Evidence of Neglect from Immature Human Skeletal Remains: An Auxological Approach from Bones and Teeth

Abstract

Child neglect is the most common form of child maltreatment and failure to thrive is one of its most common manifestations. Although growth failure has many etiologies, recognizing it is very important in aiding the identification of neglect in living children and in fatality cases, particularly in the detection of severe malnutrition. Although the forensic anthropologist may deal with a fatal case of child neglect, the assessment of growth failure from osteological observations is considerably limited. The expert relies on the assessment of dental and skeletal growth and development for the estimation of age and the assessment of growth failure. Although dental development is susceptible to environmental insults, such as malnutrition, it is more stable than skeletal growth and maturation, which is more susceptible. This chapter cautions the use of dental development for age estimation in suspected cases of child neglect and offers two general approaches for the detection of growth failure from observations in bone and teeth. One approach relies on comparing height estimates and long bone lengths to sex and age-specific references of height and long bone length, while the other relies on assessing the discrepancy between dental and skeletal age. A sample of identified Portuguese human immature skeletons is used to illustrate the consistency of results between the two approaches. Although an auxological approach to the study of bones and teeth can provide important insights into the growth status of individuals represented by their hard tissues, it cannot be definite about the diagnosis of malnutrition and, particularly, neglect as the cause of the child's death.