A Decade’s Experience Performing Forensic Medical and Psychologic Evaluations for Pediatric Asylum Seekers in the United States

Abstract

BackgroundThe number of children seeking asylum in the US has increased substantially in recent years. To add to the limited evidence base related to children seeking asylum in the US, this paper describes the sociodemographic characteristics, nature of human rights violations, and guardianship status of the children served by the Human Rights Clinic of Miami from 2010-2021.MethodsA retrospective study was conducted on affidavits for pediatric patients seeking forensic medical and psychological evaluation at the Human Rights Clinic of Miami from 2010 to 2021. We determined trends among sociodemographic characteristics and the nature of human rights violations among these patients and used logistic regression to determine factors associated with having a guardian present at the evaluation.ResultsOf the total 64 pediatric patients who received a forensic medical and psychological evaluation, over half were male (56%) and two-thirds were aged 15-17. Honduras was the most common country of origin (53%). Physical violence was the most reported human rights abuse (72%) followed by gang violence (53%), sexual violence (22%), and political violence (3%). The majority of children (87%) reported being detained at the border upon entry into the USA. Only 31% of pediatric patients had a guardian present during the evaluation, with guardianship significantly less likely for older patients (p <0.05).ConclusionsThese findings identified specific challenges unique to the pediatric population, including lack of guardianship among older children. Future efforts may include the development of formal pediatric-specific guidelines for conducting evaluations of children seeking asylum.