Children were left malnourished, infested with head lice and living in squalor surrounded by animal waste because their parents were able to play the authorities off one another, an inquiry has found.
Teachers, doctors, health professionals and social workers were all aware of the family but no formal action was taken until one of the children was admitted to hospital with severe nappy rash.
There were five "missed opportunities" by the authorities to intervene earlier because neglect was not treated as seriously as other forms of abuse, a serious case review found.
The family had been known to the authorities in Gloucestershire for 16 years with teachers, doctors, health professionals and social workers all in contact with them.
During that time there were numerous visits to GPs and complaints from teachers and health workers to social services about the state of the children.
They were found to be suffering with tooth decay, head lice, poor growth and weight gain, delayed development, anaemia, poor hygiene and severe nappy rash.
There were also concerns about missed health appointments, failures to immunise then, failures to use prescribed medication, poor school attendance and non-compliance with health professionals.
The review, which was commissioned by the county's safeguarding children board, said there were 127 recorded contacts made between the family and primary health care professionals over a 27-month period.
Over the years there were numerous notes made about the condition of the house - with it being dirty, untidy and smelling of faeces.
The review found there was ongoing evidence that the parents often turned away health professionals from their home and the mother prioritised her own needs over the children.
Even the children's grandmother admitted her daughter was "manipulative and aggressive" and very controlling. GPs noted she was "skilled at playing off one agency against the other".
The serious case review said the parents successfully avoided health and medical professionals, meaning the children were subjected to further neglect and harm.
"One of the most concerning issues in this case is the apparent lack of understanding, at the time, of neglect and its impact by a number of the key professionals working with this family," the report said.
"All of the signs were there, and had been for many years, that these children were suffering or likely to suffer significant harm due to neglect.
"At the time there were clear difficulties in ensuring that all of the information on all of the children was available to be considered and drawn together in order to ensure a complete picture.
"A child protection conference would have allowed all the professionals involved to share the history of the family and the current concerns in a setting chaired by an independent person, where the parents could not have decided who was involved and who was not."
A police investigation was launched after one child was admitted to hospital in November last year with severe nappy rash.
The children's parents were jailed at Gloucester Crown Court after neglecting five of their children between 2007 and 2012. The parents, who cannot be named for legal reasons, admitted five counts of neglect of the children.
The mother was jailed for two years and nine months, while her husband received a two-year prison term.
The children were removed from the parents prior to their jailing, with some placed with foster carers and others with family members.
The serious case review made a series of recommendations to the authorities in the county.
David McCallum, chair of Gloucestershire Safeguarding Children Board, said the authorities involved had underestimated the impact of long-term neglect.
"There was really long-term, chronic and serious neglect," he said.
"For most of the time when children's social care and other agencies were working with this family, they treated the neglect as a 'child in need' issue and that probably underestimated the extent of the harm those children were suffering.
"One of the real points of learning for all the organisations involved is that neglect can be really, really harmful to children, especially when it's long-term."
Mr McCallum said this type of case could happen again "because neglect is a really challenging area of work".
"Another factor present in this case, to be frank, the parents were concealing the neglect the children were suffering," he said.
"I have worked in safeguarding for many years and if you go back to Victoria Climbie and before that, these are some of the most difficult issues all the time and we need that constant, relentless focus on, if we are going to avoid this happening in the future."