Review Paper Treatment of Child Neglect: A Systematic Review

hild neglect is the most prevalent type of child maltreat-ment (1–3), yet it has often been overlooked in the litera-ture on child victimization. In the Canadian Incidence Study of Reported Child Abuse and Neglect, child neglect was the most common reason for child welfare investigations, accounting for 40 % of an estimated 135 573 maltreatment investigations in 1998 (1). The health and social sciences liter-ature does not reflect growing awareness of the prevalence and implications of child neglect: most studies continue to focus on sexual or physical abuse of children (4). Further, the existing research generally lacks methodological quality (4). This may in part be because child neglect is difficult to define and measure and there is no consensus regarding specific types of neglect. One commonly used approach to categoriza-Can J Psychiatry, Vol 50, No 8, July 2005 497 Objective: Child neglect is the most common type of child maltreatment. Our objective was to systematically evaluate the available evidence regarding the effectiveness of child neglect treatment programs, including those focused on victims of childhood neglect and (or) their caregivers. Method: We comprehensively searched the Medline, Psycinfo, and Eric databases from January 1980 to May 2003. Two authors independently reviewed 54 studies that met inclusion criteria. Fourteen articles met our design criterion and were assessed for their methodological quality according to guidelines developed by the US Preventive Services Task Force. Results: Of the 14 studies included in the review, 2 were rated as good, and 3 were rated as fair. We found evidence that 2 specific types of play therapy and a therapeutic day treatment program had beneficial effects for children. Further, parents and children in families where neglect had occurred showed improvement with multisystemic therapy. Conclusions: Rigorous studies of treatments for neglected children and their families are lacking. Well-designed and well-conducted evaluations are urgently required to identify effective treatments, which should then be made available to children and their caregivers