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Volume 10 Issue 4   December 2007

Developmental Problems of Maltreated Children and Early Intervention Options:
Literature Review

by Mary Zaremba

Part 1


An integrated literature review of the developmental problems identified in maltreated children, as well as options for intervention was completed by a team of authors; Crystal Wiggens, Emily Fenichel, and Tammy Mann, from Zero to Three, and submitted to the Office of the Assistant Secretary for Planning and Evaluation Services, U.S. Department of Health and Human Services, April 23, 2007. The goal of the paper was to describe the most prevalent problems experienced by maltreated infants and toddlers and benefits of early intervention for these children. As a result, the child welfare personnel and policymakers involved in the assessing and advocating for these maltreated Child children would be more informed about their needs.

The following is a mere slice of all the information found in the 27 page paper. Part 1 lists key findings from a wide review of literature related to the identification of developmental problems found in children under three who have been maltreated. The first section of the paper, Health, Growth, Motor Delays, and Compromised Physiological Systems cited the following in maltreated children:

  • acute and chronic health problems (22% – 80%)
  • failure to thrive (11%)
  • overall growth delays (20%)
  • gross and fine motor delays (4 – 47%)

Please note: wide ranges in incidence rates are a result of different methodologies used to determine extent of delays. Interestingly, information from studies note that medical problems and growth delays are not only a result of, but also risks for maltreatment.

A variety of cognitive, social, emotional (including attachment relationships) and communication problems are summarized in the report. Some of these include:

  • cognitive delays (23% – 65%)
  • speech and language delays (14% – 64%
  • poor emotional comprehension
  • increased expression of negative emotion

In addition to the aforementioned developmental areas, the paper summarizes actual “diagnosable mental health difficulties” identified in maltreated infants and toddlers:

  • Demonstration of externalizing problems such as aggression and oppositional behaviors (14 – 37%)
  • Regulatory Disorders (22%)
  • Post Traumatic Stress Disorder (7%)
  • Internalizing problems such as: depression, anxiety, somatic complaints (11%)

FamilyWhile a certain percentage of maltreated children demonstrate “poor developmental outcomes,” what about the others? Some maltreated children seem to show “academic, emotional, and behavioral resiliency” depending upon the protective factors in their lives. However, research indicates that there are other factors that weigh heavily on a child’s ability to thrive, regardless of the number of protective factors around them. Those other factors are; “low cognitive stimulation, poor parental education, parental psychopathology, low socio-economic status (SES), poor nutrition, insufficient healthcare, and pre-existing disabilities.” These factors combine to further compromise the development of these children.
Part 2 of this paper that addresses the early intervention options for maltreated children will be available in the March 2008 issue of Updates.