A growing number of families immigrating to the United States from Central America are being separated at the border, including parents of children who are under age 6. We explore what happens to these children once they are sepa- rated from their families by exam- ining the nature of the services and programs provided while they are in transitional foster care. We then draw preliminary conclu- sions about the emerging impact of family separation on outcomes for these children.

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Since 2014, there has been an increase in the number of families emi- grating from Central America who are seeking asylum in the United States (U.S. Customs & Border Protection [CBP], 2018). Most (over

90%) are from El Salvador, Guatemala, and Honduras, a region known as the Northern Triangle, where they face ongoing violence and safety concerns (Crea, Lopez, Taylor, & Underwood, 2017; Roth & Hartnett, 2018). Despite efforts by the Trump administration to deter these fam- ilies from migrating (U.S. Department of Justice, 2018), trends suggest that the destabilized conditions in the Northern Triangle—particularly in Guatemala and Honduras—continue to leave parents little choice but to emigrate (Musalo & Lee, 2017).

As the number of family apprehensions has increased, so has the CBP practice of forcibly separating children from their parents. The practice reached its height during the month of May 2018 when an estimated 2,300 children—including 102 under age 5 (MS. L. vs. U.S. Immigration and Customs Enforcement, 2018)—were separated from their parents under the Trump administration’s “zero tolerance” policy of detaining parents who are immigrants as criminals in federal facili- ties (Almukhtar, Griggs, & Yourish, 2018). Within the U.S. immi- gration system, after the point of separation children are transferred to the custody of the Office of Refugee Resettlement (ORR). ORR policy is to place those who are under age 13 in transitional foster care until a more long-term placement is identified (Office of Refugee Resettlement, 2015). A number of studies have focused on general pathways through the U.S. system for children who are immigrants (Byrne & Miller, 2012; Roth & Grace, 2015), but we know less about what happens to the youngest of these children, particularly those who have been separated from their parents while in transitional fos- ter care. This empirical article aims to address this gap. Specifically, we aim to better understand how transitional foster care programs have adapted to meet the emerging challenges of serving these chil- dren, particularly those under age 5, and to draw preliminary conclu- sions about the emerging impact of family separation on the children themselves.

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Although the Trump administration halted its practice of separating families in June 2018, our study is critical for the field of child welfare because it highlights ongoing tensions between the U.S. immigration system and child welfare principles. The practice of forcibly separating parents and children at the border was a strategy by the Department of Homeland Security (DHS) to deter future immigrants from com- ing to the United States (Ponnuru, 2018). The impact of this practice on parents and children, however, is clearly at odds with the mission of the Administration for Children and Families (ACF) (n.d.) to provide “compassionate and effective delivery of human services” and to priori- tize family preservation. Parents fear that returning home will threaten their safety and their children’s well-being, and their request for asylum is to keep their family together. Paradoxically, therefore, after present- ing themselves at the border, parents are forced to give up custody of their children, releasing them to a system where they have no legal influence and few rights. As long as the U.S. government continues to find new ways to deter immigration without consideration for the rights of children and families, these tensions are unlikely to disappear. This study provides insights into the implications of such policy shifts for the programs in place to protect immigrant children and, by asso- ciation, the well-being of the children themselves.

In the section that follows, we briefly introduce the transitional foster care program for immigrant children. Then, drawing on unique qualita- tive data from in-depth interviews with staff members at four transi- tional foster care sites, we describe the perspectives of the program staff responsible for protecting children’s well-being during the transitional period between parent separation and long-term placement.

Background

Children who are Immigrants and in Transitional Foster Care

Children who are immigrants and have been separated from their par- ents by CBP are transferred to the custody of the Office of Refugee

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Resettlement (ORR) where, even though they were “accompanied” to the border by a parent, they are classified as unaccompanied alien chil- dren (UAC)—children who migrate without a parent (Barrick, 2016). Under federal law (8u.S.c.§1232(c)(2)) and in keeping with child wel- fare statutes (Administration for Children and Families, 2015), ORR must expeditiously place UAC in the least restrictive environment while they undergo removal proceedings in immigration court. Ultimately, the least restrictive environment for most UAC means placement with a “sponsor” in the United States, typically another adult family mem- ber already living in the country (Byrne & Miller, 2012). Contacting and vetting sponsors involves a background check and, in some cases, a home visit to ensure the placement is suitable. Identifying an appropri- ate sponsor takes an average of 2 months (Wagner, 2018). ORR has a network of contract organizations across the country that provide tem- porary care for UAC while they wait to be discharged to a sponsor (or other long-term placement option). The majority of UAC are held in one of over 100 shelters in 17 different states (Unaccompanied Alien Children, n.d.), however, ORR policy requires that children under age 13 be placed in transitional foster care because they are more vulnerable (Office of Refugee Resettlement, 2015).

Transitional foster care provided by ORR-contract organizations is comparable to traditional domestic models of foster care where chil- dren are placed with state-licensed foster parents who are subject to training and monitoring requirements. While they stay with their fos- ter families at night, during weekdays UAC in transitional foster care report to the ORR-contract organization daytime facility staffed by case managers, teachers, and clinicians. At the facility they receive a range of services before they are discharged, including classroom edu- cation, health care, some form of socialization and recreation, mental health services, access to legal services, and case management (Office of Refugee Resettlement, 2015). Transitional foster care is provided by a network of ORR-contract licensed care providers, one of the larg- est of which is Lutheran Immigration and Refugee Service (LIRS). LIRS has been providing transitional foster care for UAC since 2012.

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Because the UAC population in ORR custody fluctuates depending on border apprehensions, LIRS has developed a flexible care model. This means that the LIRS transitional foster care program can accommo- date changes in the number and ages of UAC needing services. Prior to 2018, however, LIRS transitional foster care providers infrequently provided services for separated children and children under the age of five. From January 2018 through May 2018, LIRS provided transitional foster care services for 86 separated children—25 of whom were under age 5—placing additional strain on their program model’s ability to be flexible and responsive to the shifting needs of immigrant children (LIRS, 2018).

The Impact of Family Separation on Children’s Well-Being

Recent studies indicate that detention by DHS of children who are immigrants is a potential threat to their health and well-being (Linton et al., 2017), but we know little about children separated from their par- ents at the border. Across the arc of migration, children are potentially exposed to numerous adverse childhood events (ACEs) (Menjívar & Perreira, 2017; Perreira & Ornelas, 2013). These often go unreported because traditional ACE measures are unable to capture aspects of trauma experienced by children who are immigrants (Flores & Salazar, 2017). Linton and colleagues (2018) argue that our ability to capture the range of traumatizing events that impact child well-being within the U.S. immigration system requires attention to the four stages of the immigration journey itself: pre-migration, migration, detention, and post-release. Considerable research has established children’s traumatic experiences during pre-migration and migration (Becker Herbst et al., 2018), detention (Linton et al., 2017), and the period once they are released to the community ( Jani, 2017; Jani, Underwood, & Ranweiler, 2016; Roth & Grace, 2015). We contend that important events also occur during the transitional period—between the detention and post- release phases—which may also introduce stress and trauma, including (and perhaps especially) parent-child separation.

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Existing literature provides some insights into the trauma associ- ated with parent-child separation, but this research typically focuses on long-term separation when parents immigrate without their children, or when immigrant parents of U.S. citizen children are forcibly removed (Dreby, 2015). Families migrating to the United States often experience separation because a parent will leave first to find employment, often with the initial intention of staying temporarily, but the cost associated with migration and the challenge of earning enough to justify the effort can prolong a parent’s separation from their children. These periods of separation are often associated with a difficult adjustment period once the family is reunited (Menjívar & Abrego, 2009; Roth & Grace, 2015).

Other literatures suggest that children separated from their care- givers can experience negative effects to their well-being and develop- ment. Young children are at heightened risk of experiencing negative outcomes when separated from a caregiver who has been incarcerated (Murray, Farrington, & Sekol, 2012), for example, or when separated from caregivers in the context of foster care (Lloyd & Barth, 2011). Although research exists on the effects of family disruption within the U.S. child welfare system (Sandstrom & Huerta, 2013), little is known about the effects of parental separation experienced by immigrant fam- ilies apprehended at the U.S. border, or how transitional foster care programs adjust to meet the needs of very young children who have been separated from their families.

Data and Method

Data for this study were gathered from in-depth interviews with 20 staff members at four transitional foster care programs that serve children who have been forcibly separated from their parents by CBP. All four programs are part of the Lutheran Immigration and Refugee Service (LIRS) network, one of several national organizations that coordinate care for these children.

We interviewed at least three individuals at each program site: the director (or program coordinator), case manager, and clinician. The

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director oversees all aspects of the program. The case manager’s role is to facilitate general continuity of care—ensuring that children receive necessary services and support from intake to the moment they are discharged, typically to the custody of a sponsor. The clinician pro- vides therapy for the children, both in small groups and/or one-on- one. At three of the sites we were also able to interview the educator who runs classes for the children while they are in the program. The educator is responsible for curriculum development and oversight, aca- demic assessments, and educational reporting. One of the programs in our sample is larger than the others, so we conducted interviews with three of its clinicians. We developed a semi-structured interview guide that included questions about how staff members perceive the impact of family separation on children; how programs have adjusted to meet children’s needs; and any distinctions between providing services for separated children—particularly those under age 5, referred to by respondents as “tender age” children—versus UAC. Interviews at two sites were conducted over the phone, but at the other sites they were conducted in person. All interviews lasted 30–60 minutes, and were audio recorded and transcribed.

Using an interpretivist paradigm, our analysis followed several steps. We developed a codebook informed by initial themes that emerged from the data, including trauma, safety, and communication barriers. Each transcript was coded by three different team members. Inter-coder reliability was strengthen by holding weekly team meetings during the coding process to address questions concerning the code book and any coding discrepancies and strengthened inter-coder reliability. Coders also wrote memoes during the data collection and analysis phases and discussed these memos during team meetings, thereby strengthening the credibility of the study (Lietz & Zayas, 2010).

Findings

We have organized our findings based on three core themes in the data. First, we describe our respondents’ perception of the stress experienced

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by children who were separated from their parents at the border and how respondents adapted their transitional foster care program to meet these needs. Second, we show the difficulty of establishing rapport with these children for program staff and foster parents, especially for children under age five. Finally, we describe how the programs have adapted to address these challenges.

Impact of Separation on Children

The transitional foster care programs in our sample are set up to serve young adolescents who made the journey to the U.S./Mexico border without a parent or guardian (legally referred to as “unaccompanied alien children” or UAC). Respondents, therefore, often used UAC as a reference point to explain their observations about the stress experi- enced by children who had been separated. Respondents stated that the stress experienced by these two groups—UAC and children separated from their parents—was different in degree rather than in kind. Both groups missed their parents, for example, but respondents perceived that children with parents detained at the border were more emotion- ally distraught.

...[C]hildren that are travelling with like siblings or aunts or uncles, they tend to not cry as often or be as scared or nervous. But we’ve noticed that...being separated from parents, we’ve noticed emo- tionally, it is very scary for these kids. They come to us crying and huddled in the corner at times, which is very hard to see.

—Program director

Unlike UAC who knew before the journey that they would arrive unaccompanied at the U.S. border, these children were unprepared for being separated from their parents. Their assumption throughout the arduous trip was that they would continue to have the care and physi- cal presence of their parent(s). Respondents stated that the youngest children are even more confused. Whether it was because they were too young to understand or no one anticipated the possibility of separation,

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the act of forcibly separating them at the border was a form of violence that caught them by surprise and left them disoriented:

For our tender age children that are here by themselves I believe the families anticipated for them all to go through immigration together and to be released together and that’s not what has been happen- ing...And now children have no idea what to expect, they’re going somewhere, completely alone when they anticipated remaining with family. So that’s just like an increased traumatic event in their life.

— Clinical supervisor

So with the little ones, they’re confused. They don’t understand why they were separated from their parents, they don’t really get where they are. They don’t have the language yet to comprehend what we’re trying to tell them. So it’s just a lot of confusion and I think a lot of fear initially when they come.

— Clinician

Program staff who participated in this study explained that the trauma associated with being separated from their parents was visible in the behavior of the tender-aged children in their programs. But because many of them are too young to be able to articulate their needs or feel- ings, these behaviors can be difficult to predict until they are triggered by some event or memory:

Our staff is usually very friendly and nice and they [the children] feel safe and happy. But usually it seems like the kids are anxious all the time. It doesn’t matter how old they are. You can see in their faces, they’re anxious...We had a little one like 2 or 3 weeks ago, he just got here. I think he’s like 2 years old, 2 or 3. And he was just fine. He was here with his brother that is around 5, and he was fine, he was playing, and suddenly he would start crying out of the blue. And he would call his mom. So he would be “Mamá, mamá,” and he would start crying again and he would say the same thing. “I want my mom.” “Quiero mi mamá.”

— Teacher

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Other respondents made similar observations about tender-age children:

It was a little 2-year-old who was separated from his dad at the border. And I remember doing as much of my intake assessment as I could with him. He could talk a little bit and he was very happy- go-lucky when we were doing this. And when I asked him ‘Where’s your dad?’ he all of a sudden just put his head in his hands and made a pouty face and said,“En la carcel,”or in jail...[W]e facilitated that phone call with the minor and the dad. And the father just starts bawling when he hears his son’s voice, which causes the minor to start bawling and it’s just like a lot of crying and wailing—and he was inconsolable after that.

— Case manager

If forcibly separating children from their immigrant parents cre- ates strain and emotional distress for the children, its impact may be compounded if additional stressors are introduced. Two siblings, ages 8 and 3, were placed at one program while their mother remained detained at the border. The 3-year-old had a chronic medical condition that required heart surgery. The clinician noticed that the older sister assumed some of the responsibility as her brother’s caregiver through- out his procedure and recovery. According to the clinician, the sister felt that “...she had to look over her little brother’s needs, be sure that he was doing okay”—a strain that had an impact on her own well-being. She would come “...to school at times not having slept throughout the night because she was concerned about her little brother.”

Building Trust

Program staff have limited ability and resources to address the profound strain experienced by young children separated from their parents. They work to create safe environments for the children and provide counsel- ing services on site. However, many staff members expressed a concern that these supports are inherently short-term, and the nature of the

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immigration placement process requires that children be transferred numerous times—from border patrol stations, to their program, to a temporary foster care family, and eventually to their sponsor. The mul- tiple transitions in a short period of time can be taxing and confusing, especially for tender-age children.

To address this concern, program staff and foster parents attempt to reassure the child that they are safe and that their new caregiver at each transition is trustworthy. That is, they attempt to provide a continuity of care during the interim between parent separation and sponsor placement. Respondents did not identify a formula or model for doing this, but many talked about the importance of building trust—and the challenges of doing so. One case manager described how long it takes for staff at her program to build trust with tender-age children who arrive from detention feeling distraught and confused. Staff members reported that they spend time “rocking them, making sure they’re okay, singing—whatever it takes to calm them down.” Not long afterwards, they pass the child off to a foster parent. While program staff attempt to reassure the child during each of these transitions, one case manager described the experience of moving the child from one caregiver to the next as a “continuous trauma” because young children have difficulty understanding these transitions, particularly those who are pre-verbal:

You cannot explain to a small child that you’re going to be passed from this person to this person to this person and then this person will take care of you for so long until you can get back with mom and dad. It’s just, they’re not comprehending. They just know that they’re not feeling safe and that triggers emotion. — Case manager

Under the best of conditions, tender-age children quickly adapt to the foster family and going to the school run by the program staff. Fol- lowing the trauma of a child’s separation from their parent, the safe and secure environments in both the program and the foster family’s home are designed to help quiet their anxiety. One case manager explains that some tender-age children actually “thrive” within the structure of the

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program and in their relationship with their foster family. This is stabi- lizing for the child, but can be disruptive for relationships with adults who have a long-term role:

But when they have a phone call with mom and dad, it really con- fuses them; and they don’t have that emotional capacity to compart- mentalize, ‘Oh, these are my foster parents, and these are my parents back at home.’ It becomes very confusing...they have to talk to mom and dad, but then they also have to be here.

— Case manager

Some children are in the program for less than a month before being placed with a sponsor. Others stay longer while details about their spon- sor placement are resolved. Under these conditions, program staff have more time to observe and interact with them and can identify more symptoms of trauma. They also develop stronger relationships with these children, however, which can exacerbate what the case manager above described as “continuous trauma”:

We can see more issues come out the longer that they’re with us or sometimes they develop a stronger attachment to foster parents just because 5 months in our care for a three-year-old versus a 12-year- old looks very different. So sometimes I feel like they get more attached to our staff and to our foster parents in that time.

— Supervisor

Tender-age children do not understand or experience distinctions between short- and long-term caregivers. As a result, moving from the foster family to their sponsor can be difficult for children:

[A]nyone in our program, but especially the little ones, really form an attachment to their foster parents. Especially the little ones because they stay home all day and they don’t come to school and they really form a bond with them. The little one that I had that was two years old called his foster dad “tio” or uncle and called the foster mom “mom.” So he really formed a relationship with their family...

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[But] After forming that relationship with his foster dad and foster mom he had to separate from them and go back to his parents who he obviously loved, but again it was another trauma for him.

— Clinician

Program staff concurrently work to strengthen ties between the child and their parents and sponsors. Maintaining these relationships is different for each child. For example, it is not always possible to know how to contact parents while they are in detention because they can be moved unexpectedly to a different facility. Therefore, program staff must spend time tracking down parents in the detention system. One case manager explained:

She’s so young and I can’t get ahold of the mom. She’s been trans- ferred to three different detention centers and once I put money on my card for this, she’s been transferred to another one.

When making phone contact between a parent in detention and a tender-age child is successful, the value of these conversations is not always obvious: It is virtually impossible to have a meaningful phone conversation with a 2-year-old child that is compressed into several minutes.

The transitional foster care programs also work to establish rapport between the children and the sponsor with whom they will be placed during immigration proceedings. Sponsors are often friends or family members who have already immigrated to the United States but many have never met the child, especially if they are tender-aged.

Because not only is it a culture shock for them and very different, but they’re with people they’ve never met before and essentially have to rely on them as adults. So, I can only imagine how confusing that is for a little brain. And it makes me curious about how traumatic that is for them and I don’t know what their relationships with their families look like once they’re reunified. And they’re not going to be able to verbalize that and we only follow up after 30 days.

— Clinical supervisor

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Our data do not allow us to examine the long-term effects of these experiences. However, one respondent observed that the confusion that results may have emotional consequences such that “the children don’t know who to trust.” According to another respondent, numerous disruptions to relationships with caregivers while the children move through the immigration system means they will “have difficulty open- ing up, developing trust or a trusting relationship.”

Program Adaptations

The needs of tender-age children are hard to meet for transitional fos- ter care programs that have not been equipped to work with children this young. Our study highlights how staff are adapting to meet these needs, but these adjustments demand more time and resources than the programs have available. According to participants in our study, the very young infants and children in their care need to be physi- cally held and soothed, especially in the wake of potentially traumatic migration experiences and unexpected separation from caregivers. This requires one-on-one attention, which can be unrealistic for some pro- grams. Staff also identified other developmental concerns, particularly among the youngest children who have experienced separation. They require a physical space that can accommodate their need for naps, changing stations, diapers, and other such supplies. Toddlers require that foster homes and the program spaces be safe places where they can learn to be mobile and explore. Language, fine motor skills, and play are other critical developmental skills identified by respondents as important needs to be addressed. They cannot be integrated into aca- demic programming with older children and therefore require separate accommodations or stay-at-home foster families, which are difficult to recruit. They also tend to endure longer lengths of stay relative to other children in custody.

Tender-age children are often minimally verbal and cannot com- municate their historical experiences, answer intake and assessment

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questions, or articulate their needs clearly. In a best-case scenario, the parent is able to communicate information about the child to the CBP prior to (or shortly after) being separated from their child.This includes details about the child’s name, date of birth, and country of origin. If transitional foster care staff are not given that information when the child is transferred to their custody, and if the child cannot communi- cate it, staff members start an investigative process to learn as much as possible. ORR policy requires that they refer the children to appropri- ate services (Office of Refugee Resettlement, 2015), but it is difficult to do this effectively without adequate background about the child. One caseworker explained:

...a 9-year-old can say ‘Yeah, I was traveling here with so-and-so, I was going to live with so-and-so, this is what happened to me.’ Whereas a three-year-old—all you can really do is rock them and make sure they’re okay and then try to find an adult to talk to get the whole story.

Tracking down information for tender-age children taxes the time and resources of transitional foster care programs, and these demands can sometimes compete with the basic needs of the children. For exam- ple, staff are required to arrange for the children to meet individually with a lawyer, but how do they do this effectively with a 4-year-old? A teacher in one of the programs explains that some days the develop- mental needs of the youngest children combined with whatever trauma they may be dealing with prompt her to reschedule such a meeting:

So sometimes I wish I could be more flexible and be like, ‘You know what? We’re not going [to the appointment]. We’re going to play [with] play-dough and we are going to eat raisins and we’re not going to meet the lawyer. Because that’s what a mom would do. But...the policy says you have to meet with your lawyer within 14 days. So I’m sorry. I’m sorry today is bad, but we have to go.’ So, some of those things are very hard to balance.

—Teacher

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In addition to spending more time tracking down information about who these children are, clinicians have changed how they provide ser- vices. Several said they engage in play therapy with tender-age children to begin helping them heal from the trauma of being separated from their parent(s). Other clinicians do not provide the youngest children with therapy at all given that they are too young for the therapeutic groups. One clinician said he considers the “acculturation” experiences provided by their foster parents—such as trips to the aquarium or zoo— to be a developmentally appropriate proxy for talk therapy, particularly for those who are pre-verbal. Without a model designed to address the developmental needs of young children or the distinct stressors related to parent separation, it is up to these front-line workers to find creative solutions with limited resources.

Limitations

The four transitional foster care programs in our sample are not repre- sentative of all such programs providing services for separated children. It is possible that other sites may have more (or less) developed services, and additional research should compare differences across these sites to identify possible variations in the transitional foster care model. In addition, we were unable to interview immigrant children or parents for this study and did not clinically measure symptoms resulting from family separation. Despite these limitations, we are confident that our study offers a unique, data-informed window on policy and practice implications related to family separation.

Conclusion

This study provides insights into the needs of young children who have been forcibly separated from their parents migrating to the United States, as well as the programmatic challenges for the transitional foster care programs that are charged with serving them. Our study suggests that the practice of forcibly separating children from their parents at the

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border may cause additional trauma for families seeking asylum who are already fleeing traumatic circumstances in their countries of ori- gin, and transitional foster care programs are struggling to adapt their model to meet the needs of the youngest of these children. The practice of forcibly separating families who are immigrants is in clear violation of U.S. child welfare laws and should be stopped. Indeed, it sparked widespread outrage in the summer months of 2018 (McCausland, Guadalupe, & Rosenblatt, 2018), prompting the Trump administra- tion to detain immigrant families together “where appropriate and con- sistent with law and available resources” (Executive Order No.13841, 2018). This is not the first time that family separation has been used within the U.S. immigration system, raising questions about when it might be used again. In 2005, the House Committee on Appropria- tions was concerned about “reports that children apprehended by DHS, even as young as nursing infants, are being separated from their parents and placed in shelters operated by the Office of Refugee Resettlement (ORR) while their parents are in separate adult facilities” (H.R. 2360, 2005, p.38). Future research must critically document the damaging impact of family separation and help establish evidence-based alterna- tives to this practice so that it does not reemerge in the future.

The Trump administration’s proposed solution to family separation is detaining whole family units, but this, too, is problematic. The gov- ernment should pursue practice and policy options that keep families together in the least restrictive setting while their asylum claim is eval- uated (Stone, 1999). One place to start would be to reinstate the Family Case Management Program, an alternative to detention approach that provides an affordable way to keep together families of immigrants until a determination is made in immigration court. Despite a success- ful pilot of the program, it was cancelled by the Trump administration in 2017. Another alternative to detention possibility is the Intensive Supervision Alternative Program, which allows families to be released from detention with electronic monitoring. While this approach is still invasive, families are at least allowed to live in the community while they deal with legal proceedings in immigration court (Fernandez, 2017).

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There is no single policy solution, but neither is the tension between immigration law and child welfare principles likely to disappear. Ulti- mately, U.S. immigration policy and practice must be brought into alignment with child welfare principles and international law to guard the rights of all children and families.

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