It’s a silent problem. While newspapers and TV news shows regularly highlight stories of child physical and sexual abuse, the companion problem, child neglect, hardly gets a mention. Neglect, unless accompanied by pictures of squalor or emaciated kids, is much harder to capture in a headline or sound bites. Abuse is active and often characterized by violence and exploitation. Neglect is passive and often characterized by depression and resignation. Abuse makes a better news story.

But neglect is the bigger problem. In 2005, almost 900,000 children were victims of maltreatment. More than half — 63 percent — were victims of neglect. Less than 12 percent of substantiated cases involved child sexual abuse. Further, while child abuse steadily declined from 1990 to 2005, the incidence of neglect didn’t go down at all. Sadly, it is the youngest children who are most likely to be neglected.

Linda grew up as the oldest of eight kids in rural Connecticut. “My mother needed the kind of love that babies give. Once a kid started to be at all independent, she was done with him. Looking back, I know she was mentally ill. But at the time, I just thought that babies were mom’s job and everyone else was mine. I give my dad some credit. At least he worked steady and supported us but he was either working or drinking so he was no help at home.”

Although her parents brought home bags of groceries now and then, Linda and her siblings never had a meal prepared for them. They foraged in the cupboards. Mom did do some laundry but Linda can’t remember ever having clean sheets or a clean house. While their mother rocked the current baby, the other kids were left on their own. The kids did what they wanted when they wanted. “It’s a wonder we didn’t get hurt more often,” says Linda. “It was only when we all regularly showed up at school with head lice that protective services finally got involved.”

I’ve been seeing Linda for therapy for several years. Never having had order or structure or basic necessities, she finds it difficult to organize her things, manage a schedule or maintain a healthy lifestyle. Never having had love or support from her parents, she finds it difficult to love, to trust, or to reciprocate in relationships.

Neglect is the failure of caregivers to provide needed age-appropriate care. In a family like Linda’s, there is often both physical and psychological neglect. Physical neglect is the failure to provide the basic necessities of food, shelter and clothing. It also includes the failure to provide needed medical care or adequate supervision. As a result, the kids are at risk for malnutrition, illness, and physical harm. Having never experienced good care, they may become adults who often don’t know how to care for themselves or others.

Psychological neglect, though less obvious, is just as serious. Children who are constantly ignored, rejected, threatened, or belittled grow up without the inner resources that everyone needs to cope with difficult times. When children get little or no affection and physical comfort, they are vulnerable to anyone who will give them attention. Often they become sitting ducks for people who exploit them.

Brett is trying to break a drug habit. “When did you start using?” I ask. “Oh, I think I was about eight,” he replies.

“Eight?” After 35 years in this business, it takes a lot to surprise me but I still internally register some shock when I hear this kind of story.

“Yeah. My folks never looked out for us kids. They didn’t like us much. We were expected to stay out of the house and out of their sight as long as it was light. The older guys in the neighborhood thought it was funny to get the younger kids stoned. We thought being included by the big guys was cool.”

Brett is now 30 and trying to get his life together. Having been stoned for over 20 years, he lacks basic social skills, has low self-esteem, and can’t shake a chronic depression. In many ways, his psychological development stopped at age 8.

The effects of childhood neglect can be devastating and long-term. Neglected kids have poor social skills and may fall into substance abuse. Lacking true friendships, they settle for being drinking or drugging buddies. Even more often, they develop serious psychological problems including depression, post traumatic stress disorder, social anxiety, and personality disorders. Sadly, Brett is not at all unusual in his response to early neglect. At 30, he now has to learn how to give himself the parenting he never had.

It’s often school professionals who first notice neglected kids. They come to school dirty, tired, hungry, and inappropriately clothed. They sometimes become a regular fixture in the nurse’s office, complaining of vague stomachaches and headaches. They often can’t concentrate in school and don’t do well. Some are withdrawn and depressed. Others are very, very angry and rebellious. Sometimes they substitute attitude for confidence. Frequently absent, they have little chance of keeping up with the curriculum. Unable to succeed, they stay away more and more. When the school calls the parents for a meeting, the parents seldom show up. When they do show up, they may be overwhelmed and incapable or defensive and angry.

Jordan’s teacher knows she should be more sympathetic. She admits with some shame that she’s relieved when he doesn’t come to school. When he does show up, he is usually dirty and oddly dressed. He smells. The other kids avoid him. Although he is 12, he is still in the fourth grade. Frequent absences mean he probably won’t get promoted this year either. Notes and calls to his parents get no response. Jordan is neglected.

Jenny, on the other hand, always has the latest clothes and the latest technology. Her teachers are very concerned because she is sexually provocative with peers and even with her male teachers. Her guidance counselor was able to have one briefly unguarded conversation with her. Hungry for love and attention, Jenny acknowledged that she goes after sex as a route to some kind of love. The counselor has called Jenny’s mother repeatedly to request a meeting. Mother says she is much too busy. “I put off my own life long enough,” says the mother. “She’s 15 now and she can take care of herself.” Jenny is neglected too.

Neglect is found at all levels of the economic spectrum. While some kids, like Jordan, suffer the dual burden of neglect and poverty, other children, like Jenny, have parents who have plenty of material resources. They are willing and able to provide material things but not enough care and concern.

Neglected children often are undetected both because they are less obviously hurting and because America has a tradition of respecting family privacy. Sadly, the end result is that neglected children are protected neither by their parents or their community.

If you suspect neglect is occurring to a child you know, it’s important to get involved. Report it to your local child protective services. Most will allow you to do so anonymously if you prefer. Generally, a report is followed up with an investigation. Despite the impression created by high-profile cases, it is rare that children are removed from their home. That only occurs in the most severe cases, when the child is at significant risk for harm. Even in those cases, removal is usually temporary, with placement with extended family being preferred to foster care.

Sometimes the best efforts to preserve the family fail and children are placed with foster families to keep them safe and to give them a chance for a better life. Whenever possible, though, the approach in most communities and states is to educate and support the parents and to monitor the children in the hope that their own family can become a safe and healthy one. Once provided with adequate services, many parents do improve.