Refugee children's play: Before and after migration to Australia

Psycho-social Stressors Experienced by Young war Refugees in Developed Countries: A Scoping Review

BACKGROUND

Refugees escaping political unrest and war are an especially vulnerable group. Arrival in high-income countries (HICs) is associated with a 'new type of war', as war refugees experience elevated rates of psycho-social and daily stressors.

PURPOSE

The purpose of this scoping review is to examine literature on psycho-social stressors amongst young war refugees in HICs and impact of stressors on intergenerational transmission of trauma within parent-child dyads. The secondary objectives are to identify the pre-migration versus post-migration stressors and provide a basis to inform future research projects that aim to lessen the burden of stress and inform evidence-based improvements in this population.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension (PRISMA-ScR) guided the reporting of this review that was performed using a prescribed scoping review method. Extracted from five databases, 23 manuscripts published in 2010 or later met the inclusion criteria.

RESULTS

Three themes emerged: pre-migration stressors, migration journey stressors and uncertainty, and post-migration stressors. While post-migration environments can mitigate the health and well-being of war refugees, socio-cultural barriers that refugees often experience at the host country prevent or worsen their psycho-social recovery.

CONCLUSION

To assist the success of war refugees in HICs, therapeutic interventions must follow an intersectional approach and there needs to be a wider application of trauma informed models of care. Findings of this review may help inform future intervention studies aiming to improve the psycho-social health of this population.

Exploring Mental Health and Development in Refugee Children Through Systematic Play Assessment

To evaluate a standardized play observation as a measure of young children's mental health and development in a clinical and refugee population. We conducted individual play observations with 70 refugee children aged 3- to 6-years and compared them to a clinical group of 111 age-matched children regarding their level of play development, social interaction during play, traumatic re-enactments, and emotionless-cold play. Additionally, we assessed children's mental health, social-emotional development and markers of adversity by parent and educator report as well as their IQ-test scores and learning performance and related these factors to the play variables. Play variables were significantly correlated with IQ-test scores (r = 0.184, p = 0.037), learning performance (r = 0.208, p = 0.010) and vocabulary (r = 0.208, p = 0.021) in the comparison group and with social-emotional development in educator report (r = 0.368, p = 0.011), time spent in Germany (r = 0.342, p < 0.001) and parental distress (r = - 0.292, p = 0.034) in the refugee group. Children with more parent-reported adverse experiences showed less social-interactive play in the overall sample (r = - 0.178, p = 0.011). Our child-centered approach to standardized play observation augments information obtained from parent and educator reports and can provide valuable insights in subgroups where other commonly used tests are not available or applicable.

Perceived environmental barriers and facilitators of refugee children's physical activity in/around refugee accommodation: a qualitative case study in Berlin

BACKGROUND

Previous research have identified built environmental attributes associated with refugee children's physical activity (PA); however, there is a lack of research focusing on refugee children's environmental perceptions at the individual level. We examined the perceived environmental barriers and facilitators of refugee children's PA.

METHODS

Perceptions of PA environments by refugee children (n = 15, 6 to 13 years old) and their parents (n = 10) were captured by questionnaires and drawing workshops from one refugee accommodation in Berlin. Besides, photovoice was conducted with three children to obtain an in-depth understanding of their experiences of existing environments for PA. Research was applied between June and July 2019. All research material was transcribed and analysed using thematic analysis.

RESULTS

Refugee children and their parents identified micro-environments as the centre of children's daily PA, they usually played indoors but most parents perceived there was no spaces. In meso environments, children and parents thought there were insufficient spaces and were worried about neighbourhood safety. Furthermore, parents concerned more about 'space accessibility' for their children's playing purposes instead of 'space quality (e.g., equipment)' . Children also indicated the importance of informal spaces for their PA.

CONCLUSIONS

Refugee children perceive a lack of space and safety when attempting to play in the existing micro and meso environments. Related practitioners should focus on providing more play spaces in micro environments and safe access to existing neighbourhood playfields. These efforts can augment much-needed research on strategies to better integrate refuge facilities to their urban context and essential in minimising current health and spatial inequality issues these vulnerable groups face across Germany and worldwide.

Understanding Spatial Characteristics of Refugee Accommodations Associated with Refugee Children’s Physical Activity in Microenvironments: Six Case Studies in Berlin

Refugee children often spend a considerable amount of time in refugee accommodations with limited space and limited access to communal facilities. Such environmental settings make it difficult for refugee children to engage in physical activity (PA), which is essential for their health and social inclusion. While there is a strong evidence base for environmental attributes associated with non-refugee children’s PA, only a few studies have focused on refugee children. This article presents an exploratory study on the spatial characteristics of six refugee accommodations in Berlin and their relation to school-aged refugee children’s opportunities to engage in PA. Micro-environmental attributes included building typology and availability, size, and access to communal PA spaces using Space Syntax. PA opportunities were assessed using staff surveys, interviews, and field trips. Results indicated that none of the case studies provided a comprehensive range of PA opportunities. They also revealed unequal access within the facilities. Whereas the role of size was inconsistent, vital predictors included fewer floors and corridors with easy access to internal and external PA spaces. Our recommendations include prioritizing compact buildings with moderate heights when retrofitting existing facilities and raising awareness for the importance of active play for this vulnerable group.

Social cognition in refugee children: an experimental cross-sectional study of emotional processing with Syrian families in Turkish communities

More than 5.6 million people have fled Syria since 2011, about half of them children. These children grow up with parents that often suffer from war-related mental health problems. In this study, we assess emotional processing abilities of 6-18 year-old children growing up in families that have fled from Syria and reside in Turkish communities (100 families, 394 individuals). We demonstrate that mothers', but not fathers', post-traumatic stress (PTS) impacts children's emotional processing abilities. A 4% reduction of mothers' PTS was equivalent to 1 year of development in children, even when controlling for parents' traumatic experiences. Making a small investment in increased mental health of refugee mothers might have a positive impact on the lives of their children.

Built-environment attributes associated with refugee children's physical activity: a narrative review and research agenda

Research has identified built environmental attributes associated with children’s physical activity (PA); however, less is known for environmental correlates of refugee children’s PA. This narrative review summarised the current evidence of associations between built environment attributes and refugee children’s PA. Six databases were searched with three sets of terms related to exposure (built environment); outcome (PA); and target population (refugee children aged 6–12 years). Eight studies (one quantitative; seven qualitative) met the inclusion criteria. Key PA barriers were limited play space and lack of neighbourhood safety. Design of refugee facilities and surrounding environments should provide better access to formal, informal and safe spaces for children’s play.

The Function of Play for Coping and Therapy with Children Exposed to Disasters and Political Violence

PURPOSE OF REVIEW

The objectives were to identify specific characteristics and patterns of children's play following events of political violence or disasters, examine their associations with risk and resilience, and explore their implications for preventive and therapeutic intervention.

RECENT FINDINGS

Patterns of individual, dyadic, and social play are associated with measures of children's adaptation following collective traumatic events. Modifying the traditional child-centered play therapy, by integrating CBT principles or including parents, may increase efficacy. Preventive interventions in the aftermath of collective traumatic events must address children's need to play in safe spaces, with the support of significant adults. Recognizing that posttraumatic play is a multifaceted phenomenon implies the need for more individualized play therapy models, varying in level of therapist's activity and techniques employed. Research is needed to clarify the validity of play measures for assessing adaptation and to study the effectiveness of integrative play-based models.