Originally published by USA Today
A toddler with balled-up fists pounding a mat at a detention shelter in Texas prompted Colleen Kraft to bolster her criticism of the forced separation of children from their migrant parents.
Kraft, a pediatrician and president of the American Academy of Pediatrics, blasted the Trump administration’s “zero tolerance” immigration policy, which has separated more than 2,000 children from their mothers and fathers at the U.S. border.
Kraft saw the girl during a trip in April to the Lower Rio Grande Valley shelter operated by the U.S. Department of Health and Human Services Office of Refugee Resettlement.
"One girl was sobbing, wailing and couldn't be consoled," Kraft said, noting the detention workers were not allowed to comfort the children. "The helplessness we all felt was knowing these children needed their mothers."
Perhaps even more telling was the silence of other toddlers in the room. A couple of kids played with toys, but none interacted with adult shelter employees or visitors. The shelter lacked the chatter and restless activity typically found at a day care center or preschool.
“There were beds, cribs, blankets and toys,” Kraft said. “Except there were no parents.”
Doctors such as Kraft said these children, stuck in shelters away from the nurturing embrace of their parents, probably face irreversible harm in emotional and brain development. Even if the Trump administration relents on its zero tolerance policyor Congress forges a compromise that ends the separations, doctors cited scientific studies that predict long-term consequences for children that experience adverse circumstances early in life.
The American Academy of Pediatrics issued a policy statement last year, recommending that immigrant children seeking safe haven should not be placed in detention centers. Such stress could trigger symptoms such as anxiety, depression and post-traumatic stress disorder from detention, the group warned.
The pediatricians' and other doctors groups have struck a more urgent tone since April, when Attorney General Jeff Sessions ordered a zero tolerance policy for illegal border crossings, including parents who cross the border with children. The American Medical Association voted to urge the Trump administration to end the separations.
In a follow-up letter Tuesday to Sessions, Department of Homeland Security Secretary Kirstjen Nielsen and Health and Human Services Services Secretary Alex Azar, the AMA said it's "well known that childhood trauma and adverse childhood experiences created by inhumane treatment often create negative health impacts that can last an individual’s entire lifespan."
Kraft said a medical study in 1998 on adverse childhood events is "the most important" examination of linking early childhood situations to behavioral and chronic health conditions later in life.
Vincent Felitti, a retired San Diego-area internal medicine doctor, led the study on the link between adverse childhood experiences and emotional and physical problems that emerge later in life.
“The thing that most people understand is that what happens to children – including infancy – has a heavy hand playing out later in life,” Felitti said.
During the 1980s, Felitti ran a weight-loss clinic in Southern California. Though many obese patients lost weight on a medically supervised, liquid-based diet, Felitti was curious when two women inexplicably regained weight. He asked questions.
He discovered the two women had been sexually abused as children, prompting the ambitious study.
The study asked about 26,000 adults through Kaiser Permanente's Department of Preventive Medicine whether they’d agree to answer questions about childhood experiences. A total of 17,337 adults, most middle class and many college-educated, agreed to participate.
The study asked people whether they had experienced psychological, physical or sexual abuse, lived with a mother who was abused or had family members who were substance abusers, mentally ill, suicidal or imprisoned.
Felitti said that as teens, the kids would cope by smoking, drinking alcohol, overeating or taking drugs. As adults, individuals would more likely experience heart disease, autoimmune disorders and cancer. The association grew stronger the more categories of adverse events a child experienced, the study found.
Felitti said the study didn't examine whether separation from parents had lifelong consequences.
William Van Arsdell, a pediatrician at Mountain Park Health Center in Phoenix, said the biggest challenge is building confidence in children who have been separated from their immigrant parents.
Van Arsdell has treated Somalian refugees and immigrants from Mexico and Central America. Van Arsdell's clinic is in a neighborhood where deputies of Maricopa County Sheriff Joe Arpaio routinely conducted immigration sweeps this decade.
The sheriff was convicted of violating a federal judge's order that he stop such immigration crackdowns. Last August, Trump pardoned Arpaio, who is running for the Senate.
Children who went through these enforcement sweeps are often anxious and reluctant to trust adults, and many require counseling, Van Arsdell said.
"It's a slow process, a matter of trying to build confidence in the support system they have in place," Van Arsdell said. "They don't have anyone who really knows them and who they really know and rely upon. They don't have a place of emotional support."
Kraft of the pediatricians group said she worries about the long-term health consequences from this federal immigration policy.
“It makes it frustrating because we are inflicting this damage on our kids,” Kraft said. “This didn’t have to happen.”