Child neglect involves a consistent failure to meet a child’s basic physical, medical, supervisory, emotional, or educational needs. Research overwhelmingly shows neglect impedes development in cognitive skills, self-regulation, learning, mental and physical health, and relationships.
These impacts arise from the absence of essential stimulation and nurturing during sensitive brain growth periods. Children affected struggle with disruptive behaviors, depression, attachment issues, and chronic diseases extending into adulthood.
This review aimed to identify any interventions used to help children recover from the negative sequelae ofneglect in any of its forms. It was hoped this would shed light on possible mechanisms leading to recovery and inform a theory of change to support the development and use of interventions.
Key Points
Rationale
Child neglect has severe emotional, physical, cognitive, and social consequences, requiring major public health focus (Jackson et al., 2022; Krug et al., 2002).
However, past reviews found gaps in research testing interventions to help children after neglect, compared to prevention studies (Allin et al., 2005; Taussig et al., 2013).
Additionally, neglected children frequently experience other adversities like poverty, parental mental illness, or abuse. Disentangling specific developmental pathways requires considering the timing and interactions of cumulative risks (Lanier et al., 2018).
Trauma from chronic neglect may also show different brain patterns compared to acute violence (Lim et al., 2022).
This systematic review revisited the state of knowledge on existing or emerging efforts to support children following neglect, to elucidate ideas toward a theory of change.
The premise was understanding causal mechanisms behind children’s difficulties can optimize targets and techniques in interventions (Bush et al., 2016; Center on the Developing Child, 2016).
Understanding complex pathways to functional impairments is essential to build evidence-based recovery approaches for this prevalent child welfare challenge.
Both social justice and economic arguments compel investing in research and services focused on ameliorating neglect’s marked human and societal costs.
Method
Thissystematic reviewfollowedPRISMA guidelines(Preferred Reporting Items for Systematic Review and Meta-Analysis Statement) (Page et al., 2021), registering its protocol publicly.
The final search occurred in May 2022, with 3897 initial records distilled down to 8 reports meeting all inclusion criteria through a systematic screening process involving multiple independent coders.
Five key databases were searched for English studies from 2003-2022 reporting interventions and child outcomes after neglect.
Search Terms
Databases
Inclusion criteria
Exclusion criteria
Sample
Samples ranged from 10 kindergarteners (Pino et al., 2019) to 351 youths (Scivoletto et al., 2011) in Brazil. Most were young, vulnerable children in foster care or institutions.
Neglect definitions varied, frequently lacking detail on subtypes.
Results
Bucharest Early Intervention Program (BEIP)– 3 studies
Attachment and Biobehavioral Catchup (ABC)– 1 study
The Equilibrium Project (TEP)– 1 study
Fostering Healthy Futures (FHF)– 1 study
Incredible Years (IY) and Collaborative Co-Parenting– 1 study
Say-Do-Say Correspondence Training– 1 study
Insight
The review confirms an alarming gap in quality research on interventions to help children overcome developmental, emotional, relational, and other harms from neglect.
Very few studies exist that test ways to help children recover from neglect. However, early findings suggest things like high-quality foster care, attachment coaching for parents, intense support services, and simple behavior skills training show some benefits.
What’s missing is research that tracks different types of neglect and other hardships these children face. Understanding these differences can help match the best help to the specific needs.
Strengths
Limitations
Implications
Findings provide a rationale to continue studies on enriched caregiving, neurobiology-informed interventions, tailored community approaches, and simple behavioral modification following neglect. The key will be parsing impacts and mechanisms specific to neglect subtypes and co-occurring adversities.
Involving communities in participatory research can optimize the cultural relevance of interventions with marginalized groups.
References
Primary reference
Jackson, A. L., Frederico, M., Cleak, H., & Perry, B. D. (2023).Interventions to Support Children’s Recovery From Neglect– A Systematic Review.Child Maltreatment, 0(0), 1-14.https://doi.org/10.1177/10775595231171617
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
