The Basic Adverse Childhood Experience Data 

Children of Syrian refugees are being subjected to numerous ACEs, image courtesy of Wikimedia Commons

Neuropsychological studies (i.e., studies which investigate how the structure and function of the brain relate to emotion, cognition, and behavior) have repeatedly shown that environmental stress risks a broad range of undesirable health outcomes. For example, From Neurons to Neighborhoods pioneered studies into the adverse and dramatic effects that childhood stress can have on current and future health and development (Shonkoff and Phillips, 2000). This project defined “stress” as the set of changes in the body and the brain that are put in motion when there are overwhelming threats to physical or psychological well-being. Perhaps unsurprisingly, severe or chronic stress is associated with a host of cognitive and neurological deficits, including reduced cerebral volume and hemispheric integration, impaired executive function, and dysregulated reward and emotion responses (Petchell & Pizzagalli, 2011). The amygdala and the hippocampus are prime targets, and recent findings suggest that the amygdala modulates stress-induced memory and learning deficits by reducing the expression of memory-related genes in the hippocampus (Rei et al., 2015). Animal models have confirmed that the effects of stress on the amygdala and hippocampus cause disruption to learning, memory, and cognitive regulation (Malter Cohen et al., 2013).

ACEs, then, are an umbrella term for detrimental childhood experiences that are likely to produce severe or chronic stress. Experiences such as maltreatment, abuse, neglect, and trauma, are associated with a host of behavioral, physical, and mental outcomes (Petchell & Pizzagalli, 2011). In addition to the deficits explained earlier, sequelae of ACEs include, but are not limited to, reports of: poorer emotional well-being, self-harm and suicidal ideation, delinquent behavior, obesity, diabetes, poorer quality of adult relationships, substance abuse, and cardiovascular disease (Kalmakis & Chandler, 2015). It is clear that ACEs, and the stress they cause, now represent a much more comprehensive threat to an individual’s overall health than previously thought.

In summation, ACE research paints a bleak, but ultimately informative, picture of the challenges and risks that Syrian refugee children face as the flee to Europe. With this basic data in mind, then, we would end our essay with a brief example of how this data can be used to drive evidence-based policy to accommodate and ameliorate the effects of ACEs.



Recognizing Potential Deficits in Language and Advocacy 

ACEs may cause refugee children to struggle during legal proceedings, image courtesy of Wikipedia

The EU legal system, like all legal systems, represents linguistic demands at their most challenging. Navigating the asylum process may require, inter alia: communicating with lawyers, administrative judges, and law enforcement officials, often through an interpreter; reading and understanding information relating to visas, immigration law, and other legal texts, again often through an interpreter; and arranging for living or work arrangements, whether unofficial or official. Perhaps recognizing the overwhelming difficulty presented by these language demands, the European Parliament passed a recent directive establishing “Guarantees for unaccompanied minors” (EU Directive, 2013). This directive requires EU states to ensure that representatives represent and assist these children by explaining their rights, helping prepare them for personal interviews, and acting in the best interest of the child.



We now know, however, that child refugees who suffered from ACEs might struggle with these seemingly simple demands because of the many detrimental sequelae that ACEs can cause. A child might have disregulated connections between his amygdala and his hippocampus, which could cause him to struggle to learn the procedural demands and to tell consistent narratives. A child might have impaired white-matter pathways, which might impair her ability to integrate cross-modal information while communicating and to understand figurative and abstract language (Kovic et al., 2010; Kasparian, 2013). A child might have executive function deficits, which could disrupt his ability to regulate his speech and communication and to follow confusing lines of questioning (Henry et al., 2015). Finally, a child might have lower cortical volume overall, which could manifest as lower levels of overall intelligence and delayed language acquisition or use (Pangelinan et al., 2011). All of these outcomes are known effects of ACE, and all of them would cripple a child’s ability to represent himself during these legal proceedings.



Fortunately, the same basic data that revealed these nuances provide solutions to evidence-based policies, and neuroscientists are in a position to address this “special responsibility.” For example, encourage the representative officials to adopt best practices relating to interviewing child clients: this might include a formal language competency assessment and the use of open question-based techniques (Snow et al., 2012). Advocate for documents and materials that are written not just at a standardized reading level but at an even lower level so that refugee children with delayed language impairments can understand them. Suggest formal administrative policies could recognize that inconsistent narratives or communication impairments do not always represent intentional deception. Ensure that the “best interest of the child” standard, which is always assessed on a case-by-case basis, considers ACE-related deficits as part of the child’s “particular vulnerability and protection needs” (Parsons, 2010). These relative minor modifications, all based on the neuroscience data on stress and ACEs, could net major benefits for the child, for the EU immigration system, and for society as a whole.



Conclusion 

Licensed members of the legal profession have ethical and professional obligations to use their training and knowledge to promote equality and justice. Even though scientists lack such a formal responsibility, we firmly believe that active engagement and consideration of neuroscientific data in light of social contexts is a key component of a scientist’s ethical duties. The example of the Syrian refugee crisis and ACEs is just one minor component of the myriad challenges that society faces, but it is nevertheless an effective and profound example of how scientists, like legal professionals, are in a unique position to use basic data to accept and act on “special responsibilities.”



Works Cited