TMC PULSE

5 T M C » P U L S E | A U G U S T 2 0 1 8 The Trauma of Separation Placing the long-term health of immigrant children in peril T he Trump administration's "zero-tolerance" immigration policy separated thousands of children from their parents earlier this year. The policy was overturned, but reuniting these families has proved challenging. In recent weeks, some children have been reunited with their parents and caregivers, but thousands more are still waiting. Either way, childhood trauma experts say, the damage has been done. The brain development and long-term health of these young people has been jeopardized. Colleen Kraft, M.D., president of the American Academy of Pediatrics, called the practice of sep- arating families at the border "child abuse" and told reporters that the emotional strain of taking a child away from a parent disrupts brain archi- tecture and inhibits development—reiterating a well-established link between early life expe- riences and long-term health. In the immediate aftermath of separation, children suffer serious psychological, behavioral and physical strain. "We know that these kids are experiencing acute stress reactions, meaning they are terrified, unable to sleep, oftentimes inconsolable, sobbing uncontrollably and basically yearning and long- ing to be back with the parent," explained Julie Kaplow, Ph.D., director of the Trauma and Grief Center at Texas Children's Hospital. "That can manifest in younger kids as behavior problems, and it can also appear like ADHD [attention- deficit/hyperactivity disorder], so it looks like they can't focus or pay attention. In terms of physiologically, we know that there can be high levels of a stress hormone called cortisol coursing through the child's body when they're experienc- ing that level of stress. Over the longer term, these kids can develop full-blown posttraumatic stress disorder [PTSD], depression, anxiety, they may over time turn to substance use as a coping mechanism, and brain development is delayed." Substantial evidence suggests that trauma in early childhood has long-lasting effects on a child's ability to self-regulate and manage interpersonal relationships, as well, said Elizabeth Newlin, M.D., vice chair of child and adolescent psychiatry at The University of Texas Health Science Center at Houston (UTHealth) and chief of child and adolescent services at UTHealth Harris County Psychiatric Center. "The basis of our understanding of ourselves and of the outer world starts through our rela- tionship with our parent and through a secure attachment relationship with our parent—that's our greatest protection against adverse experi- ences in childhood," Newlin said. "When that's disrupted, the child is essentially left completely unprotected from all the stressors that are out there in the world. They are very quickly over- whelmed and there's a huge stress response." (continued) A Honduran child is brought to the United States Immigration and Customs Enforcement office in Grand Rapids, Mich., in July to be reunited with his father. B y A l e x a n d r a B e c k e r We know that these kids are experiencing acute stress reactions, meaning they are terrified, unable to sleep, often- times inconsolable, sobbing uncontrollably, and basically yearning and longing to be back with the parent. — JULIE KAPLOW, PH.D. Director of the Trauma and Grief Center at Texas Children's Hospital Credit: AP Photo/Paul Sancya

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