In this paper, I suggest that one major effect of abuse and neglect is that children become less interested in other people, less able to care for others, and are thus less altruistic. I argue that the capacity to care for others ordinarily co-emerges with a swathe of other capacities such as the ability to understand other minds, to empathise, to play, to defer gratification and to manage peer relationships. However, in extreme situations such as child abuse and neglect, which might be seen as not ‘evolutionarily expectable’, such capacities do not necessarily come online. These ideas are illustrated using developmental and neuroscience research, and clinical examples.