Pediatric Support for Children Eligible for Legal Humanitarian Relief.

Many children in immigrant families may qualify for legal protection-for themselves if unaccompanied, or as a derivative on parents' claims-on humanitarian grounds related to persecution or forced migration. Pediatric providers can offer a spectrum of multidirectional medical-legal supports to increase access to medical-legal services and support children who are undocumented or in mixed-status families. These activities can include providing trusted information, incorporating screening for health-related social needs, establishing networks for multidirectional referrals, and providing letters of support for legal protection. To expand workforce capacity for medical-legal services related to immigration, pediatric providers can also receive training to conduct specialized, trauma-informed forensic evaluations and can advocate at individual, local, state, federal, and global levels to address factors leading to persecution and forced migration while supporting individuals who may be eligible for legal protection. [Pediatr Ann. 2024;53(5):e183-e188.].

What Should Count as Best Practices of Forensic Medical and Psychological Evaluations for Children Seeking Asylum?

The process of being granted asylum is complex, often taking months and years. Asylum seekers face high risk of being denied asylum in the United States. As medical and psychological evaluations assist in achieving successful asylum outcomes, human rights asylum clinics are being established throughout the country to facilitate these types of evaluations. The Midwest Human Rights Consortium, a multi-institutional, interdisciplinary initiative, is working to streamline the referral process and increase the evaluator workforce through training and mentorship of practitioners. More work is needed to establish evidence-based, child-centered, and trauma-informed best practices in training evaluators and performing evaluations.

El proceso para recibir asilo es complejo y normalmente lleva meses o años. Quienes solicitan asilo enfrentan un alto riesgo de ser rechazados en los Estados Unidos. Debido a que las evaluaciones médicas y psicológicas ayudan a obtener resultados exitosos en cuanto al asilo, se han estado estableciendo clínicas de derechos humanos de asilo en todo el país para facilitar este tipo de evaluaciones. El Consorcio de Derechos Humanos del Centro de EE.UU., una iniciativa multiinstitucional e interdisciplinaria, trabaja para agilizar el proceso de derivaciones y aumentar la cantidad de evaluadores mediante la capacitación y mentoría de los profesionales. Se necesita más información para establecer mejores prácticas con base en evidencia, centradas en los niños y con datos sobre traumas en las capacitaciones de los evaluadores y las evaluaciones.

Forensic Medical Evaluation of Children Seeking Asylum: A Guide for Pediatricians.

Applications for asylum in the United States have increased significantly in the past decade, including those by children fleeing persecution. Pediatricians may serve as a resource for children seeking asylum by participating in specialized training and performing forensic medical evaluations for use in the legal process. A forensic medical evaluation comprises an interview to elicit a narrative of reported abuse, a psychological assessment, and/or a medical assessment. Evaluators document an impression of the consistency of medical and psychological findings with the trauma, which forms the legal basis for a child's asylum claim. This article provides guidance to pediatrician evaluators with an emphasis on an age- and development-specific approach to a forensic medical evaluation of children seeking asylum. Collaboration with primary care pediatricians and community partners about asylum evaluations is important to building support for immigrant children who have experienced trauma. [Pediatr Ann. 2020;49(5):e215-e221.].

An American Academy of Pediatrics State Chapter Initiative Advocating for Immigrant Children and Families.

The Illinois Chapter, American Academy of Pediatrics Refugee Immigrant Child Health Initiative (RICHI), a collaboration of physicians and child advocates, is one of the most robust state chapter programs of its kind. RICHI evolved by tapping into its key demographics to discern both patient needs and providers' skill sets. Although both may be unique to Illinois and its provider base, they can nonetheless provide a framework for creating and guiding state chapters to support the special needs of children in immigrant families. This article illustrates the importance of identifying and analyzing relevant local demographic and policy-related concerns and how to build capacity, connect to local resources, and form key partnerships. [Pediatr Ann. 2020;49(5):e228-e232.].