27 J.E. Korbin and R.D. Krugman (eds.), Handbook of Child Maltreatment, Child Maltreatment 2,
DOI 10.1007/978-94-007-7208-3_2, © Springer Science+Business Media Dordrecht 2014
Neglect is the most common and most frequently fatal form of child maltreatment, yet it continues to
garner less attention than abuse in terms of research, financial allocation, policy initiatives, and public
awareness. Child neglect poses unique challenges to researchers and policymakers, due in part to the
inherent difficulties in reaching consensus on how best to define, understand, and respond to a hetero-
geneous, multiply-determined phenomenon that typically occurs not as a result of what adults do, but
what they fail to do. Even more so than physical, sexual, and emotional abuse, child neglect dispro-
portionately affects the poorest families and occurs on a continuum with no clear cut points. It tends
to be chronic rather than episodic, frequently does not result in immediate harm to the child, and
mostly lacks evidence of malicious intent. Three decades have passed since researchers first raised
the alarm regarding the “neglect of neglect” (Wolock and Horowitz 1984), which referred to the lack
of attention paid to neglect relative to abuse, despite evidence that it is far more common and just as
harmful. In the intervening years, the importance of child neglect has been acknowledged both by
researchers, who have produced a small but growing body of evidence on causes, consequences, and
interventions (Kotch et al. 2008; Mills et al. 2011; Dubowitz et al. 2002; Chaffin et al. 2012; Slack
et al. 2011), and by advocates and policy makers, who have made important advances in how we
conceptualize and respond to this problem (Kaplan et al. 2009). There is no question that research,
policy, and advocacy focusing specifically on child neglect have led to advances in recent years.
However, it is still disproportionately understudied relative to physical and sexual abuse, given its
high prevalence and deleterious impact on the child (Dubowitz 1994; Chaffin 2006). Furthermore,
key areas of disagreement continue to hamper our knowledge and practice regarding child neglect.
Chapter 2
Child Neglect: Challenges and Controversies
Laura J. Proctor and Howard Dubowitz
L.J. Proctor, Ph.D. (*)
Judge Baker Children’s Center, Harvard Medical School, 53 Parker Hill Avenue, Boston, MA 02120, USA
e-mail: lproctor@jbcc.harvard.edu
H. Dubowitz, MB.Ch.B, MS, FAAP
Division of Child Protection Department of Pediatrics, University of Maryland School of Medicine,
University of Maryland Medical Center, 520 W. Lombard Street, Baltimore, MD 21201, USA
e-mail: hdubowitz@peds.umaryland.edu