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Border separations could have traumatic impact on children, doctors say

Forcibly separating the children of undocumented immigrants from their parents at the border sets up those children for lifelong psychological and health consequences,​ pediatricians and other health professionals are warning.

The odds already are higher that these children could suffer from depression, anxiety and other problems because they are coming from violent countries and volatile situations that have likely stressed and traumatized them.


“There is no good that can come from forced separation of a child and their family,” said Paul B. Spiegel, director of the Johns Hopkins Center for Humanitarian Health and a professor at Hopkins’ Bloomberg School of Public Health.

The separations began in May after President Donald J. Trump’s administration announced a “zero tolerance” policy for people who illegally cross the border. Even though Trump issued an executive order Wednesday halting these separations, 2,300 children already have been taken away from their parents, including at least 20 who have been placed with foster families in Maryland. There is no indication when families might be reunited.


Some of the children have been ferried thousands of miles and housed in warehouse-like settings with little or no emotional support. There is a limited number of social workers at these facilities, according to some reports.

“It is adding more trauma to these kids who have already been through a whole lot,” said Dr. Scott Krugman, a Baltimore pediatrician and past president of the Maryland chapter of the American Academy of Pediatrics. “Putting them into a [former] Walmart with hundreds of other children is not exactly a trauma-mitigating circumstance.”

When children face stressful situations, stress hormones like cortisol and adrenaline rise in their bodies. A comforting hug and soothing words from a trusted parent or adult can help alleviate these reactions, Krugman and others said.

When children don’t get that support, stress can rise to harmfully toxic levels.

Research by the Harvard University Center on the Developing Child has found that prolonged stress can disrupt development of the brain and other organ systems.

But the Harvard researchers also said the stress effect can be counteracted by positive relationships with caring adults.

Richard Barth, dean of the University of Maryland School of Social Work, said children removed from their families by social services usually are given some kind of connection with their family within 24 hours. Even a phone call can help protect against the emotional damage such a separation can have on a child, he said.

“Kids who are taken away from family and not put in a stimulating environment can become depressed,” Barth said. “They can stop eating. They begin losing curiosity and stop living the life that a child needs to develop healthily.”


Hopkins’ Spiegel said other risks include substance abuse, learning disabilities and increased engagement in risky behavior. In the long term, the stress can lead to physical health problems as well, such as cardiovascular disease, he said.

The International Rescue Committee in Maryland, which resettles refugees who have sought asylum, keeps families together to help ease what can be an emotional transition, said the group’s executive director Ruben Chandrasekar. The group’s executive director criticized the border separations.

“These people have the legal right to have their asylum cases heard without being criminalized or separated from their children,” Chandrasekar said.

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More than 51 percent of the refugees the organization places are children and many show signs of trauma. Children from war-torn Syria may run inside when a helicopter or plane flies overhead because they fear a bombing. Having family support on top of counseling and other services from the rescue committee, such as group therapy, can help kids better cope with that trauma, Chandrasekar said.

“Children are very resilient and can adapt if given the right support,” he said.

Several medical associations have come out against the Trump administration separations because of the impact on children.


Dr. Colleen Kraft, president of the American Academy of Pediatrics, said in a statement that she saw the early impact the separations were already having during a recent trip to the border. Kraft said the practice of separation goes against protecting and promoting children’s health.

“Highly stressful experiences, like family separation, can cause irreparable harm, disrupting a child’s brain architecture and affecting his or her short- and long-term health,” Kraft said. “This type of prolonged exposure to serious stress — known as toxic stress — can carry lifelong consequences for children.”

The National Academies of Sciences, Engineering and Medicine said that the impact of parents’ nurturing on a child’s well-being is greatest in the earlier years of life.

“Young children are capable of deep and lasting sadness, grief, and disorganization in response to trauma and loss,” the group said in a statement. “Indeed, most mental, emotional, and behavioral disorders have their roots in childhood and adolescence and childhood trauma has emerged as a strong risk factor for later suicidal behavior.”