This study was an analysis of the way in which social workers made decisions about the disposition of child maltreatment cases—specifically about the pattern of interventions used in cases of neglect. The cases examined were written vignettes—brief fictional descriptions of possible practice situations. Each vignette was a randomly selected combination of values of eight variables, including maltreatment category (neglect, physical abuse, sexual abuse or emotional harm). Subjects were 118 child care workers; each was given three randomly selected vignettes (total N = 327), and asked to estimate risk level and consider practice options. A multiple regression analysis showed that maltreatment category had a statistically significant effect on worker’s decision-making. Risk estimates and practice options for cases of neglect or emotional harm were at a significantly lower level than for physical or sexual abuse. As earlier research has shown that child neglect may lead to major developmental deficits, this suggests that the decision-making process needs to be examined.