outcomes described herein can be reliably applied in suspected child welfare cases, facilitating targeted resources and interventions.

Six recommendations were presented from these findings and analysis:

• Adopt a categorical definition of child emotional maltreatment
• Adopt a continuum approach to defining poor parenting
• Address gaps in training
• Expand public health strategies to promote healthy, positive parenting
• Adopt a children's rights approach to child protection and public health education
• Address gaps in research and evidence-based interventions