Mental Health Needs of Refugee Children in Specialized Early Education and Care Programs in Germany

Young children's development after forced displacement: a systematic review

OBJECTIVES

To examine the impact of displacement experiences on 0- to 6-year-old children's social-emotional and cognitive development, as well as influencing factors on reported outcomes.

STUDY DESIGN

We systematically searched MEDline, Psyndex, Cochrane Library, Web of Science, Elsevier, TandF, Oxford Journal of Refugee Studies, Journal of Immigrant & Refugee Studies, and Canada's Journal on Refugees for existing literature regarding social-emotional and cognitive outcomes in children directly exposed to forced displacement due to political violence. Results were synthesized in the discussion and displayed using harvest plots.

RESULTS

Our search generated 9,791 articles of which 32 were selected for review and evaluation according to NICE criteria. Included studies provided results for 6,878 forcibly displaced children. Measured outcomes were diverse and included areas such as peer relations, prosocial behavior, family functioning, play, intelligence, learning performance, and language development. Repeated exposure to adverse experiences, separation from parents, parental distress, as well as duration and quality of resettlement in the host country were reported as influencing factors in the reviewed studies.

CONCLUSION

As protective factors like secure and stable living conditions help to promote children's development, we call for policies that enhance participation in the welcoming society for refugee families. Early integration with low-threshold access to health and educational facilities can help to mitigate the wide-ranging negative consequences of forced displacement on young children's development.

Refugee child health: a systematic review of health conditions in children aged 0-6 years living in high-income countries

This study describes the extent, quality and cultural appropriateness of current research on the health conditions of refugee children aged 0-6 years settled in high-income countries. A systematic review was conducted, including original articles published on the health conditions experienced by refugee children. A total of 71 papers were included. The studies varied considerably in their research design, population characteristics and health conditions. Studies included information on 37 different health conditions, with the majority non-communicable diseases, in particular growth, malnutrition and bone density. Although the studies identified a wide range of health issues, a coordinated effort to prioritise research on particular health topics was lacking, and health conditions studied do not align with the global burden of disease for this population. Additionally, despite being rated medium-high quality, most studies did not describe measures taken to ensure cultural competency and community involvement in their research. We suggest a coordinated research effort for this cohort, with greater emphasis on community engagement to improve the evidence-base of the health needs of refugee children after settlement.

Socio-Emotional Problems and Learning Skills of Roma and Recently Arrived Refugee Children in German Elementary Schools

Abstract. Background: In Germany, many recently arrived and minority families live in multi-ethnic, high-poverty districts. Multiple risk factors threaten their children’s development. Aims: We examined the socio-emotional problems of these children in relation to their academic learning skills and executive functioning. Method: We compared teacher-rated socio-emotional problems of n = 112 Roma children (90% foreign-born), n = 101 refugee children (all foreign-born), and n = 56 German-born immigrant children (age in months: M = 99.66, SD = 13.61) between groups and to norm data. We related socio-emotional problems to receptive vocabulary, cognitive reasoning, motor skills, and executive functioning in n = 83 refugee and Roma children. Results: Roma children showed higher rates above cut-off than norm data in all subscales, more problems in all subscales but emotional symptoms than immigrant children, and more hyperactivity/inattention and peer problems than refugee children. Refugee children showed higher rates above cut-off than norm data in all subscales and more peer problems than immigrant children. Academic learning skills were overall below average among recently arrived children. Prosocial behavior was positively linked to fine motor skills. Other socio-emotional problems were not linked to academic learning skills and executive functioning. Gross and visuo-motor skills correlated positively with other academic learning skills. Limitations: We analyzed cross-sectional data. We did not include risk factors or non-immigrant German children. Conclusion: The heightened socio-emotional problems and low academic learning skills of refugee and particularly Roma children in high-poverty districts could jeopardize their educational trajectories. Additional support measures could increase their chances for educational participation.

Global child health in Germany - Time for action

Child health is central to the SDG agenda. Universities in the UK and other European countries provide leadership in research and education for global child health to inform related policy and practice, but the German contribution is inadequate. German paediatricians and other child health professionals could make more substantial contributions to the debate at home and internationally, but lack opportunities for scholarship and research. We argue, that there is a momentum to advance global child health in academia and call on German universities to realise this potential.

Academic Achievement and Psychosocial Adjustment in Child Refugees: A Systematic Review

Child refugees are at high risk for problems with academic achievement and psychosocial well-being. We aimed to review the literature concerning these outcomes in primary school-aged child refugees. This study was a systematic review and included studies that reported on outcomes of interest in child refugees between 5 and 12 years of age. Our search generated 3,172 articles; we selected 313 for review and included 45. Child refugees are diverse in their educational performance, and early deficits often resolve with time spent in the host country. These children are at an increased risk of emotional and behavioral difficulties, and multiple factors are associated with these outcomes. Although educational difficulties of primary school-aged child refugees in high-income countries tend to resolve, the risks for psychosocial problems persist. This review provides a deepened understanding of the diverse educational and psychosocial experiences of these children and highlights the need for developing health and educational programs to support this population.

Pre-school Teachers' Stereotypes and Self-Efficacy are Linked to Perceptions of Behavior Problems in Newly Arrived Refugee Children

Introduction: Since 2015, increased numbers of refugee families with pre-school-aged children have arrived in Germany. In pre-schools, teachers' professional competence for teaching those children and adapting to their socio-emotional needs has become increasingly important. Previous research linked teachers' stereotypes and cultural beliefs to their self-efficacy and enthusiasm when teaching immigrant children. This study investigated the links between domains of pre-school teachers' professional competence (i.e., negative stereotypes, multicultural beliefs, self-efficacy, and enthusiasm when teaching newly arrived refugee children), and examined whether teachers' professional competence was linked to their perceptions of newly arrived refugee children's behavior problems. Method: In a cross-sectional self-report survey, N = 147 German pre-school teachers reported on their professional competence and completed the Strengths and Difficulties Questionnaire (SDQ) for a selected refugee child from their pre-school group. We used regression modeling to link teachers' negative stereotypes and multicultural beliefs to their self-efficacy and enthusiasm for teaching refugee children. Next, we examined the links between teachers' beliefs, values, and motivational orientations to their ratings on the SDQ subscales. Last, we linked demographic data on teachers and children to teachers' professional competence and SDQ ratings. Results: Teachers with more negative stereotypes toward newly arrived refugee children and less agreement with multicultural beliefs reported lower self-efficacy and enthusiasm for teaching newly arrived refugee children. Teachers with more negative stereotypes perceived more hyperactivity/inattention and total difficulties. Teachers with higher self-efficacy perceived less hyperactivity/inattention, less total difficulties, and more prosocial behavior. Additionally, teachers who had more experience with refugee children reported more negative stereotypes and higher agreement with multicultural beliefs. Teachers having more overall work experience perceived more total difficulties. Boys were perceived to display more externalizing behavior problems, less prosocial behavior, and more total difficulties. Older children were perceived as displaying more prosocial behavior and children from African countries were perceived as displaying more conduct problems. Discussion: Our findings suggest that pre-school teachers' stereotypes and self-efficacy might be related to perception biases concerning newly arrived refugee children's externalizing behavior problems. Implications for the professional development of pre-school teachers and teacher-informant diagnostics of refugee children's socio-emotional needs are discussed.