This is an excellent compilation by Dr. Diana Birch about asylum seeking children. This monograph clearly describes the perils faced by these children, their fears, abuse faced, need to seek an asylum, journey to different countries, and the problems faced by them after arrival. The real stories put forth in this article directly from the experiences of these children make the article very realistic and is an eye opener for all readers.

The monograph describes the difference between refugees and asylum seekers. It also talks about the reason for seeking asylum, such as the abuse faced in their country  (both physical and sexual), political unrest, chaos and gross insanity such as murders and/or rape. The major impact on these children and adolescents is poignantly depicted by the first hand stories and the pictures from the workshops showing the efforts these children put forth to depict the hardships they have faced. It is sad, however, to realize that these children are the very few fortunate ones who survived with many others dead on their journey.

Once they reach their country of asylum the fate of these children is still in question. There are no clear rules governing their future and the lack of information of these children complicates the matters. The article clearly expresses the need for evaluation of objective measures over a wide range of physical, psychological, social, familial, experiential and cultural parameters to get closer to truth. It encourages multifactorial assessment of these children to provide them with a safer and brighter future.

The charity “Youth Support” appears to come to the rescue of these children and has established a long tradition of allowing people to express themselves at international conferences on adolescent health and welfare. The workshops mentioned in this article were held in London and going by the participation, it is made clear that these children wanted to spread the word. These workshops included the children expressing themselves and displaying their talent by acting and dancing in the course of showing their journey to a different country.

The problem of young asylum seekers is mainly lack of information. Most of the children are either abused or bereaved, thrown out from gangs or are incarcerated. They do not even have a birth date. They range from the children from Jamaican ghettos to distraught children from Afghanistan. There are many difficulties faced by the children as well as the government of the asylum giving countries. Medical assessment begins with history and interview where personal details like name, ethnic origin, state, racial origin, language and sex are asked. Others like stated age, entering country, links with UK, general background, family background, early history, religion, schooling, relationships including sexual, work/community, trouble with authorities are also included. Interview technique is important and needs to be conducted by professionals.

Mental and emotional development is an area which definitely needs assessment as these children come from a background which adds very little to their growth and they grow up having a false perception of the community and the world in general. Also, these children need a very close assessment which includes risk taking behavior, self worth, peer group influences, responsibility, future time behavior and assessment that includes pattern matching testing  and Raven’s progressive matrices. For in depth cognitive assessment the Leiter international performance scales are used. Assessment of ability and psychological skills is also done. Most importantly all the assessment is appropriately matched to different racial and ethnic groups.

In conclusion, this is an excellent monograph which throws light on the lives of asylum seeking adolescents, the problem they face and the in-depth assessment of all parameters including physical, sexual, emotional development. The work done by the author in bringing these children together is highly commendable and recommended to others interested in youth.

Prof. Donald E. Greydanus

Donald E. Greydanus MD, FAAP, FSAM is Professor of Pediatrics and Human Development at Michigan State University College of Human Medicine and Director of the Pediatrics Residency Program at Michigan State University/ Kalamazoo Center for Medical Studies. He is the Pediatrics Program Director at the MSU/Kalamazoo Center for Medical Studies Program in Kalamazoo, Michigan, USA. He has published extensively on adolescent health and lectured in many countries on adolescent health as well. He has published: 1) Co-edited 22 books  2)100 Book chapters  3) Co-edited 26 Journal issues  4) Over 200 articles

Dr. Greydanus has received various honors and awards from various organizations including the American Academy of Pediatrics, William B. Weil, Jr., M.D. Distinguished Pediatric Faculty Award at Michigan State University College of Human Medicine;  Honored Alumnus Award from Mayo Awards Committee for distinguished achievements in pediatrics;  The Society for Adolescent Medicine's - Outstanding Achievement in Adolescent Medicine Award; Mayo Graduate School of Medicine, and others.