Clinical features of the neglected child:
(1) clinical and pathologic signs of advanced malnutrition (ketosis, steatosis despite absence of subcutaneous fat, thymic atrophy, etc)
(2) presence of other visible signs of illness (dehydration, skin rash, etc)
(3) poor hygiene
(4) exclusion of organic causes for malnutrition (metabolic disorder, malabsorption, etc).
Historical features:
(1) failure of the parent or guardian to bring an obviously ill child in for care
(2) inconsistencies in history
(3) abnormal family dynamics (poverty, poor education, etc)
Limitations:
• The mild degree of neglect can be easily missed.
• Abnormal family dynamics may not always be obvious. This can occur with wealthy or well-educated parents.
