Understanding and responding to chronic neglect: A mixed methods case record examination

Neglect is the most prevalent form of maltreatment, and thus comprises the bulk of cases for Child Protective Service (CPS) agencies, yet it remains under-studied. Cases in which children experience repeated or "chronic" neglect are particularly concerning. A growing body of research indicates that the effects of chronic neglect create a harmful accumulation of problems for child well-being, including detrimental impact on early brain development, emotional regulation, and cognitive development. The aim of this retrospective case record review study was to examine risk and protective factors of chronic neglect and relevant CPS agency responses and practices. Results demonstrated that families experiencing chronic neglect had multiple significant stressors (four or more stressors for all families in this study), such as domestic violence, poverty, children with behavioral problems, and/or substance abuse, indicating chaotic and toxic living environments. Key implications are outlined for strengthening CPS response to cases of chronic neglect, including the need for comprehensive assessment of families, more effective and consistent use of standardized risk assessment tools, and better recognition of past patterns of neglect to mitigate the risk of accumulation of harm.