case study - Reading
Topic: Family Separation
Students will evaluate the quality of scientific information and analyze the connection of scientific research and application to personal, social or ethical issues in the modern world (i.e., Early Intervention, Environmental Sustainability and/or Social Justice).
Resources are attached:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112822/
SPED 620 Early Intervention Critical Analysis Case Study Guidelines
Case studies of current issues pertaining to early development and intervention will be presented throughout the semester (e.g., Lead Poisoning, The Opioid Crisis, Zika Virus, Family Separation, COVID-19). Students will read/view a variety of different sources (e.g. research articles, newspaper articles, podcasts, videos, etc.) and engage in discussion/activities about each assigned topic.
Students will evaluate the quality of scientific information and analyze the connection of scientific research and application to personal, social or ethical issues in the modern world (i.e., Early Intervention, Environmental Sustainability and/or Social Justice).
Papers should be 3 pages in length, using APA format. Students can earn up to 30 points each paper, per the following:
Summary of Topic - 5 points (approximately 1 page)
· Provide a brief summary of the environmental risk factor (i.e., the topic): 2 points
· Explain what the impact is on perinatal and early development: 2 points
· Describe any treatment or other recommendations: 1 point
Critique of Current Scientific Evidence - 10 points (approximately 1 page)
· Briefly review the current research on the topic; what are the major findings?: 2 points
· Provide your own analysis of the quality of the existing research; what are the strengths and weaknesses?: 5 points
· Share your recommendations for future studies; what are the priorities?: 3 points
Application and Reflection - 10 points (approximately 1 page)
· Apply the information about the topic to the field of Early Intervention; what is the impact on young children and families?: 4 points
· Reflect individually on what you’ve learned; what are the personal, social and ethical issues this topic raises for you?: 3 points
· What are the implications for the field of Early Intervention, policy-makers, global leaders, etc.?: 3 points
Format and Proofread - 5 points
· 3-4 double-spaced pages: 1 point
· APA format, including in-text citations and reference page: 2 points
· Written in a professional manner and is thoroughly edited: 2 points
Awesome Student #1
Case Study Critique: Zika Virus
September 25, 2018
Zika Virus
There is a virus first discovered in 1947 in a Ugandan forest that can cause birth defects
in child born of those infected. Does this statement cause alarm? What about if you
learned that that the cause of that same virus is found in 124 locations in your home
state? That takes it closer to home. These facts are about the Zika Virus. It is transmitted
through the Aedes aegypti mosquito and was first seen in Uganda in 1947. It can also be
passed through pregnant women to their fetuses, which can lead to birth defects and
microcephaly. Another less common transmission is from intercourse with those infected.
The virus can affect those infected for three weeks and although the virus can be so life
altering, only 20\% of those infected show any symptoms. The most common symptoms
are fever, rashes, and red eyes (“Zika Virus,” 2017).
Although the virus was not discussed in previous years, the spread of Zika to
South America led to a buzz in the Americas. The first case of Zika virus was shown in
Brazil. This is the reason for more concern now that more cases are seen and the virus
continues to spread throughout South America, Central America, and the Caribbean. The
first cases reported in the U.S. were in Florida in July 2016 and in Texas in November
2016. This was once seen as an issue that didn’t affect the States, but the U.S. is
discovering more cases, with 124 virus-carrying mosquitos in California (Dellabella,
2018). Little is known about the virus even with this increased concern and many years of
Zika existing.
The current research is limited and lacks in substantial details on the Zika Virus;
although, this virus can deliver severe impacts on a child’s early learning and
development. There is even a possibility of pregnancy loss in humans. A study was done
on monkeys infected in a laboratory in early pregnancy and “fetal death in utero occurred
in more than one-fourth” of these subjects (“Pregnancy Loss Occurs,” 2018). This is a
large number and alarming because humans are so similar to monkeys. The same article
reports “a 5.8 percent miscarriage rate and a 1.8 percent stillbirth rate in a cohort of
pregnant women with symptomatic Zika virus infection in French Guiana, Guadalupe or
Martinique.” This is tragic for those mothers who cannot escape the “Zika zones”
(“Pregnancy Loss Occurs,” 2018). More research is needed to discover why some babies
pass away in the womb and others don’t. Also, why some pregnancies of those infected
lead to birth defects and some are spared.
A crucial piece to this Zika puzzle is missing: there is no known cure or vaccine
for the virus. Even though those infected have the illness for a few weeks, a vaccine
would be beneficial to stop the spreading of Zika and to avoid having children being born
with major setbacks passed from their infected mothers. There has been much talk over
the delivery of a vaccine and a new study shows the beginning of human trials. The
National Institute of Allergy and Infectious Diseases (NIAID) has surveyed the genes of
the virus and administered the created vaccine to 28 non-pregnant human adults. Testing
in monkeys with this same process has shown success; however, human adults could
have a different reaction. The trials for this specific study will last a year and should
provide critical information towards a functional vaccine (“NIH Begins Clinical Trial,”
2018).
The fact that there is no vaccine available to the public is a huge hole in the
current research on Zika Virus. Many dates have been given as for when a vaccine would
be developed, but instead of making promises to calm the public, more funding should be
directed on research in this field. The lack of articles and studies involving a cure or
vaccine for Zika is alarming.
The topic of Zika Virus comes up in different personal, social, and ethical ways.
The news articles are leading with fear and scare tactics. With one NBC news article
reporting that “Zika Virus is Scarier than we thought” (NBC News, 2016). At which level
were different groups in varies countries and even between cities in those countries,
concerned? How can the news report an increase in fear on the whole population of those
effected?
The topic even is displayed in pop culture and in regards to celebrities that are
loved by their fans. An article discusses the fear for Meghan Markle and her new husband
traveling to Tonga and Fiji. The public is not involved with their plans to procreate yet
they are trying to provide a warning for them (Hallemann, 2018). The virus discussion
was even linked with the news of John McCain passing from brain cancer. The
beginnings of tests done on mice in a laboratory have used the “virus to target and
destroy glioblastoma cells in mouse brains” (Mundell, 2018). The next stage of research
should be if that process in humans would kill wanted brain cells. This type of research is
in the extremely early stages and the research on Zika linked with brain cancer is a new
topic. Why is this only being talked about after the death of a celebrity?
With the virus hitting closer to home, the main focus should be on spreading
education and facts while aiming to prevent babies born with birth defects. The babies do
not only need extra care immediately after birth, but will need aid throughout their entire
lives. Many politicians are seen trying to minimize Zika itself while the news tries to do
the opposite. With Florida being the first known case in the U.S. and Miami bringing in
so many tourists, the mayor of Miami tried to do damage control, denying the claim that
there is a cluster of reported infections from non-traveling people (CBS News, 2016). If
the numbers are not being correctly reported or confusing messages are being sent, how
can more action take place? In the same video, the reporter said that women in the “Zika
zone” need to avoid these areas. How can a pregnant woman who lives in these cities
leave? What does covering themselves with bug spray, like the news advises, do long
term? Worrying about the virus is also not healthy on an expecting mother and for her
child in the womb. One Wynwood, FL mother-to-be said “it’s going through my mind
24/7” (CBS News, 2016). Chronic stress can lead to a premature birth or other
complications with the growing child. At the end of this clip, the reporter states that
a new study came out saying “Zika can affect adult brains when it comes to memory
and learning” (CBS News, 2016). This is the end of the video and CBS leaves viewers
with this to dwell upon. The news presents whatever they have, even if it’s barely
anything substantial.
The main point is that even if a Zika-carrying mosquito is not in my backyard,
I have access to information about the virus and have the education on how it can
possibly affect a pregnancy (short-term AND long-term). What can be done about
those who are not able to receive this kind of education? What about those that do
not have air conditioning, screens over their windows, or the realistic possibility of
being rid of built up water near their homes? Where are the developments to solve
these issues? In the extensive research I have done, I did not find any information
about this. That is where it hits home for me.
References
CBS News. (2016, August 19). [Video file]. Retrieved from
https://www.cbsnews.com/news/zika-virus-florida-new-cluster-of-locally-
transmitted-cases-reported-in-miami-beach/
Dellabella, H. (2018, September 14). Threat of Zika Virus Still Significant in California.
Retrieved from https://www.infectiousdiseaseadvisor.com/zika-virus/zika-travel-
transmission-united-states/article/795174/
Hallemann, C. (2018, September 13). Why People Are Talking About Prince Harry,
Meghan Markle, and Zika Right Now. Retrieved from
https://www.townandcountrymag.com/society/tradition/a23104850/prince-harry-
meghan-markle-zika-royal-tour/
Mundell, E. (2018, September 18). Could the Zika virus fight the brain cancer that killed
john McCain? Retrieved from https://medicalxpress.com/news/2018-09-team-
zika-vaccine-brain-cancer.html
NBC News. (2016, April 11). [Video File]. Retrieved from
https://www.nbcnews.com/nightly-news/video/cdc-zika-virus-is-scarier-
than-we-initially-thought-663771715985?v=railb&
NIH Begins Clinical Trial of Live, Attenuated Zika Vaccine. (2018, August 16).
Retrieved from https://www.niaid.nih.gov/news-events/nih-begins-clinical-trial-
live-attenuated-zika-vaccine
Pregnancy Loss Occurs in 26 Percent of Zika-Infected Monkeys. (2018, July 2).
Retrieved from https://www.niaid.nih.gov/news-events/pregnancy-loss-occurs-26-
percent-zika-infected-monkeys
Zika Virus. (2017, September 8). Retrieved from https://www.niaid.nih.gov/diseases-
conditions/zika-virus
Case Study #1: The ZikV Virus
Awesome Student #2
9/25/18
The ZikV Virus was first found in humans in Uganda in 1952, and can be
transmitted through a variety of ways, including mosquito bites, sexual contact or passed
from a pregnant mother to their child. What is known as Congenital ZikV infection can
cause microcephaly, or a birth defect where the child’s head is much smaller than the
average head size for a newborn, as well as other major birth defects and neurological
harm. ZikV can cause fever, rash, headache, joint pain, red eyes and muscle pain. ZikV is
also linked to miscarriages and stillbirths. Still, 80\% of those infected with ZikV display
no symptoms, making an outbreak in the local mosquito population a risk when those
infected do not know. There is currently no vaccine to prevent ZikV, as well as no cure
for the virus. Preventative measures for people at risk could be wearing clothing to cover
your skin from mesquites and decrease the risk of being bitten, where insect repellent,
stay at home when the bugs come out the most, and using condoms or not having sex.
The ZikV virus has been around since the early 1950’s, but almost 70 years later
is when the western world finally became aware of it. The western world’s attention
turned more toward ZikV Virus because of the 2015 Olympics in Brazil, where people
from all over the world were convening at a place where the ZikV virus was much more
common. Before 2015, many of the world’s health professionals felt that the ZikV
infection was relatively harmless, and just recently has the federal and state government
officials in the United States and elsewhere realized the severe health related outcomes.
One critique of Western medicine is that it needs to collaborate with the world as a whole
by identifying the problem and focusing on a cure or a vaccine to eradicate the virus.
While scientists and policies have spent more time focusing on preventing the virus from
spreading, this may be more difficult as many people do not know they have the virus.
Theoretically then, the scientists time might be better spent educating people about ZikV,
in what types of environments they can get it, the symptoms, and the fact that no
symptoms may be present. This type of information is important for the early
interventionist as well, to understand the personal, social and ethical issues people in this
population might face, as well as spread awareness of the disease to bring to light the
importance of a cure.
The scientific researchers have often focused on the examination of infant
infestation of the ZikV virus infection, including “a comprehensive physical examination,
with special attention to precise occipital-frontal head circumference, weight, length,
neurological examination, assessment for dysmorphic features, hearing screen, postnatal
head ultrasound study, and ZIKV infection testing for all infants with possible congenital
ZIKV infection prior to hospital discharge” (Russel et al., 2016). The problem with this
is that when the doctor discovers these problems with the unborn or newborn child, it is
already too late as there is no cure of microcephaly or ZikV virus. It seems that
unfortunately, the scientific and political energy is put into preventative measures, after
the outbreak has occurred. Some of the preventative measures include condoms to
prevent transition through sexual contact, another is the use of bug spray, intended to
prevent bug bites, although not much research has gone into what the poisons of bug
spray can do to the human body, as well as what the effects of bug spray can be on a
pregnant woman or child. There is much more that needs to be done on multiple fronts,
the policies need to change to allow more alternative solutions to bug sprays and better
access to information sexual transition. There needs to be more research in the area of
preventative measures against ZikV virus, as well, providing individuals with more
options may offer better results. Health care polices and research studies will need to
collaborate with early intervention to come to a consensus as to what needs to be done to
better prevent and/or cure the ZikV virus.
Those in the field of early intervention need to be aware of the personal, social
and ethical issues related to the information they know about ZikV, as early
interventionists are often called upon to care for infants and young children as well as
their families that are affected by ZikV (Porter, Mimm. 2017). Early interventionists need
to spread awareness throughout the western world to encourage more individuals to
become aware of what ZikV is and how it effects pregnant women as well as infants.
They should act as advocates for individuals with ZikV, insisting and pursuing more
research and staying informed on any new information that is presented. There are still
many unknowns about the ZikV virus as well as Microcephaly, early interventionist’s
need to focus more on reaching a larger audience, some could argue that the more
publicity would lead to more action. The scientist of the world need to start working out
problems collaboratively on a solution to the virus focus more on vaccines and providing
clean and useful preventative measures.
Looking through the lens of an early interventionist, it is important to know how
ZikV may affect a child’s long-term health and development, if early intervention is
helpful or can be, and what the social and economical implications for those with ZikV
are. Something more that can be done is for, western medicine and science need to
collaborate to find the answer to the two most important questions; “What is a cure or
vaccine to ZikV virus?”, as well as, “What are safe and effective ways to prevent from
the ZikV virus?” While we have suggestions for the later, these two questions still remain
unanswered, and it is the job of the people and the early interventionist to raise awareness
about ZikV and possibly inspire a cure. There are many things to consider when thinking
about the ZikV virus, such as the preventative measures that could be better and safer as
well as the lack of information and research to further the search in understanding ZikV
more and eventually finding a cure. Once the majority of the western world feels the
importance in finding a cure to the ZikV virus then maybe it will gain the publicity it
needs to be taken to proper channels to finally find a cure.
Work Cited
Porter, S., Mimm, N. (2017). Infants with Congenital ZikV Virus Infection. Infants &
Young Children, 30(1), 17-27, doi:10.1097/iyc.0000000000000084
ZikV Virus. (2018, September 05). Retrieved from https://www.cdc.gov/ZikV/index.html
December 2017 | Issue Brief
Living in an Immigrant Family in America: How Fear and
Toxic Stress are Affecting Daily Life, Well-Being, & Health
Samantha Artiga and Petry Ubri
Executive Summary
Immigration policy has been and continues to be a controversial topic in the U.S. Over the course of the
election and since taking office, President Trump has intensified national debate about immigration as he has
implemented policies to enhance immigration enforcement and restrict the entry of immigrants from selected
countries the Administration believes may pose a threat to the country. The climate surrounding these policies
and this debate potentially affect 23 million noncitizens in the U.S., including both lawfully present and
undocumented immigrants, many of whom came to the U.S. seeking safety and improved opportunities for
their families.1 They also have implications for the over 12 million children who live with a noncitizen parent
who are predominantly U.S-born citizen children.2 We conducted focus groups with 100 parents from 15
countries and 13 interviews with pediatricians to gain insight into how the current environment is affecting the
daily lives, well-being, and health of immigrant families, including their children. Key findings include:
Immigrant families, including those with lawful status, are experiencing resounding levels of
fear and uncertainty. Fears affected participants across backgrounds and locations, with particularly
pronounced effects for Latinos and Muslims. Undocumented parents fear being deported and separated from
their children while many of those with lawful status feel uncertain about their status and worry they may lose
their status or permission to remain in the U.S. These feelings of uncertainty escalated after rescission of the
Deferred Action for Child Arrivals (DACA) program in September 2017. Parents said that although they try to
shield their children from these issues, many children are hearing about them at school and fear potentially
losing their parents to deportation or having to leave the U.S., the only home many have ever known.
“…we wake up every day with the fear of being deported, of the separation of our families, to
have to leave the kids.” –Latino Parent, Boston, Massachusetts
“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to
expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California
Parents and pediatricians said that racism and discrimination, including bullying of children,
have significantly increased since the election. Many felt that Latinos and Muslims have been the
primary targets of increased racism and discrimination. They also noted that the increased bullying of children
in schools extends beyond immigrants to children of color, regardless of their immigration status.
“They get bullied… told things like, ‘now you and your family will have to leave.’ …And so, even
though those kids don’t actually have to worry about their immigration status, I think obviously
a child, they don’t know the details of how the system works.” –Pediatrician, Pennsylvania
Living in an Immigrant Family in America 2
Daily life has become more difficult for immigrant families due to increased fear and
uncertainty. Some parents said that it is harder to find employment in the current environment, further
increasing financial strains on families. Increased fears also are affecting some families’ daily routines. Some
parents, particularly those who are undocumented or who have an undocumented family member, said they
are only leaving the house when necessary, such as for work; limiting driving; and no longer participating in
recreational activities, like visiting their local park. As a result, they and their children are spending long hours
in the house behind locked doors. Parents also indicated that they and their children are increasingly fearful of
interacting with police or authorities.
“Before, there were many kids in the parks… but now… the kids spend more time inside these
days, because we are afraid of being deported.” –Latino Parent, Boston, Massachusetts
“My spouse does not go out of the house… The last thing she wants is to get stopped and that
they start asking her questions…” –Latino Parent, San Diego, California
Most parents said they are continuing to access health care for their children and maintaining
their children’s Medicaid and CHIP coverage, but there were some reports of changes in health
care use and decreased participation in programs. Parents note that they highly prioritize their
children’s health and generally view hospitals and doctors’ offices as safe spaces. However, there were some
reports of changes in health care use, including decreased use of some care, and decreased participation in
Medicaid and CHIP and other programs due to increased fears.
“The thing is… if you are at the hospital you are safe. They can’t go into a hospital, a school or
a church… because it is a sanctuary.” –Latino Parent, Chicago, Illinois
Increased fears are having significant negative effects on the health and well-being of children
that have lifelong consequences. Parents and pediatricians reported that children are manifesting fears in
many ways. They described behavioral changes, such as problems sleeping and eating; psychosomatic
symptoms, such as headaches and stomachaches; and mental health issues, such as depression and anxiety.
Parents and pediatricians also felt that fears are negatively affecting children’s behavior and performance in
school. Pediatricians uniformly expressed significant concerns about the long-term health consequences of the
current environment for children. They pointed to longstanding research on the damaging effects of toxic stress
on physical and mental health over the lifespan. They also expressed concerns about negative effects on
children’s growth and development, and felt that the current environment is compounding social and
environmental challenges that have negative impacts on health.
“When youre worried every day that your parents are going to be taken away or that your family
will be split up, that really is a form of toxic stress… we know that its going to have long-term
implications for heart disease, for health outcomes for these children in adulthood.”
–Pediatrician, Minnesota
Together these findings show that immigrant families across different backgrounds and locations are feeling
increased levels of fear and uncertainty amid the current climate, and that these feelings extend to those with
lawful status. The findings show that these fears are having broad effects on the daily lives and routines of some
immigrant families. In addition, they point to long-term consequences for children in immigrant families,
including poorer health outcomes over the lifespan, compromised growth and development, and increased
challenges across social and environmental factors that influence health.
Living in an Immigrant Family in America 3
Introduction
Immigration policy has been and continues to be a controversial topic in the U.S. Over the course of the
election and since taking office, President Trump has intensified national debate about immigration as he has
implemented policies to enhance immigration enforcement and restrict the entry of immigrants from selected
countries the Administration believes may pose a threat to the country (Appendix 1). The climate surrounding
these policies and this debate potentially affect 23 million noncitizens in the U.S., including both lawfully
present and undocumented immigrants, many of whom came to the U.S. seeking safety and improved
opportunities for their families.3 They also have implications for the over 12 million children who live with a
noncitizen parent, who are predominantly U.S-born citizen children.4 This brief provides insight into how the
current environment is affecting the daily lives, well-being, and health of immigrant families, including their
children. The findings are based on focus groups with 100 parents in immigrant families from 15 countries and
telephone interviews with 13 pediatricians who serve immigrant communities.
Methods
During Fall 2017, the Kaiser Family Foundation worked with PerryUndem Research/Communication to
conduct focus groups with 100 parents in immigrant families. Focus group participants were selected to
represent a range of races/ethnicities, countries of origin, and immigration statuses and to provide for
geographic diversity of experiences. A total of 10 focus groups were conducted in 8 cities in 4 states (Chicago,
Illinois; Boston, Massachusetts; Bethesda, Maryland; and Anaheim, Fresno, Los Angeles, Oakland, and San
Diego, California). In addition, 13 telephone interviews were conducted with pediatricians and clinics serving
immigrant families. With assistance from the American Academy of Pediatrics, pediatricians were identified
who serve different immigrant populations across a range of states (Arkansas, California, District of Columbia,
Illinois, Minnesota, North Carolina, Pennsylvania, Texas, and Vermont). The Blue Shield of California
Foundation supported the focus groups and interviews conducted in California.
Focus groups were conducted in 5 languages with parents from 15 countries of origin. There were six Spanish-
speaking focus groups with parents from Mexico, the Caribbean, and Central and South America; one group
with Korean parents; one group with Portuguese-speaking parents from Brazil and Cape Verde; one group with
Farsi-speaking parents from Afghanistan; and one group with Arabic-speaking parents from Iraq, Egypt, and
Syria. Participants included individuals with a range of immigration statuses, including undocumented
individuals, refugees/asylees, and lawful permanent residents (“green card” holders). (See Appendix 2 for an
overview of selected immigration statuses.) Four of the groups were held in focus group facilities; the
remaining six groups were organized and held in community-based organizations serving the community.
Since participants in the groups hosted by community-based organizations were often receiving services
through the organization, they generally were connected to more resources and more knowledgeable about
their rights compared to the general community.
One-on-one telephone interviews were conducted with pediatricians. Interviewed pediatricians serve a variety
of immigrant families, including Latino immigrants from Mexico and Central and South America as well as
immigrants from an array of other countries and regions, including Bhutan, Burma, China, India, Korea,
Myanmar, Mongolia, Vietnam, Yemen, the Democratic Republic of the Congo, Somalia, Ethiopia, Eritrea,
Eastern Europe, and the Middle East.
Living in an Immigrant Family in America 4
Key Findings
OVERVIEW OF PARTICIPATING PARENTS AND THEIR FAMILIES
Participating parents immigrated to the U.S. to escape war or gang activity in their native
countries, for job and educational opportunities, and/or to reunite with family. Some parents told
stories of losing loved ones to war or gang violence in their native countries and said they immigrated to the
U.S. to find safety. Similarly, refugees and asylees immigrated to escape war or persecution in their native
countries. Many parents also noted that their native countries have high rates of poverty, inadequate education
systems, and poor job prospects, and that coming to the U.S. provides their families better educational and
employment opportunities. Some participants also came to the U.S. to join other family members who had
previously immigrated. Participants varied widely in their length of time in the U.S. Some have been in the U.S.
for many years, while others arrived more recently. Some came to the U.S. as children and have no experience
in their native countries. A number of participants, particularly refugees and asylees escaping war, expressed
how grateful they were for the opportunity to be in the U.S.
“They killed three members of my family and… I left.” –Latino Parent, Boston, Massachusetts
“I am Salvadoran and, due to the war, I came here. My brother was killed and then I came here.”
–Latino Parent, Boston, Massachusetts
“In Mexico there aren’t opportunities, even for young people. The environment is too violent.”
–Latino Parent, Chicago, Illinois
“Many of us came as children, and we had no idea about the future. Now we have no option but
to stay because… we are afraid to go back to a place that we are not familiar with.” –Latino
Parent, Bethesda, Maryland
“Ive been here since I was 6 years-old; I have a daughter who is 6 years-old. Im not familiar
with any other country. I love this country.” –Latino Parent, Bethesda, Maryland
“…my dad brought us here so that way we could have better education.” –Latino Parent, Fresno,
California
“The United States government took us in because we were not feeling safe in our countries and
because we were being discriminated against. We thank the United States for that.” –Arabic-
speaking parent, Anaheim, California
“One of the top reasons is safety in terms of bodily safety, mental, and emotional…” –Afghan
Parent, Oakland, California
“…over there [in Mexico], there’s a lot of crime.” –Latino Parent, Fresno, California
Children of participating parents are mostly U.S.-born citizens. Similarly, pediatricians noted that in
many families that they serve, the children are U.S. born citizens while one or both parents may be
undocumented. Some parents also have older children that they brought with them to the U.S. who either have
obtained status under the Deferred Action for Childhood Arrivals (DACA) program or are undocumented, and
a few have children who are still in their native country. Parents noted that many of their children have never
visited their native countries and that the U.S. is the only home they have known. Children of refugees and
asylees include a mix of those that fled to the U.S. with their parents and younger children born in the U.S.
Living in an Immigrant Family in America 5
Finances and language barriers are a major concern for many participants. Participants generally
have at least one worker in the family, often in service, construction, or landscaping jobs. Many noted that they
are trying to find as much work as possible, but still are living paycheck to paycheck. They noted that the costs
of rent and groceries continue to increase, making it difficult to make ends meet. Participants who arrived to
the U.S. more recently, particularly those from Middle Eastern countries, described challenges assimilating to
life in the U.S., noting the pressure to find employment quickly and the difficulty they face finding a job due to
language and cultural barriers. Some noted that they had professional careers in their native countries and
have had to work in less-skilled service jobs here in the U.S. as they become established.
FEARS AND CONCERNS AMONG FAMILIES
Parents and pediatricians said that fears of deportation and overall feelings of uncertainty have
increased since the presidential election. Parents who are undocumented or who have an
undocumented family member expressed growing fears that they will be separated from their children and/or
spouse. Some also fear returning to their native country because of the violence and gang activity there. A
number of participants have friends and/or family members who were recently detained or deported. They also
described recent immigration raids and enforcement activity in their neighborhoods, along roadsides, and in
their workplaces. One pediatrician noted that, although these fears among undocumented immigrants often
are perceived to primarily affect Latinos, there are growing numbers of undocumented Asians who also are
feeling increased fear.
“The area where I live… the majority of raids happen there. And we hear many cases about
deporting people from their apartments in that area… The community is so scared.” –Latino
Parent, Bethesda, Maryland
“If my husband is deported, how am I supposed to live here without him? There is no way. It
breaks up a whole family.” –Portuguese-speaking Parent, Boston, Massachusetts
“…we wake up every day with the fear of being deported, of the separation of our families, to
have to leave the kids.” –Latino Parent, Boston, Massachusetts
“…I am both mom and dad for my children… So, I must be there, and I think, God forbid it, but
if I get detained, they will deport me…” –Latino Parent, Chicago, Illinois
“…everybody is afraid because they have their lives here. They don’t have papers, but they’ve
got their life here and they don’t have anything in Mexico anymore because, I mean, it’s years
ago. There’s no way they can support themselves over there.” –Latino Parent, Fresno, California
“It happened to me several times where you hear somebody knock on your door and they pick
up your relatives and they take them and they lock them up.” –Latino Parent, Fresno, California
“They’re putting more pressure at the border. They check everything.” –Latino Parent, San
Diego, California
“I think everybody is a lot more scared. There’s more fear in me personally speaking… now I
feel it personally. Not before, but now I do.” –Latino Parent, Los Angeles, California
“The worst fears are that they’re going to separate us… that they’re going to be separating
families.” –Latino Parent, Los Angeles, California
Living in an Immigrant Family in America 6
Feelings of increased fear and uncertainty extend to those with lawful status. For example, Korean
parents in Chicago and Afghan parents in Oakland said they feel having a green card is no longer sufficient and
that they need to obtain citizenship to secure their status. Some said that, even with a green card, they no
longer feel safe traveling out of the country because they worry that they will have problems reentering the U.S.
Some parents also said that it has become more difficult to obtain citizenship since the election, and that the
length of time to obtain a green card or citizenship has increased. Arabic-speaking parents and a number of
pediatricians reported that refugees and asylees feel unstable and worry about whether they will be able to
remain in the country. Pediatricians emphasized that refugees and asylees come from histories of government
persecution and that it is difficult for them to trust that they will remain protected. In addition, some parents
expressed concerns that the government might eliminate Temporary Protected Status (TPS) for people from
Nicaragua, El Salvador, and Honduras.5 Some parents said that, although current policies have not affected
them, they are worried that rules may change, causing them to lose status or permission to remain in the U.S.
“I feel unsettled. Even though we already have the green card, if we do not apply for citizenship,
I don’t think we can be at ease.” –Korean Parent, Chicago, Illinois
“Before this, we were living here with permanent residency without citizenship and we thought
it wouldn’t be a problem… but after Trump was elected, I thought, if I want to live here and
raise my son, I will need to apply for citizenship.” –Korean Parent, Chicago, Illinois
“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to
expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California
“There’s no stability. [The President] could write a tweet on Twitter tomorrow and turn things
upside down.” –Arabic-speaking Parent, Anaheim, California
“…The new laws being approved, they have us with a sense of uncertainty… TPS… DACA, whats
gonna happen in six months?” –Latino Parent, Bethesda, Maryland
“The concern is that today it’s one group, and tomorrow it can be another. We may be happy
today that we’ve been left alone, but tomorrow might be another story.” –Afghan Parent,
Oakland, California
“When President Trump was elected there was just huge, huge fear in our refugee communities
and our immigrant communities. It didn’t matter that they had legal status…” –Pediatrician,
Vermont
“Even if they, themselves, may not be directly at risk because they should be in an immigration
status that helps them, especially for refugees, they are so used to being afraid of government
and distrustful of government…” –Pediatrician, California
Living in an Immigrant Family in America 7
Parents and pediatricians noted particular concerns among individuals that have obtained
DACA. In the focus groups that were conducted prior to the rescission of DACA, parents expressed concerns
about the security of DACA, fearing that it would be eliminated. In the groups conducted after the rescission of
DACA, parents reported that fear and uncertainty among individuals with DACA had intensified, with many
worrying about their current situation and losing hope for the future.
“The kids who are in school are also worried, the ones who are going to college, because we
don’t know what will happen with DACA…”—Latino Parent, Boston, Massachusetts
“I speak in the case of DACA. Everybody is on the right path. Everybody is studying, but they
still face risks. So it can happen to any of us… Everything depends on [the President] and on the
laws they create.” –Portuguese-speaking Parent, Boston, Massachusetts
“It’s going backwards, because everything Obama helped the dreamers– well now everyone is
scared because Trump wants to take that away…” –Latino Parent, San Diego, California
“…she was able to get DACA... if she won’t be able to renew it, she’s thinking they’re going to
come and pick her up because they have all of her information.” –Latino Parent, Los Angeles,
California
“…I have two cousins and they were under DREAM Act… they all have jobs and they were going
to schools and… they know their whole lives here. And then for that to all just be taken away.”
–Latino Parent, Fresno, California
“I know someone with DACA who recently got it and…since he got his work permit a lot of
doors opened up for him… So his dreams were like enormous, but now stopping DACA, he is so
afraid.” –Latino Parent, Bethesda, Maryland
“[I was] in [the DACA application] process when we heard the news. It was really painful… I was
doing things right, out on my own… to look for a future for me and my kids. So its like
depression comes in—what am I going to do now?” –Latino Parent, Bethesda, Maryland
“Recently also, I have a couple of patients… more than a couple… who I’ve talked with recently,
who are DACA recipients that are feeling very much unsure as to what their future is going to
be.” –Pediatrician, District of Columbia
Parents varied in the levels of fear they felt. A variety of factors influenced the level of fear felt by
parents, including their and their family members’ immigration statuses; experiences in their native countries;
reasons for immigrating to the U.S.; length of time in the U.S.; the extent of diversity, support, and leadership
in their local communities; and exposure to deportations and immigration raids. For example, some
participants in California who were from Mexico noted a willingness to reestablish their lives in Mexico if they
or a family member was deported, particularly those in San Diego who are close to the border. In contrast,
participants from other countries who came to the U.S. to escape war and/or persecution said that returning to
their native country is not an option. Parents who have been living in the U.S. for many years generally felt
more secure than those who had arrived more recently. Parents connected to local community organizations
felt they are more informed about their rights compared to others in the community and that rumors spread
through social media or word of mouth often lead to increased fears and panic based on misinformation. One
pediatrician noted that, among Asian communities, there is reluctance to talk about immigration status, which
limits sharing of information and may contribute to increased fears stemming from rumors or misinformation.
Living in an Immigrant Family in America 8
“…the Latino communities here in the valley, specifically here in Fresno, perhaps you don’t feel
supported because our leaders, our community leaders, they haven’t achieved the level to be
able to offer the support to everyone.” –Latino Parent, Fresno, California
“That is the problem with many people, they don’t get informed, they don’t look for the real
information. They are only based on what they heard on the news or what their friend told
them.” –Latino Parent, Chicago, Illinois
Children are also feeling increased fear and uncertainty about potentially losing their parents
to deportation or having to return to their parents’ native countries. Parents across the groups,
including those with lawful status, recounted stories of their children and children in their community coming
home in tears immediately after the presidential election and worrying about what would happen to them and
if they would have to leave the country. Parents said that, although they try to shield their children from these
issues, many children are hearing about them at school. Parents also said that some children have expressed
fears and concerns about their parents’ home countries, noting that the U.S. is the only home they know.
“…after Trump was elected, children cried at school and said they had to migrate to Canada.
The children talk about it among themselves a lot.” –Korean Parent, Chicago, Illinois
“After the inauguration, my youngest ones were crying because they thought I was going to be
deported…” –Latino Parent, Chicago, Illinois
“My children would come home from school and say that at school they were saying that all
parents would be deported...” –Portuguese-speaking Parent, Chicago, Illinois
“All the children, even if they were born here, are fearful. They fear that anytime they’ll come
back from school and won’t find their parents there.” –Latino Parent, Chicago, Illinois
“And so she’s gotten sad. And she’s even cried just watching the news and seeing how
immigration is doing raids and how they pick people up.” –Latino Parent, Fresno, California
“….she worries too much, more than what kids should worry about. I mean she’s just a little
girl. I mean you can’t really tell her to not worry.” –Latino Parent, Fresno, California
“[My son] age 15… asks, ‘how am I going back to Brazil if I have to start all over again?...’ He
says… ‘If I return, I have to start over and lose a lot of time, and I don’t know if I would adapt
there again.’” –Portuguese-speaking Parent, Boston, Massachusetts
“Well my kids got scared for me. You know, when Donald Trump won, the youngest one hugged
me and said ‘mom, you don’t have any of your papers.’” –Latino Parent, Los Angeles, California
“I think there’s just general fear and uncertainty that even kids that are in not-mixed citizenship
status families, but… are either children of color or children who are Latino or children whose
family prefer to speak Spanish…” –Pediatrician, North Carolina
“Honestly, it’s not just undocumented families… but also families where kids are LPRs [Lawful
Permanent Residents] or have refugee status. I mean even those families—parents have come to
me and said that their kids have been worried.” –Pediatrician, Pennsylvania
“…now to have these …
750 First Street NE, Suite 800
Washington, DC 20002-4241
SocialWorkers.org
The primary mission
of the social work
profession is to enhance
human well-being and
help meet the basic
human needs of all
people, with particular
attention to the needs
and empowerment
of people who are
vulnerable, oppressed,
and living in poverty.
The National Association of Social Workers (NASW) is the largest
membership organization of professional social workers in the world,
with nearly 130,000 members. NASW works to enhance the professional
growth and development of its members, to create and maintain
professional standards, and to advance sound social policies.
Social Justice Brief
CONTRIBUTORS:
Will Francis, LMSW
Government Relations Director, NASW–Texas Chapter
Allan Wachendorfer, LMSW
Director of Public Policy, NASW–Michigan Chapter
Mel Wilson, LCSW, MBA
Manager, Department of Social Justice & Human
Rights, National Association of Social Worker
Migrant and Asylum-Seeking Families:
Analysis of Federal Government Policies and Procedures
Social Justice Brief
» 1 «
This NASW social justice brief is intended to
present a comprehensive analysis of the
complexities of that human rights crisis and
the challenges that it poses related to
» “ground-level” systems of adult and
child detention procedures;
» the conditions of detention;
» social work involvement in both adult
detention and child-welfare policies
and service delivery;
» legal due process protections for
affected families and minors;
» scope and capacities of family
detention facilities; and
» challenges related to child welfare,
foster care, and family reunification.
The brief includes recommendations for
policy reforms, best practices for justice,
and comprehensive approaches to
Migrant and Asylum-Seeking Families:
Analysis of Federal Government Policies and Procedures
National policies on responding to families and unaccompanied minors,
particularly those entering at the Mexico-U.S. border, recently took a sharp turn
as the Trump administration implemented the so-called zero-tolerance policy.
This policy - when coupled with family separation policies–has blurred the lines
between how families and children are traditionally processed when they cross
the border. As we know by now, the results have been that these unclear and
rushed procedures have contributed to potentially life-long harm to both parents
and children who are entangled in this morass.
UNACCOMPANIED ALIEN CHILDREN (UAC) APPREHENSIONS BY COUNTRY
COUNTRY FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FYTD 2018
El Salvador 5,990 16,404 9,389 17,512 9,143 2,690
Guatemala 8,068 17,057 13,589 18,913 14,827 16,480
Honduras 6,747 18,244 5,409 10,468 7,784 6,350
Mexico 17,240 15,634 11,012 11,926 8,877 6,690
Source: www.cbp.gov/newsroom/stats/usbp-sw-border-apprehensions
Social Justice Brief
» 2 «
addressing the psychosocial needs of
immigrant children families.
Background
Migrant asylum-seeking families and
unaccompanied migrant children have been
crossing the Mexico-U.S. border for many
years. The chart shows a statistical picture of
the persistent movement of children to the
United States by their country of origin. The
trek for most of the children—and asylum-
seeking families—can be close to 2,000
miles. It is well documented that children and
their parents make such a perilous journey
due to the violent and terrible economic
conditions in their country of origin. Once at
the border, the families (or unaccompanied
children) can either declare themselves as
asylum-seeking families or unaccompanied
migrant children or illegally cross into the
United States and face a minor misdemeanor
charge under federal law.
Either scenario places their case within the
jurisdiction of the U.S. Department of Homeland
Security (DHS), and their first contact in the
United States will be an official from that
agency. U.S. Customs and Border Protection,
the largest federal law enforcement agency
within the DHS, is responsible for processing
asylum seekers and unaccompanied children.
The second official contact for asylum-seeking
adults is DHS’s United States Citizenship and
Immigration Services Bureau (USCIS).
Prior to the Trump administration’s zero-
tolerance and family separation policies,
the government agencies managed the
unaccompanied migrant children and asylum
seeker processes with bureaucratic
efficiencies, although there were flaws in the
system. However, the announcement of zero
tolerance by Attorney General Sessions not
only exacerbated the deficiencies in our
current system, but also created a policy and
human rights crisis.
Far-Reaching Anti-Immigration
Policies That Prolong Family
Separation
Zero-tolerance and family separation
immigration policies did not emerge from a
vacuum. As early as March of 2017, it was
becoming clear that DHS had internal
discussions about formulating and implementing
a policy of separating children from their
parents at the border. At the time, the Trump
administration’s stated goal was to deter
mothers from making the arduous journey
with their children from Central America to
the U.S. border.
The architects of the family separation policy
did not move to actualize it until later.
Between July and October 2017 the Trump
administration initiated a zero-tolerance “pilot
program” in El Paso, Texas. During that
period, court records and interviews with
migrants reveal that federal prosecutors were
aggressive in criminally charging any adult
who entered the United States without
documentation. What was significant about
the pilot program was that migrant parents
with young children were not exempt from
being charged. The administration was able
to simultaneously test its zero-tolerance and
family separation strategies.
The Trump administration saw its crackdown
as a deterrent that would reduce the number
of undocumented people—especially
families—coming to the United States. However,
https://www.theatlantic.com/international/archive/2018/06/central-america-border-immigration/563744/
https://www.theatlantic.com/international/archive/2018/06/central-america-border-immigration/563744/
https://www.theatlantic.com/international/archive/2018/06/central-america-border-immigration/563744/
https://www.uscis.gov/humanitarian/refugees-asylum
https://www.uscis.gov/humanitarian/refugees-asylum
https://www.justice.gov/opa/pr/attorney-general-announces-zero-tolerance-policy-criminal-illegal-entry
https://www.justice.gov/opa/pr/attorney-general-announces-zero-tolerance-policy-criminal-illegal-entry
https://www.usatoday.com/story/news/politics/2018/06/19/ag-jeff-sessions-trumps-unwavering-voice-zero-tolerance/714035002/
https://www.pbs.org/newshour/nation/how-trumps-family-separation-policy-has-become-what-it-is-today
https://www.reuters.com/article/us-usa-immigration-children-idUSKBN16A2ES
https://www.reuters.com/article/us-usa-immigration-children-idUSKBN16A2ES
https://www.nbcnews.com/storyline/immigration-border-crisis/trump-admin-ran-pilot-program-separating-migrant-families-2017-n887616
https://www.nbcnews.com/storyline/immigration-border-crisis/trump-admin-ran-pilot-program-separating-migrant-families-2017-n887616
https://www.nbcnews.com/storyline/immigration-border-crisis/lucky-ones-maria-her-son-crossed-border-perfect-moment-n886106
https://www.nbcnews.com/storyline/immigration-border-crisis/lucky-ones-maria-her-son-crossed-border-perfect-moment-n886106
Social Justice Brief
» 3 «
data reported by DHS in July 2018 suggest that
the zero-tolerance policy has had little effect.
The data show that, from May to June, the
number of arrested by the U.S. Border Patrol
dipped a meager 0.4 percent. Ironically, some
of that drop can be attributed to normal
reductions of crossings due to increased
temperature in the Southwest during that period.
More recently, the Trump administration made
a series of policy and procedural changes
that affirmed its parent–child separation intent.
For example, in June of 2018, DHS officials
began requiring that asylum-seeking parents
sign a form that gave them a two-option
ultimatum: (1) voluntarily leave the United States
with their children or (2) be deported, leaving
their children behind. There are indications
that the form is even being given to asylum
seekers who have passed a credible fear test
hearings before an immigration judge.
DHS has further exacerbated the already
confusing and ill-planned family separation
crisis by implementing the Trump
administration’s policy of intentionally denying
bond to some parents who have been separated
from their children. These parents are eligible
to apply for asylum. Under this policy, parent–
child separation is further and unnecessarily
extended. The administration has taken these
steps in spite of the fact that on June 2
through 6, 2018, a federal judge ordered the
Trump administration to take immediate steps
to reunify separated families. Migrants who
are denied bail have a right to appeal.
However, the appeal process is lengthy.
It is noteworthy that the U.S. Department of
Justice (DOJ) increased the number of
immigration judges in anticipation of an influx
of immigration cases. DOJ also pressured
judges to expedite deportation cases to such
a degree that in August 2018, immigration
judges complained that DOJ is undermining
their independence by reassigning cases to
maximize deportations. In fact, the National
Association of Immigration Judges (NAIJ) filed
a labor grievance against the DOJ after
Attorney General Sessions overrode an
immigration judge’s decision and removed
dozens of cases from the judge’s caseload.
After a person passes a credible fear interview,
U.S. Immigration and Customs Enforcement
(ICE) deportation officers will make a bond
determination. This is what the individual must
pay to be released from detention while his or
her case is being adjudicated. On average,
immigration bonds are close to $1,500.
Though the asylum seeker’s bond money is
reimbursed after their case is resolved, many
cannot afford to pay bail. As a result, the
parent faces a double barrier to being
released as they await their hearing. The
parent is either being denied bail or is unable
to afford bail. Needless to say, few parents
post bail.
Perhaps one of the more insidious “under the
radar” policy changes that affects asylum-
seeking adults attempting to become
financially viable while awaiting adjudication
is the rescinding of an Obama-era employment
guidance by Attorney General Sessions in
June of 2018. The 2011 guidance, issued by
the Office of Special Counsel for Immigration
Unfair Employment Practices, ensured asylum
seekers were authorized to work indefinitely
and could obtain Social Security cards
“without employment restrictions.” Sessions
deemed working rights protections to be
“unnecessary, outdated, inconsistent with
existing law,” and had been imposed without
congressional approval.
http://media1.s-nbcnews.com/i/today/z_creative/iceform.jpg
http://immigrationimpact.com/2018/07/19/children-coerce-parents-signing-deportation/
https://www.uscis.gov/humanitarian/refugees-asylum/asylum/questions-answers-credible-fear-screening
https://www.uscis.gov/humanitarian/refugees-asylum/asylum/questions-answers-credible-fear-screening
https://www.motherjones.com/politics/2018/07/ice-family-separation-bond-denial-1/
https://www.motherjones.com/politics/2018/07/ice-family-separation-bond-denial-1/
https://www.nytimes.com/2018/06/26/us/politics/family-separations-congress-states.html
http://thehill.com/latino/401011-immigration-judges-lash-out-against-sessions
http://thehill.com/latino/401011-immigration-judges-lash-out-against-sessions
https://www.uscis.gov/humanitarian/refugees-asylum/asylum/questions-answers-credible-fear-screening
https://www.msn.com/en-us/news/us/attorney-general-jeff-sessions-rescinds-guidance-safeguarding-the-right-of-refugees-asylum-seekers-to-work-in-the-us/ar-AAzybVg?ocid=spartandhp
https://www.msn.com/en-us/news/us/attorney-general-jeff-sessions-rescinds-guidance-safeguarding-the-right-of-refugees-asylum-seekers-to-work-in-the-us/ar-AAzybVg?ocid=spartandhp
https://www.msn.com/en-us/news/us/attorney-general-jeff-sessions-rescinds-guidance-safeguarding-the-right-of-refugees-asylum-seekers-to-work-in-the-us/ar-AAzybVg?ocid=spartandhp
Social Justice Brief
» 4 «
Collectively, anti-immigrant policies implemented
by the Trump administration have produced
almost insurmountable barriers for migrants
and asylum-seeking parents. It is likely that the
executive actions are tied to a comprehensive
zero-tolerance initiative. Ultimately, they create
conditions that will ensure that an increasing
number of separated children will be placed in
an Office of Refugee Resettlement (ORR) facility.
This will also make family reunification far more
difficult and increase the amount of additional
trauma the children and families experience.
Asylum Protections
Asylum seekers fit into a special category
which is defined as a protection granted to
foreign nationals already in the United States
or at the border who meet the international
law definition of a “refugee.” The United
Nations 1951 Convention and 1967 Protocol
define a refugee as a person who is unable
or unwilling to return to his or her home
country, and cannot obtain protection in that
country, due to past persecution or a
well-founded fear of being persecuted in the
future “on account of race, religion,
nationality, membership in a particular social
group, or political opinion.” Congress
incorporated this definition into U.S.
immigration law in the Refugee Act of 1980.
Because the United States signed the 1967
Protocol -and through U.S. immigration law- it
has a presumed legal obligations to provide
protection to those who qualify as refugees.
The Refugee Act established two paths to
obtain refugee status—either from abroad as
a resettled refugee or in the United States as
an asylum seeker.
Impact of Trump Administration
Policies on Adults and Children
Migrant Family Detention
To begin with, it’s important to clarify that
in this brief we will not be focusing on
unaccompanied migrant children, but rather
on children who are part of a detained family
unit. Since the implementation of zero-tolerance,
the distinction between these two groups has
been blurred, and DHS has been combining
these two separate groups into one.
There were nearly 49,000 adults and children
within family units apprehended at the
U.S.-Mexico border between January and
June of 2018. According to U.S. Customs
and Border Protection data, this is over twice
the number of family apprehensions as
compared with those of the previous year.
https://www.americanimmigrationcouncil.org/research/asylum-united-states
https://www.americanimmigrationcouncil.org/research/asylum-united-states
http://www.refworld.org/docid/3be01b964.html
http://www.refworld.org/docid/3be01b964.html
http://www.refworld.org/docid/3be01b964.html
https://www.americanimmigrationcouncil.org/research/asylum-united-states
http://www.pewresearch.org/fact-tank/2018/07/06/border-apprehensions-of-migrant-families-have-risen-substantially-so-far-in-2018/
http://www.pewresearch.org/fact-tank/2018/07/06/border-apprehensions-of-migrant-families-have-risen-substantially-so-far-in-2018/
https://www.cbp.gov/newsroom/stats/sw-border-migration
https://www.cbp.gov/newsroom/stats/sw-border-migration
Social Justice Brief
» 5 «
During May 2018—the first month when the
zero-tolerance and family separation policies
were fully implemented—border agents
apprehended 9,485 family members at the
Southwest border. Though there was an
increase as compared to apprehensions in
May 2017, it is fewer people than in the
same period of 2014 (12,772 apprehensions).
The increase that began in 2013 was an
immigration spike due to increases in border
crossings among Central American children.
The administration’s zero-tolerance policy
resulted in a total of 2,342 children being
separated from families between May 5 and
June 9 of 2018. Close to 2,000 adults from
those families were referred for prosecution.
However, analyses of DHS records suggest
that more than 4,100 children have been
separated since October 2016.
The merging of children categorized as
unaccompanied minors with those removed
from families seeking asylum has generated a
significant rule change—one also designed to
deter asylum seeking families—that clearly
blended these two different groups to frighten
and therefore discourage families with
legitimate claims from seeking solace and
support in the United States. This change
ensures that DHS will process children of
asylum-seeking parents through different
paths from their parents. The parents will go
through the criminal justice system; the
children go through the ORR’s child-welfare
system. Perhaps reflecting the obvious scrutiny
that the administration has received about
early childhood trauma from family
separation, HHS designated three facilities as
tender age centers (a tender age child is
defined as any child under the age of 13).
As a result, the 572 children separated from
their parents—and yet to be reunited—will be
lumped in with the 30,000 unaccompanied
migrant children referred to ORR thus far in
2018. The immediate concern is that ORR’s
child placement centers lack needed capacity
and oversight as they face pressure to place
these children.
Children Required to Appear at
Immigration Hearings Alone
When asylum-seeking children are labeled as
unaccompanied migrants, this status forces
them to go before an immigration court to
determine if they qualify for refugee status
without their parents present. Procedures for
processing asylum and immigration petitions
have on occasion reached the point of
absurdity. There have been reports of children
as young as three years old being made to
appear alone in immigration court for
deportation hearings. Although having
unaccompanied minors go through deportation
hearings without a parent or guardian is not
new, since the administration’s family
separation policy an increased number of
preteen children—including toddlers—are
being required to appear alone, exposing
them to further trauma.
Some of the children recently separated from
their parents could likely be asked to endure
court proceedings—which they often cannot
possibly comprehend or understand if they do
not speak English—even as they emotionally
struggle with the ongoing trauma of being
taken from their parents. Prior to the zero-
tolerance policy, parents were usually taken
to immigration court along with their young
children. During those hearings, the parent,
not the child, was asked to explain the
http://www.pewresearch.org/fact-tank/2014/06/10/number-of-latino-children-caught-trying-to-enter-u-s-nearly-doubles-in-less-than-a-year/
https://www.nbcnews.com/news/amp/ncna887616?__twitter_impression=true
https://www.washingtonpost.com/local/immigration/dhs-proposal-would-change-rules-for-minors-in-immigration-detention/2018/05/09/267af486-4f00-11e8-b725-92c89fe3ca4c_story.html?noredirect=on&utm_term=.dc01c155a304
https://www.washingtonpost.com/local/immigration/dhs-proposal-would-change-rules-for-minors-in-immigration-detention/2018/05/09/267af486-4f00-11e8-b725-92c89fe3ca4c_story.html?noredirect=on&utm_term=.dc01c155a304
https://www.cnn.com/2018/06/20/politics/immigration-border-separations-tender-age-shelters/index.html
https://www.washingtonpost.com/graphics/2018/local/tracking-migrant-family-separation/?noredirect=on&utm_term=.2402dcafddab
https://www.nbcnews.com/news/latino/surge-migrant-children-government-shelters-trump-admin-pushes-zero-tolerance-n878601
https://www.nbcnews.com/news/latino/surge-migrant-children-government-shelters-trump-admin-pushes-zero-tolerance-n878601
https://www.nbcnews.com/news/latino/surge-migrant-children-government-shelters-trump-admin-pushes-zero-tolerance-n878601
https://www.texastribune.org/2018/06/27/immigrant-toddlers-ordered-appear-court-alone/
https://www.texastribune.org/2018/06/27/immigrant-toddlers-ordered-appear-court-alone/
Social Justice Brief
» 6 «
circumstances that led the family to seek
asylum in the United States.
We should be reminded that the children’s
health is predicated on a foundational
relationship with a caring adult—especially a
parent. When children are separated from
their parents, their stress hormones respond
with intensity, which can lead to developmental
delays. Children develop speech slower, their
motor skills don’t come along as quickly as
they should, and they start to have difficulty
forming proper attachments with other
human beings.
As pointed out by the head of the American
Academy of Pediatrics, the presence of a
social worker isn’t enough to mitigate those
effects. The younger the child—and the longer
they are in this stressful situation—the more
challenging it is to reverse the damage. Early
traumatic experiences can have lifelong
consequences, often leading to learning
disabilities, high risk for drug and alcohol
abuse, and potentially even higher risk of heart
disease or cancer when they become adults.
Trump Rescinds Family Separation
Policy, But Keeps the Zero-Tolerance
Policy in Place
In June 2018, under pressure from family and
child advocates, Trump signed an executive
order rescinding his family separation
immigration policy. However, in announcing
the change in family separations, the President
“doubled down” on his zero-tolerance policy.
By doing so, he made an already murky
situation cloudier. The truth is that his new
executive order ending the family separation
policy did not resolve the problem of
reunifying the 3,000 children who at that
time were already separated.
Family Has Long Been Plan A: Flores
Agreement’s Role in Preventing Its
Implementation
A policy of prolonged family detention is not
without legal challenges. The Flores settlement—
the court ruling that prevented children from
being kept in immigration detention with their
parents for more than 20 days—has been a
standard for over 20 years. However, in spite
of Flores, Attorney General Sessions announced
that the government had begun detaining
families throughout the completion of the
adjudication of their immigration cases. That
duration could easily mean months of detention
(or longer) for some asylum seekers. In fact,
well before Sessions’ announcement, President
Trump had argued that he should have the
power to detain migrant families who cross
the U.S.-Mexico border together.
The administration sought to modify the
Flores settlement agreement to allow for
the detention of children beyond 20 days.
However, in July 2018, a federal judge in
California pointedly rejected the
administration’s request. The U.S. District
Court judge stated the administration’s
request was “wholly without merit.” She
found that “nothing prevents the government
from reconsidering their current policy of
family detention and reinstating
prosecutorial discretion.”
The challenges to family separation continue.
For instance, in the summer of 2018, the
American Civil Liberties Union filed a federal
lawsuit (Ms. L v. ICE case) seeking to reunite
https://www.vox.com/policy-and-politics/2018/6/18/17475810/immigration-family-separation-health-crisis
https://www.vox.com/policy-and-politics/2018/6/18/17475810/immigration-family-separation-health-crisis
https://www.vox.com/policy-and-politics/2018/6/18/17475810/immigration-family-separation-health-crisis
https://www.vox.com/policy-and-politics/2018/6/18/17475810/immigration-family-separation-health-crisis
https://www.vox.com/policy-and-politics/2018/6/18/17475810/immigration-family-separation-health-crisis
https://www.cbsnews.com/news/trump-executive-end-family-separation-at-border-immigration-today-2018-06-20/
https://www.cbsnews.com/news/trump-executive-end-family-separation-at-border-immigration-today-2018-06-20/
https://www.vox.com/2018/6/11/17443198/children-immigrant-families-separated-parents
https://www.vox.com/2018/6/20/17484546/executive-order-family-separation-flores-settlement-agreement-immigration
https://www.justice.gov/opa/case-document/file/1077076/download?utm_medium=email&utm_source=govdelivery
https://www.msn.com/en-us/news/us/federal-judge-rejects-trump-administrations-bid-to-alter-rules-on-detaining-minors/ar-AAzORNC?ocid=spartandhp
https://www.msn.com/en-us/news/us/federal-judge-rejects-trump-administrations-bid-to-alter-rules-on-detaining-minors/ar-AAzORNC?ocid=spartandhp
Social Justice Brief
» 7 «
an asylum-seeking mother and her 7-year-old
daughter fleeing violence in the Democratic
Republic of Congo. Upon entering the United
States, the mother and child were forcibly
separated and placed apart in detention centers
over 2,000 miles apart. As a result of the suit,
a federal judge temporarily blocked the Trump
administration from deporting parents and
children that it forcibly separated. The Judge
also temporarily put a hold on all family
separation deportations until further briefing
Jail-Like Conditions in Family
Detention Facilities
One of the most problematic aspects of family
detention polices under zero-tolerance is that
families are placed in settings identical to
jails. In a family detention model, the entire
family is part of a criminal case. Therefore,
their detention is incarceration and they are
not free to leave unless they are granted bail.
In the facilities currently used for long-term
family detention conditions and restrictions
exist for parents and children similar to jails.
For example, in Berks County, Pennsylvania,
bright lights reportedly keep children from
sleeping well, and they can be disciplined if
they try to climb into a parent’s bed for comfort.
Alternatives to Family Detention
These conditions are not necessary, as there are
alternatives to family detention. Significantly,
national law enforcement leaders have taken
a lead on making this point. In June of 2018,
over 50 high-ranking members of the Law
Enforcement Immigration Task Force signed
on to a letter to congressional leadership,
asking them to consider evidence-based
alternatives to family detention that also
ensure families attend immigration hearings
and keep required related appointments.
Some of the alternatives include regulated
and mandated check-ins with law enforcement,
communication with authorities by telephone,
linking families to community-based
psychosocial services, or electronic
monitoring of some individuals.
Studies show that asylum seekers are very
compliant in appearing for their immigration
court hearings, with around 90 percent of
children attending immigration proceedings
when a lawyer is present. The Family Case
Management pilot program was a proven
alternative to detention, yet it was terminated
last year by the Trump administration. The
program was highly successful with the families
present for hearings over 99 percent of the
time. As stated by many law enforcement
officials, immigrant families are not threats to
national security. Furthermore, there is a
consensus that incarcerating asylum-seeking
families does not make our communities safer.
Until recently, there was an effort to divert
families from detention. As previously
mentioned, the Family Case Management
Program was a promising program that
served 1,600 individuals between 2015,
when it was introduced by the DHS, and
2017. Instead of keeping children in detention
centers with their parents, families in certain
cities were released and monitored by social
workers, who helped them find lawyers,
housing, and transportation, and made sure
they attended their court hearings. The program
was designed to have social workers assume
community supervision duties until the
immigration court decided the fate of the family.
Using alternatives to family detention saves
taxpayer dollars and creates opportunities to
https://www.humanrightsfirst.org/resource/long-term-detention-mothers-and-children-pennsylvania
https://www.humanrightsfirst.org/resource/long-term-detention-mothers-and-children-pennsylvania
https://www.humanrightsfirst.org/resource/long-term-detention-mothers-and-children-pennsylvania
https://leitf.org/2018/06/law-enforcement-leaders-urge-alternatives-family-detention/
https://www.americanimmigrationcouncil.org/research/taking-attendance-new-data-finds-majority-children-appear-immigration-court
https://www.americanimmigrationcouncil.org/research/taking-attendance-new-data-finds-majority-children-appear-immigration-court
https://thinkprogress.org/trump-ended-successful-migrant-monitoring-program-because-didnt-deport-enough-bd506068c05c/
…
Statement by Center Director Jack
P. Shonkoff, M.D. on Separation of
Families
The policy of separating families is a critical issue that transcends political
ideology and partisanship and speaks to the heart of what the mission of the
Center on the Developing Child is all about.
June 20, 2018
Two critical concepts at the core of our understanding of early childhood development stand out
from decades of scientific research. First, healthy brain development in babies and young children
requires the consistent availability of a stable, responsive, and supportive relationship with at least
one parent or primary caregiver. Second, high and persistent levels of stress can disrupt the
architecture of the developing brain and other biological systems, with serious negative impacts
on learning, behavior, and lifelong physical and mental health.
Sudden, forcible separation of children from their parents is deeply traumatic for both. Above
and beyond the visible distress “on the outside,” this overwhelming experience triggers a massive
Menu
https://developingchild.harvard.edu/about/
https://developingchild.harvard.edu/science/key-concepts/serve-and-return/
https://developingchild.harvard.edu/science/key-concepts/toxic-stress/
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biological stress response inside the child, which remains activated until that familiar caregiver
returns. Even more important, continuing separation removes the most important resource a child
can possibly have to buffer the effects of toxic stress—a responsive adult who’s totally devoted to
that child’s well-being. Stated simply, each day we fail to return these children to their parents,
we compound the harm and increase its lifelong consequences.
There are multiple ways to mitigate this potential damage, but the best thing we could do for
the children who have been separated from their parents at the border is to reunite them
immediately. If children were being fed poison and someone asked, “What’s the best treatment?”,
the best answer is not to come up with an antidote. The solution is to stop poisoning them in the
first place.
Jack P. Shonkoff, M.D.
Founding Director
Center on the Developing Child at Harvard University
See also: Migrant Family Separation Congressional Testimony by Jack P. Shonkoff, M.D. –
February 7, 2019
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P O L I C Y R E S O U R C EP O L I C Y R E S O U R C E
Three Priorities for Babies at the Border
Jul 11, 2019
In recent weeks, families, advocates, policymakers, and Administration personnel have given us a
window through the walls of migrant detention camps, again focusing national attention on the life-
altering experiences of families with children crossing the border. As we learn more about the young
children being held in detention, often separated from their families and under reportedly grossly
inadequate care, ZERO TO THREE is compelled to reiterate what decades of research clearly spell out
about the impact of trauma on young children.
Babies’ brains develop at rapid fire speed, and what happens to them today informs who they will be tomorrow. Young
children being held in detention at the border need our urgent attention and action. We must act on their behalf
immediately.
There is a common misperception that babies are too young to be affected by the events around them. In truth, at the
very foundation of babies’ development, intense trauma almost inevitably creates physiological damage to their brains
and emotional damage that they will carry into the future – particularly if their needs are not met appropriately and
immediately. Out of deep concern for young children, families, and the future of our country, ZERO TO THREE remains
in strong, informed opposition to any practice that causes trauma and long-term harm to children. As we apply our
research-based lens to current immigration practices and debate, we have three priorities:
Babies do not belong in congregate care or detention.
Research clearly shows that babies’ physical and social environments have a significant impact on their development.
Even under the best circumstances, caring for young children outside of community-based family settings deprives
them of the proper care they need to thrive. There is definitive scientific evidence that being held in congregate care
(24-hour residential facilities for groups of children) or detention is harmful for young children. In congregate care,
young children are stripped of critical one-on-one relationships that support healthy brain development. Placing babies
and toddlers in detention centers, even with their families, is also not a viable option. The only safe placement for
young children is in a family setting. In the unique circumstance of a young child entering our country with an adult
deemed to be dangerous or unfit to provide care, the young child must remain in a community-based family setting,
such as with foster parents.
Congregate Care: Science tells us that infants and toddlers need consistent and personalized care from trusted,
loving adults. When we place migrant babies in congregate care, as recent reports indicate, we deprive them of the
nurturing relationships they need and derail their development. In such group settings, multiple adults are
responsible for the care of a child, working rotating shifts, and are not individuals that the child knows or trusts.
Studies from around the world show that children placed in congregate care settings experience serious
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compromises in cognitive, language, and especially, social development. Landmark studies of young children
exposed to institutional rearing in Romania show alterations in the structure and functioning of their brains, and
serious psychiatric and social impairments lasting into adulthood.
Family Detention: Sending infants and toddlers to institutional detention is detrimental to their health and well-
being. The contention that children are only temporarily being held in detention facilities does nothing to change
the impact on their development. Recent reports from detention camps indicate that children, including babies, are
not being provided with the basics of hygiene and care, including regular diapering and nutritious food. Beyond
these violations to basic needs, detention places children in an environment of confinement, deprivation of stimuli -
and in some cases, overstimulation - and developmentally inappropriate and often harsh treatment, which cause
severe stress for both the children and their caregivers. Historically, evaluations of children who have been detained,
even with their families, reveal alarming outcomes, with many children displaying developmental delays and signs of
emotional disturbance such as a short attention span, aggression, withdrawal, difficulty coping, and learning
difficulties. If the legal protections established for children’s care in such facilities (including time limits and
regulations) are not adhered to, or are reversed, infants, toddlers, and their families in detention facilities are
vulnerable to prolonged stays, abuse, and neglect. Further compounding the risks to their well-being, families in
detention may face inadequate access to services including the medical and mental health care they so desperately
need.
Families who have been separated must be reunified immediately, and
the practice of separating children from their parents must not
continue.
While the practice of separating children from their families was prohibited by Executive Order, it is evident from
reports out of detention camps that this practice continues, with very young children removed from the adults who
care for them, and reportedly turned over to unrelated older children for their care. While the rapid development of
infants and toddlers makes them particularly vulnerable to trauma, families offer an essential buffer to those
experiences. When children are separated from their parents after crossing the border, that primary bond is severed.
This causes stress hormones to flood babies’ brains, disrupting their neurological circuitry in ways that profoundly
affect their short- and long-term physical and emotional health, and their ability to form relationships and learn. That
trauma is compounded when children are placed in the care of strangers untrained to care for young children, either
older children or adults who are ill-equipped to protect them, much less nurture their healthy development. The broad
consensus of researchers and practitioners is that to continue to separate families in this way is tantamount to child
abuse. Additionally, children who have already been separated must be immediately reunited with their caregivers,
providing them with the close relationship they need to cope with the trauma they have undergone.
Young children who have been held in detention and/or have been
separated from their families need access to voluntary infant and early
childhood mental health services and support.
Decades of psychological and brain research have demonstrated that adverse experiences during the first three years,
including forced parental separation and placement in incarceration-like settings, can have profound immediate and
long-term harm on child development. In the short-term, children may experience anxiety, depression, and self-
regulatory issues, including sleeplessness or eating issues. Over time, they may show regression in behavior and
cognition, and demonstrate symptoms of post-traumatic stress disorder. This type of trauma, particularly when not
addressed by an experienced and trusted clinician, has severe implications for both physical and emotional health over
time, increasing young children’s risk for learning difficulties, problems forming relationships, and adult health issues.
Caregivers, who are also deeply psychologically and physiologically impacted by their recent experiences, also need
support to provide their children with the care they need. When families have been separated, reunification itself may
be difficult, as separated young children don’t have the capacity to understand what has transpired and may feel
abandoned by their parents. This is complex work, requiring a focus on both parent and child, and requiring specialized
expertise and developmentally appropriate, evidence-based support. Infant and early childhood mental health
professionals across the United States are able to help, but they need pathways to families.Individuals interested in
connecting families with IECMH professionals can utilize this directory
(https://www.zerotothree.org/resources/preview/98cd198a-8f4f-4811-b6ed-fb09c7c19c5a) to find a contact in their
state.
As experts in early childhood development, we know that every day matters for the well-being of babies and toddlers
who have experienced trauma at the border and elsewhere. Appropriate support and treatment are urgently needed,
and time is truly of the essence for the protection and care of young children’s rapidly developing brains. As we
consider babies at the border, we must use what decades of science and research tell us to inform policy and practice
decisionsright now.Their future – and the best interests of our nation – depend onit.
Take Action
Be a Big Voice for Little Kids
We have three simple ways for you to make a difference for
traumatized babies at the border.
ACT NOW! (HTTPS://WWW.ZEROTOTHREE.ORG/RESOURCES/PREVIEW/E500F20B-041E-47DF-B179-
C4BA3215802C)
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1Childhood Traumatic Grief: Information for Pediatric Providers
Why are pediatric providers important for grieving children?
Pediatric providers often support children and families through the death of a parent, sibling, or other important person.
One in fourteen children will experience the death of someone close to them by age 181. Following a death, while most
grieving children will successfully adjust to the death in time, some children may experience a condition called Childhood
Traumatic Grief, in which traumatic stress reactions related to the death interfere with the child’s ability to grieve and
adjust.
Especially after a death, many families are willing to seek help for physical complaints. However, they may be reluctant to
ask for help for psychological or emotional issues or be unaware of a psychological component to physical health. Pediat-
ric providers are in a unique position to identify children having ongoing difficulties. Often they are the first professionals
to see a child needing help for Traumatic Grief and, therefore, in the best position to make referrals.
1 What Is Childhood Traumatic Grief?
Childhood Traumatic Grief is a condition in which children develop traumatic stress reactions to the death of family mem-
ber, friend, or other important person in their lives. These symptoms then interfere with the bereavement process. In
Childhood Traumatic Grief, even happy thoughts and memories of the significant person remind children of the traumatic
way the person died. Children with Traumatic Grief get “stuck” on the traumatic aspects of the death and cannot proceed
through the normal bereavement process.
Childhood Traumatic
Grief: Information for
Pediatric Providers
One in fourteen children will experience the death of
someone close to them by age 18.
This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS).
The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.
2Childhood Traumatic Grief: Information for Pediatric Providers
2 Who develops Childhood Traumatic Grief?
Children with Childhood Traumatic Grief experience the cause of death as horrifying or terrifying, whether the death was
sudden and unexpected (e.g., due to homicide, suicide, a school shooting, motor vehicle accident, drug overdose, natural
disaster, war, terrorism) or due to natural causes (e.g., cancer, heart attack, stroke). Even if the manner of death does not ap-
pear to others to be sudden, shocking, or frightening, children who perceive the death in this way may develop posttraumatic
stress reactions that lead to Childhood Traumatic Grief.
3 What are the signs a child might have Childhood Traumatic Grief?
In Childhood Traumatic Grief, the following traumatic stress reactions may interfere with the child’s grieving process:
Intrusive reactions such as upsetting thoughts, images, nightmares, memories, or play about the frightening way the
person died
Physical or physiological distress such as headaches, stomachaches, symptoms mimicking the way the deceased died,
jumpiness, trouble concentrating
Avoidance reactions such as withdrawal; acting as if not upset about the death; or avoiding reminders of the person,
the way the person died, places or things related to the person, or events that led to the death
Negative mood or beliefs related to the traumatic death such as anger, guilt, shame, self-blame, loss of trust, believing
the world is unsafe
Increased arousal such as irritability, anger, trouble sleeping, decreased concentration, dropping grades, increased
vigilance, and fears about safety of oneself or others; self-destructive or risk-taking behaviors (e.g., substance abuse,
suicidality)
Guidance for pediatric trauma screening is available at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initia-
tives/resilience/Pages/PTSD-Fact-Sheet.aspx.
3 How does Childhood Traumatic Grief impact physical health?
Childhood Traumatic Grief can have a significant impact on children’s physical health and be indicated by the following:
Somatic symptoms severe enough to warrant sick-child pediatric visits
Presentation of new somatic symptoms with no clear underlying medical cause
Presentation of symptoms that mimic the deceased person’s cause of death
Significant worsening of existing chronic medical conditions (e.g., diabetes, asthma)
Noncompliance or decreased compliance with usual medication regimens
Depressed affect, changes in behavior, and other psychiatric symptoms
Self-injurious or suicidal behaviors, substance abuse, or other risky behaviors
Changes in eating or sleeping behaviors
4 How can you assess children with Childhood Traumatic Grief?
Children with Childhood Traumatic Grief often avoid talking about death or the person who died. Ask children directly about
their experiences with trauma or the death of an important person. Not asking may inadvertently communicate to the child
that it is unacceptable to discuss these things with adults. If your questions make the child’s symptoms worse, this may be
a sign that professional help is warranted. Pediatric providers often are in the best position to talk to children about trauma
and death because your patients already have a trusting relationship with you.
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/resilience/Pages/PTSD-Fact-Sheet.aspx
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/resilience/Pages/PTSD-Fact-Sheet.aspx
3Childhood Traumatic Grief: Information for Pediatric Providers
You may want to ask the parent to step out of the room during these conversations, because children with Traumatic Grief are
often overly concerned with causing their parents additional emotional distress and may deny symptoms in a parent’s pres-
ence to avoid upsetting them. To evaluate the presence of Childhood Traumatic Grief, pediatric providers can do the following:
Routinely ask parents and caregivers if their children have experienced any deaths or traumatic events since their last
visit.
Ask children directly whether anything very scary or upsetting has happened since the last visit.
Follow up with children and families known to have recently experienced a death or with children who are approaching
an anniversary or reminder of a death.
Pay particular attention to children who have experienced traumas in addition to the death of a significant person, as
exposure to additional trauma may worsen Traumatic Grief symptoms.
Inquire about adjustment to deaths that are seemingly long past, as grief reactions sometimes surface at later points
in life or developmental stages.
5 What can you do to help children with Traumatic Grief?
FOR CHILDREN
Assure the child that many children experience similar reactions following the traumatic death of an important person.
Provide support and assurance that help is available.
Be sensitive when doing invasive medical procedures or examinations that may somehow remind the child of previous
traumatic experiences or experiences related to the death.
Be aware of the effect of anniversary dates of the loss and potential reminders of the death (e.g., Mother’s Day, Father’s
Day, holidays) and adjust medical appointments, procedures, and treatment recommendations in light of how Childhood
Traumatic Grief impacts physical illness and treatment compliance.
Address treatment compliance issues directly with the child and parent. If barriers to compliance persist, a mental
health consultation is warranted.
FOR CHILD AND PARENT
Discuss making a referral for specialized treatment with both the child and parent.
Refer the child to a mental health professional, ideally one who has experience in treating childhood traumatic stress
and Traumatic Grief.
Encourage the family to call you if additional symptoms or other concerns arise, or if they have difficulty in arranging
mental health follow-up.
Reassure children and parents that these problems can be successfully treated and that children can recover with
appropriate help.
FOR PARENTS
Keep materials on hand to educate parents about Childhood Traumatic Grief (available at https://www.nctsn.org/what-
is-child-trauma/trauma-types/traumatic-grief).
Educate parents about the value of getting professional help for the child’s Traumatic Grief.
https://www.nctsn.org/what-is-child-trauma/trauma-types/traumatic-grief
https://www.nctsn.org/what-is-child-trauma/trauma-types/traumatic-grief
4Childhood Traumatic Grief: Information for Pediatric Providers
Where do you find additional information and help?
Effective treatments are available for Childhood Traumatic Grief and children can return to their normal functioning.
Additional information for children, parents, professionals, pediatricians, and educators is available at the National
Child Traumatic Stress Network, www.NCTSN.org with materials specific to Traumatic Grief at www.nctsn.org/trau-
ma-types/traumatic-grief.
Footnotes
https://www.judishouse.org/cbem-methodology-and-sources 1.
Currently two treatment models have scientific evidence of helping children recover from Childhood Traumatic Grief:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for children ages 3-18 years and their parents or primary
caregivers provided in 12-15 individual or group sessions. More information is available here:
https://www.nctsn.org/interventions/trauma-focused-cognitive-behavioral-therapy
Trauma Grief Components Therapy for Adolescents (TGCT-A) for teens ages 13-17 years, provided in groups.
More information is available here: https://www.nctsn.org/interventions/trauma-and-grief-component-therapy-ad-
olescents
http://www.NCTSN.org
http://www.nctsn.org/trauma-types/traumatic-grief
http://www.nctsn.org/trauma-types/traumatic-grief
https://www.nctsn.org/interventions/trauma-focused-cognitive-behavioral-therapy
https://www.nctsn.org/interventions/trauma-and-grief-component-therapy-adolescents
https://www.nctsn.org/interventions/trauma-and-grief-component-therapy-adolescents
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e. Embedded Entrepreneurship
f. Three Social Entrepreneurship Models
g. Social-Founder Identity
h. Micros-enterprise Development
Outcomes
Subset 2. Indigenous Entrepreneurship Approaches (Outside of Canada)
a. Indigenous Australian Entrepreneurs Exami
Calculus
(people influence of
others) processes that you perceived occurs in this specific Institution Select one of the forms of stratification highlighted (focus on inter the intersectionalities
of these three) to reflect and analyze the potential ways these (
American history
Pharmacology
Ancient history
. Also
Numerical analysis
Environmental science
Electrical Engineering
Precalculus
Physiology
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ness Horizons
Algebra
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Physical chemistry
nt
When considering both O
lassrooms
Civil
Probability
ions
Identify a specific consumer product that you or your family have used for quite some time. This might be a branded smartphone (if you have used several versions over the years)
or the court to consider in its deliberations. Locard’s exchange principle argues that during the commission of a crime
Chemical Engineering
Ecology
aragraphs (meaning 25 sentences or more). Your assignment may be more than 5 paragraphs but not less.
INSTRUCTIONS:
To access the FNU Online Library for journals and articles you can go the FNU library link here:
https://www.fnu.edu/library/
In order to
n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading
ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.
Key outcomes: The approach that you take must be clear
Mechanical Engineering
Organic chemistry
Geometry
nment
Topic
You will need to pick one topic for your project (5 pts)
Literature search
You will need to perform a literature search for your topic
Geophysics
you been involved with a company doing a redesign of business processes
Communication on Customer Relations. Discuss how two-way communication on social media channels impacts businesses both positively and negatively. Provide any personal examples from your experience
od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages).
Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in
in body of the report
Conclusions
References (8 References Minimum)
*** Words count = 2000 words.
*** In-Text Citations and References using Harvard style.
*** In Task section I’ve chose (Economic issues in overseas contracting)"
Electromagnetism
w or quality improvement; it was just all part of good nursing care. The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases
e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management. Include speaker notes... .....Describe three different models of case management.
visual representations of information. They can include numbers
SSAY
ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3
pages):
Provide a description of an existing intervention in Canada
making the appropriate buying decisions in an ethical and professional manner.
Topic: Purchasing and Technology
You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class
be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique
low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.
https://youtu.be/fRym_jyuBc0
Next year the $2.8 trillion U.S. healthcare industry will finally begin to look and feel more like the rest of the business wo
evidence-based primary care curriculum. Throughout your nurse practitioner program
Vignette
Understanding Gender Fluidity
Providing Inclusive Quality Care
Affirming Clinical Encounters
Conclusion
References
Nurse Practitioner Knowledge
Mechanics
and word limit is unit as a guide only.
The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su
Trigonometry
Article writing
Other
5. June 29
After the components sending to the manufacturing house
1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend
One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard. While developing a relationship with client it is important to clarify that if danger or
Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business
No matter which type of health care organization
With a direct sale
During the pandemic
Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record
3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i
One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015). Making sure we do not disclose information without consent ev
4. Identify two examples of real world problems that you have observed in your personal
Summary & Evaluation: Reference & 188. Academic Search Ultimate
Ethics
We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities
*DDB is used for the first three years
For example
The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case
4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972)
With covid coming into place
In my opinion
with
Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA
The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be
· By Day 1 of this week
While you must form your answers to the questions below from our assigned reading material
CliftonLarsonAllen LLP (2013)
5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda
Urien
The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle
From a similar but larger point of view
4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open
When seeking to identify a patient’s health condition
After viewing the you tube videos on prayer
Your paper must be at least two pages in length (not counting the title and reference pages)
The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough
Data collection
Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an
I would start off with Linda on repeating her options for the child and going over what she is feeling with each option. I would want to find out what she is afraid of. I would avoid asking her any “why” questions because I want her to be in the here an
Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych
Identify the type of research used in a chosen study
Compose a 1
Optics
effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte
I think knowing more about you will allow you to be able to choose the right resources
Be 4 pages in length
soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test
g
One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research
Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti
3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family
A Health in All Policies approach
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum
Chen
Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change
Read Reflections on Cultural Humility
Read A Basic Guide to ABCD Community Organizing
Use the bolded black section and sub-section titles below to organize your paper. For each section
Losinski forwarded the article on a priority basis to Mary Scott
Losinksi wanted details on use of the ED at CGH. He asked the administrative resident