Refugee Children Research Articles

Differences in the rates of admission and major orthopedic surgery care between Turkish and displaced children injured in a major earthquake

Abstract Background The burden of displacement makes child refugees, asylum seekers, and migrant children less resistant to medical problems. On February 6, 2023, the southeast and the southcentral regions of Türkiye were struck by two sequential large earthquakes. The study aimed to analyze the characteristics of musculoskeletal injuries and the initial orthopedic surgery data resulting from the earthquake and compare the differences between Turkish and displaced children, particularly those who underwent major musculoskeletal interventions at the four state hospitals of the Adana metropolitan region. Methods The retrospective study analyzed the medical records of the survivors admitted to the four general hospitals run by the government in the Adana, Türkiye metropolitan area between February 06, 2023, and February 13, 2023, the first seven days following the earthquake. The analysis data included age, gender, nationality, time of admission, types and localization of injuries, and treatment methods. Results The number of cases under 18 years of age requiring orthopedic intervention was 969. The distribution of the cases based on nationality was as follows: there were 517 Turkish (53.35%), 371 Syrian (32.71%), and 81 children of unknown nationality (CUN) (8.36%). The files show that the patients requiring surgery, including fasciotomy, fracture surgery, and amputation (n = 281), were mainly treated at the level I trauma center (n = 171, 60.85%). In terms of the daily distribution of admissions based on the type of musculoskeletal injuries, the admissions of children with foot fractures in the first days were significantly increased (p = 0.0134). Regarding surgery rates, the fracture surgery and fasciotomy rates were significantly higher in cases admitted earlier. (p < 0.0001 and p = 0.0009, respectively). In terms of nationality, there were no significant differences regarding the date of admission, the number of cases who underwent amputations, and the discharge number and types. Conclusion The study revealed that after the severe earthquake disaster, the state hospitals of the Adana metropolitan region provided unbiased healthcare for all the region’s children. Regarding orthopedic care, the response was given accordingly in this particular disaster, highlighting that level I trauma centers should always be ready for such intensity due to the short preparation time in case of a severe disaster.

School administrators’ and teachers’ pedagogical responses to demographic change based on their meaning-making of multicultural students in South Korea

ABSTRACT Public schools in South Korea have faced unprecedented changes because of demographic shifts, particularly the influx and growth of three types of ‘multicultural students’: children of married migrant women, foreign workers, and North Korean refugees. In this situation, teachers are challenged to implement educational policies and a standardised national curriculum for those unfamiliar with the Korean language, culture, and education system. This study, conducted between Fall 2022 and Summer 2023, involved interviews with 16 elementary and secondary school administrators and teachers from urban and rural regions. It revealed that teachers’ perceptions and biases about multicultural students significantly influenced their educational practices, resulting from interpretive processes and problematic framing. The data indicate that teachers’ meaning-making and pedagogical responses to multicultural students are insufficient for systematically addressing the structural inequalities and social injustices faced by these students. Ultimately, these teachers’ responses and practices fell short of providing equitable education that South Korea’s multicultural education policies aim for. The study concluded that comprehensive teacher training in cultural competence and bias awareness is essential for bridging the gap between policy and practice. It recommends the development of reflective practices, continuous professional development, and the creation of supportive school environments to enhance multicultural education’s effectiveness.

Refugee Children’s Perspectives on Participating in Music Therapy

Refugee Children’s Perspectives on Participating in Music Therapy

Holistic Healing: A Multidisciplinary Approach to Addressing Psychosomatic and Mental Health Challenges in a Young Refugee

Our hypothetical case study depicts the experience of a newly arrived refugee child, a 10-year-old refugee from war-torn Kyiv, Ukraine. She presented with symptoms of anxiety-related physical complaints following displacement and relocation to the United States. This case study illustrates the care provided by a pediatric nurse practitioner. A multidisciplinary approach was used to address her psychosomatic symptoms, mental health, malnutrition, immunization status, and social integration challenges.

“War is destructive, but it reconstructs anew…:” Refugee Education and State Consolidation in Imperial Austria during the First World War

Abstract This article explores aspects of the organization of refugee education in imperial Austria during the First World War. Authorities in charge of refugees’ control and their eventual assistance interpreted access to education in two ways. First, it was an avenue of relief through schooling, aimed to counter the effects of uprootedness and, thus, safeguard some continuity in refugee children’s lives. Second, it was a way to ensure the making of productive and loyal citizens. In this context, this article looks at various policies regarding organization of schooling for displaced children. Moreover, it analyzes the ways language entered the realm of the refugee-focused classroom. Officials used schooling in refugee students’ vernacular to relieve the effects of their displacement and to reinforce ethnonational classifications of imperial subjects. At the same time, education through refugee children’s growing exposure to German language courses became a measure of a gradual inculcation of an imperial consciousness. Furthermore, it was a civilizing dimension of displacement management and, in this way, it became an avenue to consolidate a war-feeble state.

Understanding and addressing the needs of refugee and asylum-seeking children and young people

Abstract Issue/problem Europe is home to an increasing number of refugee and asylum-seeking children at risk of health and wellbeing needs due to their life experiences. They are frequently marginalised, impoverished, and face barriers accessing the healthcare and support they need. Bevan, an English social enterprise providing health and wellbeing services to Inclusion Health populations, carried out a needs assessment of migrant children registered at one of its General Practices to determine challenges and opportunities to ensuring their right to health. The knowledge and learning generated is relevant across sectors; organisations and geographical boundaries. Description of the problem The assessment included a literature review, audit of child new patient health checks, service mapping, multi-agency stakeholder interviews and a consultation event with unaccompanied minors. Findings informed Bevan’s Migrant Children and Young People (CYP) Strategy, local service development and system-wide recommendations. Results Key areas of concern identified included mental health; safeguarding; development; nutrition; and inter agency working. Challenges to meeting needs were complex and included national policies, poor provider understanding of rights and entitlements, language and cultural barriers, health service waiting lists, housing and silo-working. Lessons Responding to findings Bevan invested in an in-house CYP mental health service and CYP social prescriber, opened a drop-in clinic and wellbeing service for unaccompanied minors, and initiated orientation and health information sessions for new arrivals with peer advocate support. Bevan now hosts a city-wide cross-sector Migrant CYP stakeholder group and collaborates with regional and national partners to develop resources to promote the health of migrant CYP. Key messages • The needs assessment enabled development of a responsive integrated service for migrant CYP that meets their health needs and addresses their social determinants of health. • The Migrant CYP stakeholder group has improved inter-agency working, helped identify service gaps, increased advocacy opportunities, and facilitated co-creation of solutions to meet population needs.

5.Y.1. Refugees and mental health

Abstract Research suggests an elevated risk of mental health conditions (depression, posttraumatic stress disorder, anxiety) among refugees, due to exposure to trauma, displacement, and the challenges of adapting to new environments. Children and adolescents with refugee background face additional challenges, including family disruptions, education interruptions, and uncertain futures. However, the data are heterogeneous and more detailed data are needed. To address this gap, we present data on refugee’s mental health and resilience. First, data on resilience and mental health from Germany are presented. These data are adjusted for demographics and suggest that in case data are adjusted to the living situation in the host country the migrant status is less relevant. The second study presents the mental health of refugee adolescents and children in Greece. The third study presents results based on a Portuguese prospective cohort study Perinatal Health in Migrants: Barriers, Incentives, and Outcomes (baMBINO). This study investigates postpartum depression among refugee women in Portugal highlighting the need for access to care. Last, a systematic review and meta-analysis provides data on depression, anxiety and stress of 62,522 refugees from more than 30 countries. This data suggests that life experiences are critical for refugees’ mental health. Based on the presentations the audience will be engaged in discussion on how to better early prevent mental health conditions in refugees. Key messages • Mental health of refugees is a Public Health challenge. • Pre- and post migration experiences impact refugees and migrants mental health conditions.

Mental health and resilience of students with a refugee background in Greece.RaRE project findings

Abstract Background Research highlights the mental health challenges faced by children and adolescents from refugee backgrounds due to various risk factors encountered during migration, including exposure to violence, family disruptions, insecure legal status, and educational interruptions. These factors increase the risk of psychological issues and academic difficulties. This study investigates the relationship between mental health and resilience in refugee adolescents in Greece. Methods The study focuses on refugee adolescents aged 12-18 from Syria, Iraq, Afghanistan, Somalia, and Ukraine, the countries with the highest numbers of school-age refugees in Greece. Data were collected from 37 refugee children, 37 teachers, 4 parents, and 19 guardians using Poisson sampling. Results are based on responses to the Strengths and Difficulties Questionnaire (SDQ) and the Child Youth Resilience Measure (CYRM), with triangulation of self-completed questionnaires from students, parents/legal guardians, and teachers. Pearson correlation coefficient was employed for analysis. Results We present the pairwise Pearson correlation coefficients of students’ responses to psychometric tests in relation to those of teachers, along with the corresponding p-values for a two-tailed test of significance. Specifically, cor(SDQst,SDQt)=0.443 (p-value=0.006), cor(SDQst,CYRMt)=-0.341 (p-value=0.039), cor(CYRMst,SDQt)=-0.333, (p-value=0.006), cor(CYRMst,CYRMt)=0.323 (p-value=0.051). All p-values are below 0.05 or very close to it, so we reject (or we are close to) the null hypothesis of no association at 5% significance level for every case. On the contrary, we note that the corresponding coefficients between students and parents/legal guardians are all statistically non-different from 0 at 5% significance level. Conclusions Educators exhibit a solid understanding of students’ challenges and resilience compared to parents and guardians. These promising findings support further research.

Correlation of screen exposure to stress, learning, cognitive and language performance in children.

The omnipresence of mobile screens and convenience to operate them has led to increased screen time for young children whereas the sequelae of prolonged exposure are not known yet. 70 refugee children (RG) and 111 children of a clinical comparison group (CG) from a help-seeking population (age: M = 5.10; SD = 1.11; range 3.00-6.97years) were assessed concerning their amount of daily screen exposure time in relation to parental education and distress. Salivary cortisol was collected as a marker for biological stress and children were tested concerning learning performance, non-verbal IQ and vocabulary with the Kaufmann Assessment Battery for Children (KABC-II). Language skills were assessed in educator rating. The amount of children's screen exposure was negatively related to parental education and positively to distress. In the CG, higher amounts of screen time were associated with elevated cortisol levels and lower learning scores. On both measures, the RG and CG only differed in the condition of screen time less than one hour/day, for higher amounts of screen time the CG approached the more problematic scores of the RG. Whereas in the whole sample the amount of screen time was negatively correlated to language performance, it was not correlated to non-verbal IQ-scores. As a higher amount of media exposure in our clinical comparison group is associated with elevated biological stress, decreased learning and lower language performance, it should be classified as a relevant environmental factor and regularly considered in clinical assessments of children and therapeutical interventions, especially in vulnerable subgroups. German clinical trials register, registration number: DRKS00025734, date: 07-23-2021.

Social-Emotional Outcomes in Refugee Children: A Pilot Randomized Controlled Trial of a School-Based Mindfulness Intervention Implemented in a Refugee Camp

Social-Emotional Outcomes in Refugee Children: A Pilot Randomized Controlled Trial of a School-Based Mindfulness Intervention Implemented in a Refugee Camp

A child-centred intercultural approach to the socio-educational inclusion of migrant and refugee children

The increasing trend of child migration, whether forced or voluntary, poses a challenge to policies aimed at ensuring social cohesion and protecting children's rights. Inclusive educational environments play a crucial role in the integration of migrant and refugee children by promoting intercultural dialogue and participation. This study aims to explore the potential of a child-centred approach to the socio-educational inclusion of migrant and refugee children in Europe, proposing a framework of inclusive interculturalism to address the specific challenges these children face in educational settings. A narrative review was conducted, examining a wide range of peer-reviewed sources to synthesise current knowledge on child-centred education and its applicability to migrant and refugee children. The review identifies key challenges in adopting a child-centred approach, including socio-cultural, linguistic and psychological barriers that hinder migrant and refugee children's full participation in education. It highlights the importance of promoting agency, cultural competence and emotional well-being through inclusive and intercultural educational practices. Implementing a child-centred, inclusive intercultural approach can promote social cohesion and reduce inequalities by ensuring that all children, regardless of their background, have access to quality education and opportunities for personal development. However, more empirical research is needed to translate these theoretical frameworks into practical interventions.

Teachers’ perspectives and practices relating to refugee girls: a mixed-methods multidisciplinary survey

ABSTRACT Teachers’ perspectives are key to understanding practice and support for high-risk groups like refugee children. This mixed-methods multidisciplinary study explored primary teachers’ perspectives and skills on issues of equity, migration and social-emotional skills, using an online survey. The survey contained quantitative perspective questions and qualitative scenarios. Triangulated results suggested that teachers’ perspectives around equity and social-emotional skills differ from their practice when responding to student scenarios. Their perspectives on migration, however, are aligned with their scenario responses. Results show a skill gap that may impact teachers’ ability to support refugee children in adjusting to and thriving in their classrooms.

Protective and Promotive Factors in Migrant and Refugee Children Facing Violence: A Systematic Review.

Migrant and refugee children are at risk of experiencing various forms of violence before, during, or after migration. This study systematically identifies, reviews, and synthesizes evidence on protective and promotive factors that contribute to the resilience of migrant and refugee children facing violence. Of the 3,663 articles identified through search in five electronic databases and snowball technique, 31 quantitative or qualitative research studies met the inclusion criteria. To be included in the review, studies had to (1) have been published after 2013; (2) have been published in English; (3) include migrant or refugee children and/or adolescents aged 18 or below at the time of interview or migration; (4) mention some types of maltreatment, peer violence, or community violence faced by the children or adolescents; (5) examine the association between the hypothesized protective or promotive factors and indicators of adaptive functioning; and (6) include outcome measures that assessed adaptive functioning such as well-being or absence or low-levels of internalizing and externalizing problems. Quality assessment did not lead to the exclusion of any studies. Five levels of protective and promotive factors were identified: individual, family, school and peers, community, and spatial dimension, which converged to highlight the importance of regulatory, interpersonal, and meaning-making strengths for these children. Understanding and addressing these protective and promotive factors is crucial for promoting well-being and improving mental health outcomes in migrant and refugee children facing violence. The findings of this review have significant implications for designing intervention programs and public policies that support these children effectively.

Integration of displaced students into the culturally and linguistically different school environment

AbstractThe rapid increase in the number of refugees arriving in the last decade and the discussion about the integration of Syrian refugees into Turkish society has received special attention. As an important tool of socialisation in childhood, the educational system and school environment need to be structured using refugee‐friendly and equity‐based methods to meet the needs and expectations of refugee children. Based on the perceptions of school leaders and teachers, this study attempts to understand the challenges faced by Syrian refugee students during their integration into the school environment in Turkey and explore the practices of educators in meeting these challenges. A phenomenological qualitative design explored educators' beliefs, thoughts and experiences regarding the education of Syrian refugee children in Turkish schools. Participants of this research were 21 educators including 4 principals, 3 assistant principals, and 14 teachers working in primary and secondary schools with Syrian refugee students. The results show that Syrian refugee students in Turkey encounter various challenges as they adjust socio‐culturally, psychologically, and academically within the school setting. Although some of the teachers apply culturally relevant methodologies unconsciously, there is a gap in professional training on this. Educators declare the need for more practical and inclusive approaches despite the efforts by the Ministry of National Education. Hence, this study suggests the necessity of targeted training programmes because the purpose is to better equip teachers with effective strategies of integration. Thus, it is recommended that gradual language education and mutual cultural activities are widely applied to make refugee students feel more comfortable and to successfully improve their academic achievement. Context and implications Rationale for the study This research is motivated by the precarious situation of Syrian refugee students residing in Turkey. Why the new findings matter The new findings underline large gaps in culturally responsive pedagogy among educators and call forth the need for all‐round, hands‐on training programmes to better facilitate the academic and socio‐cultural integration of refugee children. The findings also reveal a gap in the familiarity and application of culturally responsive pedagogy among educators, pointing to a need for professional development in this area. Implications for practitioners, researchers and policy makers This paper, therefore, calls for the practical training of practitioners in culturally responsive pedagogy to become more supportive of their refugee students. A call is sent out to the framers of the educational policies, which incorporates comprehensive professional development along with inclusive education policies that address the requirements of refugee children. Building on these findings, researchers might explore systems, strategies, and interventions to effectively integrate displaced students into the classroom. The study thus requires collaborative efforts in the creation of supportive school environments that juxtapose socio‐cultural and academic success for quality education among refugee students.

EDUCATION OF REFUGEE CHILDREN WITHIN THE INTREF PROJECT FRAMEWORK

Amidst growing migratory movements and hurdles of assimilation, the INTREF initiative strives to craft a comprehensive strategy for the schooling of refugee children, melding e-learning, emotional and social support, along with adaptable teaching methods. This endeavor learns on principles like linguistic diversity, cross-cultural skills, and customizing the educational journey, crucial for assimilation and triumph within academic settings. Studies indicate the indispensability of bespoke linguistic assistance, cognizance of cultural variances, and personalized educational tactics for the seamless school transition and societal assimilation of children in refuge. The project devised a survey instrument aimed at evaluating the baseline educational scenario in the participating nations and formulating education plans tailored to specific needs. This survey zeroes on four pivotal areas: linguistic proficiency, cross-cultural consciousness, embracing diversity, and pedagogical customization. Feedback from 31 students, 30 teachers and 28 parents revealed a pressing need for augmented linguistic aid in Slovenia, heightened cross-cultural understanding, and classroom method modification to enrich the academic experiences of culturally diverse children. The findings also underscore a discernible discrepancy between the perspectives of educators versus those of parents and children. The insights from this survey lay the groundwork for creating innovative instructional units and resources, finely adapted to the needs of children in refuge. By forging links between theoretical insights and practical application, as well as among various educational stakeholders, INTREF is ready to enrich the discourse and practices surrounding inclusivity, and endeavor made increasingly pertinent by the recent global disruptions, including the migratory dilemma and the COVID-19 outbreak. Keywords: educational system, individualization of education, integration practices, intercultural competence, refugee children

Father-separation and well-being in forcibly displaced Syrian children

ABSTRACT Forcibly displaced children often face separation from their parents, particularly fathers. These children endure the hardships of war, displacement, and the loss of a key attachment figure. Despite the critical role of attachment in children’s well-being during periods of heightened stress, the impact of separation due to war and displacement has received little attention in empirical work. Findings from 1544 Syrian refugee children (M age = 10.97, SD = 2.27) living in informal settlements in Lebanon with their mothers (M age = 38.07, SD = 8.49), including 367 father-separated children, show that father-separated children experienced more war-related events and worse refugee environments. Structural equation modelling showed that beyond the direct relation of war exposure and quality of the refugee environment on well-being, father separation was uniquely related to more depressive symptoms and worse self-development, but not to anxiety, PTSD, or externalising problems in children. Maternal parenting did not explain these outcomes, though it had a protective function for children’s well-being.

Playing with, through and around absence: A clinical commentary on cross-cultural encounter in individual Developmental Transformations (DvT) sessions with refugee children

Playing with, through and around absence: A clinical commentary on cross-cultural encounter in individual Developmental Transformations (DvT) sessions with refugee children

Fleeing Nazi Persecution: Jewish Refugee Child Diarists as Family Chroniclers

This article examines the diaries of young Jewish refugees who documented their emigration from Germany and Austria in the 1930s and who wrote for family members, imagining future readers of their accounts. These diaries offer unique access to children's voices during the Holocaust, showing how some child refugees became family chroniclers, self-consciously documenting a story of Jewish resistance and survival, as well as a tragedy of loss. Their diaries became treasured material objects and autobiographical texts that perform a writing subject, a child as author and narrator, asserting agency in a situation in which they were multiply marginalised as children and as Jewish refugees.

The Child and the Animal in Times of War: Halahmy’s The Emergency Zoo and Contemporary News Reports on the War in Ukraine

This article looks at both Miriam Halahmy’s historical novel for children, The Emergency Zoo, set during several days of mass pet culling in London prior to World War II and Hilda Kean’s published research on the somewhat conveniently forgotten phenomenon, entitled The Great Dog and Cat Massacre. In both these works we observe the strong connection between child and pet, emphasised all the more in a period of uncertainty brought on by impending conflict. The reader is also presented with a detailed exploration of the child’s worldview as compared to that of the adults’ largely hierarchical humanistic perceptions, a way of thinking which is taken as one of the key contributory causes of the terrible pet cull of 1939. Comparisons are then drawn with the treatment of the child–animal relationship and that of household pets during the current Russo-Ukrainian War (the largest European conflict since World War II) as broadly represented in newspaper articles and photographic reports. These reports not only recognise the importance of the child–animal relationship (especially in terms of alleviating trauma and providing a sense of well-being) but also demonstrate that animals are both perceived as refugees and rightly given refugee status. Through an analysis of the strong contemporary media focus on the child and animal refugee, along with the comparison drawn with both Halahmy’s novel and Kean’s historical study, the article concludes that there is clear evidence showing that more recent perceptions of the child–animal relationship and the improved status of pets have been specifically shaped by both posthumanist thinking and the various debates concerning the nature and consequences of the Anthropocene.

Intestinal parasitic infections in Ukrainian war refugee children living in Poland

Introduction: The armed aggression of the Russian Federation against Ukraine in February 2022 forced millions of Ukrainian citizens to flee their country and seek refuge mainly in the European Union. Many of them found shelter in Poland. There are now over one million Ukrainian war refugees living in Poland, including 500,000 children. The attention of Polish medical services has been recently drawn to the previously unknown epidemiological status of infectious and invasive diseases in the paediatric population of Ukrainian refugees. The aim of this study was to assess the prevalence of intestinal parasitic infections in the group of Ukrainian children living in Poland. Materials and methods: The study involved performing parasitological examination of stool samples collected in May 2023 from 37 Ukrainian refugee children aged 3–7 years, who were living in Szczecin (Poland) and were attending a preschool set up to address the needs of the local Ukrainian community. Stool samples were tested by light microscopy using three different methods (direct smear, decantation, flotation) at the Department of Epidemiology and Tropical Medicine at the Military Institute of Medicine – National Research Institute. Results: Intestinal parasites were detected in 3 out of 37 children (8.1% of the study group; there was one case of infection with Ascaris lumbricoides and two cases of infection with Blastocystis spp.). The infected children’s parents or guardians did not observe any diarrhoeas or other gastrointestinal symptoms within 6 months prior to the examination. Conclusions: The presence of intestinal parasites among Ukrainian war refugee children living in Poland justifies the screening for parasitic diseases in this population. The obtained results will allow to take appropriate preventive and therapeutic actions.