Non-verbal cognitive development, learning, and symptoms of PTSD in 3- to 6-year-old refugee children

Abstract

As IQ tests are commonly used as key assessment method, we address the question whether our commonly used standardized IQ tests are appropriate for children from families of diverse cultures and different educational levels in a refugee population. We examined 109 refugee children aged 3–7 years (M = 5.10 years, SD = 1.25) with the “Kaufman Assessment Battery for Children “ (KABC-II; Kaufmann & Kaufmann, 2015) on a language-free scale (Scale of Intellectual Functioning, SIF) and learning performance (subtest Atlantis). With a non-verbal IQ of 81.5 (SD = 18.01), the population mean of the refugee children is more than one standard deviation lower than the mean of the German norm population. Standardized scores follow the normal distribution and are not correlated to any of the assessed markers of adversity (flight duration, time spent in Germany, child PTSD in parent rating, parental symptom load, and parental education level).Conclusion: The interpretation of IQ test results for refugee children should be done cautiously as results may underestimate their cognitive capacity. Environmental factors, such as high illiteracy among parents in this study, the lack of institutional education of children and high lifetime stress, may explain our findings.Trial registration: DRKS00021150. What is Known:• There is a high pervasiveness for the use of standardized IQ tests in the German health and education system to determine eligibility for special education and social services. What is New:• Refugee children score significantly lower than German children in a language-free IQ test. As results are normally distributed and not correlated to any of the assessed markers of adversity, the low scores in the refugee group might be due to missing formal education.

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

“…Parental distress was identified as indicator for children's general and traumarelated symptom load in both groups, and significantly correlated with refugee children's social play. This is in line with previous findings that potentially traumatized parents may struggle to provide their children with a sense of security and stability [48,49], affecting both children's mental health and engagement in play [14,25,28,29,40]. Childcare is known to serve as protective measure for children facing adversity [27,38], which could explain why the correlation between parental distress and children's social play was significant only in the refugee group without regular childcare enrollment.…”

“…Our data revealed no associations between parent ratings of children's trauma-related and general symptom load and markers of child mental health from other perspectives such as systematic play observations or educator assessments, leading us to reject Hypothesis 2.1. Consistent with prior research [28,29], it moreover suggests that parents might have overestimated their children's distress, underscoring the need for complementary perspectives of children's symptomatology.…”

“…This article was part of the InterCuLtUral Child DEvelopment Project (INCLUDE), design and methods were adapted from previously published studies [28,29]. The cross-sectional study was conducted between June 2021 and August 2022 in two reception camps for refugees in Munich, Germany.…”

“…Given the elevated risk of accumulating adversities in the course of displacement, collecting data on young children's mental health and development is highly relevant, though it is challenging due to their limited ability to verbally articulate experiences and symptoms [16,43]. This has lead researchers and clinicians to rely on parental reports [24,28,29], although these may be influenced by the parent's own symptomatology [2,16,28,29]. Supplementary reports by educators are recommended to enhance sensitivity [28,29], but limited access to daycare makes it difficult to obtain a multi-context perspective in refugee settings [5].…”

“…This has lead researchers and clinicians to rely on parental reports [24,28,29], although these may be influenced by the parent's own symptomatology [2,16,28,29]. Supplementary reports by educators are recommended to enhance sensitivity [28,29], but limited access to daycare makes it difficult to obtain a multi-context perspective in refugee settings [5]. Play observations offer a viable solution to these challenges [10,12,13,22].…”