Although neglect is a common form of child maltreatment, it can be difficult to detect within a clinical interview between a social work clinician and client for the purpose of assessment and intervention, leading to a failure to act and secure a child’s safety. This Canadian study utilized the objective structured clinical exam (OSCE) to assess social work clinicians’ ability to recognize and respond to a case of suspected child neglect. Twenty-three participants (social work students, recent graduates of a Masters in Social Work programme, and experienced social workers) conducted a 15-minute interview with a standardized client followed by a structured reflective dialogue focusing on case conceptualization and emotional awareness. Qualitative analysis of the reflective dialogues revealed participants’ difficulty in detecting child neglect as opposed to focusing on a client’s negative self-beliefs or mental health issues. Implications for social work education and practice are suggested.