In one photo, a little girl looks up at a U.S. Border Patrol agent, her expression filled with grief as her mom is arrested. In secretly captured recordings, voices of toddlers inside detention centers cry out for absent parents.
The images and sounds of immigrant children separated from moms and dads at the U.S. border has raised a groundswell of anger nationwide this week.
But mental health experts and pediatricians say they also worry about the long-lasting effects of family separation on fragile young minds. Some even say children who watch the images on television or hear parents and adults talk about it are also at risk.
“It is a form of child abuse,” said Dr. Colleen Kraft, president of the American Academy of Pediatrics, in a recent interview this week on “CBS This Morning.”
Kraft and other experts raised opposition and concern recently about the Trump administration’s “zero tolerance” policy, which includes separating and detaining immigrant children from parents who seek amnesty.
The issue garnered so much negative attention that President Donald Trump said he’d change his policy on Wednesday, weeks after it went into effect, so that parents and children would be detained together.
However, at the time of publication, it remains unclear how children will be unified with their parents already in detention.
Even though the policy has officially ended, mental health experts worry that damage may already have been done.
The impact of ‘toxic stress’
Many of these children have already faced a series of stressful events in their own countries and on their way to the border, mental health experts note. Without a parent to offer comfort, trauma can persist and lead to behavioral issues that society will ultimately pay for.
“We know very young children who are exposed to this type of trauma go on to not develop their speech, not develop their language, not develop their gross and fine motor skills, and wind up with developmental delays,” Kraft added.
In a strongly worded statement that called the practice of separation cruel and needless, the president of the American Psychological Association (APA) cautioned that the ripple effects could be costly, even after the policy has ended.
“While we are gratified that President Trump has ended this troubling policy of wresting immigrant children from their parents, we remain gravely concerned about the fate of the more than 2,300 children who have already been separated and are in shelters,” Jessica Henderson Daniel, PhD, said in a new APA statement today. “These children have been needlessly traumatized and must be reunited with their parents or other family members as quickly as possible to minimize any long-term harm to their mental and physical health. In the interim, they should be assessed for and receive any needed mental or physical health care by qualified health care professionals.
In a statement from the American Academy of Pediatrics (AAP), the authors point out that constant movement can lead to “toxic stress.”
“Toxic stress, which is caused by prolonged exposure to heightened stress, has detrimental short- and long-term health effects,” said the AAP statement. Children in particular can experience long-term consequences from this stress, as their brains are still developing.
Toxic stress is defined “as the excessive or prolonged activation of the physiologic stress response systems in the absence of the buffering protection afforded by stable, responsive relationships.”
Stress can flood the body with inflammatory hormones and set off a cascade of “neuroendocrine-immune responses.” These include elevated heart rate, blood pressure, and respirations.
If that stress continues, it can lead to toxic stress that can alter the architecture of a child’s developing brain.
“Toxic stress early in life plays a critical role by disrupting brain circuitry and other important regulatory systems in ways that continue to influence physiology, behavior, and health decades later,” authors wrote in a 2012 AAP statement.
As the brain architecture changes, it can result in children being at risk for a multitude of health conditions as they age. According to AAP authors, this includes “maladaptive coping skills, poor stress management, unhealthy lifestyles, mental illness and physical disease.”
Adults traumatized as children speak out
The pictures of crying children being separated from their parents echoes historical events of the past. It’s led some people, who have gone through similar situations, to condemn the new policy.
On social media, stories emerged from people across generations, including Holocaust survivors, refugees whose families sought amnesty, and U.S.-born citizens who remember being detained inside Japanese-American internment camps.
They all say the images of children held in warehouse-like conditions reignited negative memories of similar events through the last century.
The impact of those events during their childhood continue to haunt them into adulthood.
“You take a child away from the parents, the home, from everything that they know, they are never the same,” said Rachelle Goldstein, co-director of the Hidden Child Foundation, a New York-based organization which represents Jewish Holocaust survivors who were hidden during the war. Goldstein was 3 years old when she was separated from her parents in Belgium.
In a video released through the Anti-Defamation League, Goldstein said many of the hidden children during the Holocaust are now in their 70s and 80s. But they’ve never forgotten the feelings of being alone without a parent.
“They still think of that and it still hurts. It still aches,” she said. “A young child in particular, and a mother, they are one in a sense. It’s one entity. How can you break that up?”
Actor George Takei, now 81, said in a column he wrote for Foreign Policy that remaining with his family is what got him through those years he lived in an internment camp, set up for Japanese-Americans during World War II.
“At least during the internment, we remained a family, and I credit that alone for keeping the scars of our unjust imprisonment from deepening on my soul,” he wrote. “I cannot for a moment imagine what my childhood would have been like had I been thrown into a camp without my parents.”
The health risks of trauma
Such stories are common among the thousands of children who attend classes within the Los Angeles Unified School District (LAUSD), says School Mental Health Director Pia Escudero.
LAUSD is the second-largest district in the nation. Because Los Angeles serves as an entry point for families from many countries fleeing wars and instability, the district has set up special programs for children and parents who already have faced trauma.
“Trauma is an event that renders an individual or family or community helpless,” Escudero said. “A situation where a family is disrupted and children are taken away is very much within a traumatic event. For a government or entity to induce separation is very traumatic.”
She says professionals watching recent events worry that family separation can make a child feel unsafe long after they’re reunited.
Children who feel unsafe are more likely to harbor distrust toward adults and turn to a fight-or-flight mentality. They may skip school or make bad choices in friendships.
“We see the trajectory of untreated trauma,” Escudero said. “Many times, it looks like ADHD, or like inattentive children.”
She also says “vicarious trauma” remains concerning. Children seeing other children suffer can fill them with fear or “hyperarousal.”
She says the school district developed a model for parents that can be helpful during any kind of overwhelming events, including natural disasters. The model includes listening to a child express fears, protecting them from ongoing images and talk on television and social media, connecting them to groups or services that can help, and projecting a level of calmness.
“If we do the right thing,” Escudero said, “we can mitigate the impacts of trauma.”