Home > Acts of Omission: An Overview of Child Neglect > Acts of Omission: An Overview of Child Neglect: Interventions

Acts of Omission : An Overview of Child Neglect
Bulletin for Professionals

Author(s):  Child Welfare Information Gateway

Year Published:  2001

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You are in section: Table of Contents 1 - How big is the problem? 2 - What is neglect? 3 - Selected issues 4 - What are the characteristics of… 5 - What are the consequences of… 6 - Interventions 7 - Research 8 - Summary and conclusion References Endnotes

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Interventions

"Neglect" is a complicated issue that poses significant challenges to treatment providers. Reviews of intervention programs designed to treat neglecting families have indicated that these programs have had difficulty achieving desirable outcomes (Gaudin, 1993). The interventions that did have some success addressed problems individually, were long-term, and delivered a broad range of services (Ethier, et al., 2000; Gaudin, 1993). The severity of the families' problems was the most powerful predictor of outcome; the more severe the problems, the less likely the families were to achieve the targeted outcomes (Gaudin, 1993).

These issues are discussed in Child Neglect: A Guide for Intervention⁸ (Gaudin, 1993). Gaudin states that assessments should look at the individual personality of parents, family systems issues, and community stressors and resources. Interventions then should be tailored to the type of neglect and to information gleaned from the assessment. His recommendations for practitioners include:

• Assume that parents want to improve the quality of care for their children.
• Identify and reinforce hidden strengths and build interventions upon them.
• Be culturally sensitive. Tatara (1995) emphasizes that cultural misperceptions can lead either to overinclusion (identifying a behavior as risky when in fact the risk is low) or underinclusion (ignoring a situation when intervention is really needed).
• Do not generalize families; each family is unique.
• Build parental feelings of self-esteem, hope, and self-sufficiency; do not foster dysfunctional dependency.
• Clearly outline service plans and use case management to broker formal and informal services.
• Set clearly stated, limited, achievable goals that are agreed upon by parents and children; systematically reinforce the parents' incremental steps.
• Use legal authority as a last resort.

Recent research also suggests that programs should actively seek out fathers or father figures and engage them in the interventions (Dubowitz, Black, Kerr, Starr & Harrington, 2000).

Gaudin (1993) also discusses aspects of various interventions. Interventions generally include some level of home visitation; in some cases, daily contact may be needed to monitor a child's safety, preserve a family and prevent removal of a child into foster care. Interventions can range from short-term crisis intervention to long-term support and stabilization to removal of children from their families for their protection. Family-focused interventions include all family members, not just the alleged child victim and parent perpetrator.

Interventions are not limited to families and children; they can target societal conditions as well, such as unemployment, lack of medical care, and poor housing. Some researchers feel that improvements in these societal conditions may well result in a lower rate of neglect. Waldfogel (2000, September) (citing Paxson and Waldfogel, 1999) suggests that higher welfare benefits may be correlated with fewer families being reported for neglect and fewer children being placed in foster care.

Child Protective Services (CPS)
Within the child welfare system, CPS offices usually are the first to respond to reports of child neglect.⁹ In general, the system works in the following manner. A report is received about suspected child neglect. If the information meets the threshold for what constitutes neglect in that particular jurisdiction, the report is referred for an investigation. CPS staff have legal authority to investigate the allegation. The investigator speaks with relevant parties in order to determine whether or not the child has, in fact, been neglected, and whether or not the child is still at risk of harm. If neglect is found and the child is still at risk, the child and family may be referred for services. In severe or high-risk cases, the court may order that the child be removed from his or her caretaker and placed with a relative or foster family while services are provided. Whether or not the child is removed, associated services (such as parenting skills classes for the parent and counseling for the child) may be provided by programs within the child welfare agency or by community-based agencies. In general, if the child has been removed, he or she will not be returned to the family unless and until the court determines that the family can provide a safe and stable environment. If the child has remained at home during the provision of services, the family's participation may be voluntary, and many factors may play a role in the length of service and the decision to terminate services. These factors include the family's wishes, the programs' guidelines, and the availability of insurance or payment for the services.

CPS-Problems and Reform Efforts. While the CPS system provides critical first-response services to children reported for neglect, some researchers and practitioners believe that in its current state, the response is not adequate for many families reported for neglect. Reports of child neglect (compared to physical or sexual abuse) are least likely to meet the threshold for investigation or intervention, resulting in many neglected children not being eligible for any CPS services (English, 1999). In addition, a sole reliance on an authoritative, investigative response is not necessarily appropriate for many families (English, Wingard, Marshall, Orme, & Orme, 2000), but in most jurisdictions, this is the only means of entry to the child welfare system.

To address these and other problems, some CPS systems have implemented a "multi-track" response system in which reports of child maltreatment determined to be low-risk (which includes many neglect reports) are referred for an "assessment" rather than an investigation. This response is generally voluntary and, compared to an investigative response, uses a more holistic approach and is more likely to use community-based agencies to provide services.

It remains to be seen whether or not multi-track response systems are effective. Important issues still to be addressed are

• What criteria are used to differentiate high-risk reports that are referred for investigation versus low-risk reports that are referred for assessment (English, 1999)?
• Do families referred for voluntary assessments follow through with recommendations for services (English, et al., 2000)?
• Does this alternative response adequately address the safety needs of the children involved (English, 1999)?

While these answers are still unclear, it is encouraging that some CPS systems are exploring alternative responses to better serve families in need.

Promising Practices
As mentioned earlier, intervention programs serving neglecting families face numerous challenges. But there are programs that show promise in addressing and treating child neglect. The following sections describe two such projects.

The Chronic Neglect Project St. Louis, Missouri, Division of Family Services (DFS). Recognizing the challenges in effectively serving chronically neglecting families, the St. Louis, Missouri, DFS established a Chronic Neglect Program in 1997 in which staff receive training to recognize and treat chronic neglect.¹⁰ This program examines patterns of behavior, rather than individual incidents, when determining whether or not to intervene to protect a child. A Child Neglect Specialist is available to provide consultation to the staff.

The program emphasizes the empowerment of the family so the family takes ownership of their needs and solutions. Some of the outcomes the program strives to achieve include:

• Significant improvement in parental behavior
• Clear indication of bonding between the parent and child
• A home free of safety hazards
• For children who experienced medical problems as a result of the neglect, documented improvement in their physical development.

The program also emphasizes lasting change; its guidelines state that improvements must have been maintained for at least six months before closing a case to minimize the chance for a re-occurrence (Missouri Division of Family Services, n.d.).

Family Connections Program, University of Maryland at Baltimore. Family Connections is one of a number of Child Neglect Demonstration Programs funded in 1996 by a 5-year grant from the Children's Bureau of the U.S. Department of Health and Human Services. This program combines services with education and research.¹¹ Some of the principles of Family Connections include providing individual assessments and services tailored to the needs of each family, developing partnerships with all family members, empowering family members to have control over their own lives, and delivering culturally competent interventions geared to achieve targeted outcomes. Some of the targeted outcomes include

• The family's ability to meet basic needs
• The parents' abilities to cope with daily stresses and achieve self-sufficiency
• The children's demonstration of developmentally appropriate functioning
• The family's ability to mobilize resources and constructively resolve family conflicts
• The family's effective use of social supports
• The parents' (and/or caregivers') demonstration of appropriate attitudes and skills related to the children's needs.

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You are in section: Table of Contents 1 - How big is the problem? 2 - What is neglect? 3 - Selected issues 4 - What are the characteristics of… 5 - What are the consequences of… 6 - Interventions 7 - Research 8 - Summary and conclusion References Endnotes

next

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Updated on October 9, 2009