Recently, Dr. Julie M. Linton met with a young mother and her 10-year-old son, who’d been reunited after being separated at the U.S.-Mexico border by federal immigration authorities.
The mother and child had fled violence from a Northern Triangle country (Guatemala, Honduras and El Salvador) and endured a perilous journey of thousands of miles to seek asylum in the U.S. During her clinical encounter with the woman and her boy, the pediatrician asked if they’d been separated. Her question was met with agonizing silence.
The mom started to shake. Tears welled in the boy’s eyes. Finally, the mother whispered, “Seven days,” Linton says. She’s co-chair of the American Academy of Pediatrics Council on Community Pediatrics Immigrant Health Special Interest Group. The dramatic reaction by the young mom and her son shows the deep emotional and mental harm caused by even relatively brief forced separations, distress that won’t be erased when and if parent and child are reunited, Linton and other experts say. “It was chilling,” Linton says. “To see this kind of psychological reaction to a seven-day separation makes me worry about the short-term and long-term effects on the health of this child and his mother.” The episode illustrates that simply reunifying migrant kids with their parents doesn’t mean all will suddenly be well between parent and child, Linton says. Dealing with the damage created by forced separations will take some work.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
The trauma of being forcibly separated from a parent or parents makes children more susceptible to toxic stress — a response that can occur when a child experiences strong, frequent and/or prolonged adversity, according to the Center on the Developing Child at Harvard University. Chronic neglect, exposure to violence and the burdens of family economic hardship can trigger toxic stress. So too can being ripped away from your parent or parents without explanation and placed in a government holding facility or shelter to be cared for by strangers, Linton says. Confusion surrounding the sudden separation exacerbates the kids’ distress, says Dr. Nathalie Quion, a pediatrician with Children’s National Health System in the District of Columbia. “The children don’t understand why the parents are gone and not present while they’re in a detention center with other children who are also experiencing isolation and parental separation,” Quion says.
In addition to the boy Linton worked with, thousands of migrant children and their parents face the consequences of toxic stress after being separated by the Trump administration as part of the “zero tolerance” policy launched in the spring.
Exposure to toxic stress can lead to an array of health problems for children:
— Regression in language skills and toilet training
— Depression and anxiety
— Difficulty regulating emotions
— Challenges in making and maintaining long-term relationships
— Difficulty concentrating, which makes it hard to learn in school
Under the Trump administration initiative unveiled in the spring that put thousands of migrant children at risk for these health issues, federal authorities incarcerated and prosecuted adults who crossed the southern border without the proper documentation, rather than simply sending them back. In carrying out the policy, U.S. officials separated more than 2,500 children from their parents, according to court papers filed by Trump administration officials. Some migrant parents told journalists that federal authorities took their children without explanation or claimed they were taking the child away for a bath and would bring him or her back shortly. In late June, a federal judge in California ordered the administration to stop separating kids from their parents and to reunite those who officials had already pulled apart. As of Aug. 10, the government had reunited more than 1,900 migrant children with their parents, according to The Washington Post. More than 550 children remained separated from their parents.
Federal authorities have separated 103 migrant children under the age of 5 from their parents, according to court papers filed in connection with a lawsuit filed by the American Civil Liberties Union in federal court in San Diego against the Trump administration’s zero tolerance policy.
Children in that age group are particularly susceptible to reacting in ways that unnerve their parents when they’re reunited — such as behaving as if they don’t remember their mother or father. A handful of migrant parents recently told The New York Times their toddlers didn’t recognize them. One woman said her 3-year-old daughter cried out and tried to squirm away as she hugged her.
[See: 8 Unexpected Signs You’re Stressed.]
While it may appear that some younger kids don’t recognize their parents when they’re reunited, that’s not what’s going on, says Dr. Alan Shapiro, medical director and co-founder of Terra Firma, a New York City-based group that promotes the well-being of immigrant children through direct services and advocacy. “What we are seeing here is the effects of acute trauma on the children,” Shapiro says. “It is not that they don’t recognize their parent; it is that they have been acutely traumatized by the separation and now are confused and disoriented by what has happened to them. We must remember that these are children who have already been exposed to so much even before arriving to the U.S. They might even be displaying anger; cognitively and developmentally they don’t understand why ‘mommy didn’t protect me.’ You can imagine how devastating this is to a parent.”
Dr. Gilbert Kliman, medical director of the Children’s Psychological Health Center Inc. in San Francisco, agrees. The nonprofit is dedicated to helping children suffering from traumatic experiences, autism spectrum disorders, developmental disabilities and serious emotional disturbances. Assuming that kids who behave indifferently or as if they’re afraid when they’re reunited with a parent is because they no longer remember their mother or father after a forced separation is a misunderstanding, Kliman says. “I think what’s being observed is the difficulty these children have in fundamentally trusting the parent,” he says. “It’s difficult for children, especially very young kids to make eye contact and have intimate interpersonal transactions with someone they feel has betrayed them.” Many of the migrant children separated from their parents are too young to understand their mother or father completed an arduous, treacherous journey north to the border to try to protect them and had no control over the separation, Kliman says.
Kliman and other mental health practitioners are volunteering to meet with asylum-seeking mothers and children who were separated and then reunited. Kliman and five other mental health professionals examined 17 mothers and met with 17 children of those moms. “We were able to give psychometric measures to the mothers, and they all had objective signs of post-traumatic stress disorder,” he says. It’s not surprising the women were showing signs of PTSD, because they fled gang and domestic violence and governmental persecution and endured a dangerous journey to get to the border, only to experience more trauma by being forcibly separated from their children by U.S. authorities. The children ranged in age, from 3 to 17.
Some young kids who don’t see a parent for weeks or months at a time because the parent goes away on a business trip or a military deployment, for example, may also feel abandoned, Kliman says. However, the chances that such kids would develop feelings of abandonment are much lower than the odds that a child suddenly taken from a parent would, he says. “It’s much more likely to happen in confusing circumstances where the child’s taken care for by strangers after being taken from a parent with no explanation,” Kliman says. Preparing kids for long-term parental absences can help mitigate their anxieties, he says.
Similarly, when reuniting children with parents after a forced separation, it’s important to prepare them for seeing their parent again, says Joyanna Silberg, a psychologist and senior consultant for child and adolescent trauma at Sheppard Pratt Health System, based in Baltimore. She wrote the book “The Child Survivor: Healing Developmental Trauma and Dissociation.”
“You don’t want another ‘grab them and take them away’ situation,” she says. Ideally, a caretaker who the child has developed an attachment with during his or her separation from a parent would inform the boy or girl of an imminent parental reunion. The caretaker could say something like, “Mommy had to leave, but mommy’s coming back,” Silberg says. To mitigate the damage caused by the forced separation, the mother and child should, together, see a therapist trained in early attachment, Silberg says. A forced separation interrupts the physiological attunement that’s part of the attachment between a parent and a young child. Examples of physiological attunement would be a child reaching out his or her arms and a parent responding by picking him or her up or a toddler smiling at a mom who smiles back, Silberg says.
[See: 10 Things Pediatricians Advise That Parents Ignore — and Really Shouldn’t.]
Through talking and using games, a therapist trained in early attachment issues can help a child and parent redevelop their physiological attunement, she says. “It’s just so confusing for a child to have suddenly lost the anchor of [his or her] life,” Silberg says. “When the child and parent are reunited, the child may not think the mother or father is the anchor anymore. So that connection has to be built back.”
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Reunited Migrant Children and Parents Face Health Challenges originally appeared on usnews.com
