Skip to main content
Top
Published in: Journal of Immigrant and Minority Health 1/2020

01-02-2020 | Care | Original Paper

Mental Health Needs of Refugee Children in Specialized Early Education and Care Programs in Germany

Authors: Thimo Buchmüller, Hanna Lembcke, Francesca Ialuna, Julian Busch, Birgit Leyendecker

Published in: Journal of Immigrant and Minority Health | Issue 1/2020

Login to get access

Abstract

Refugee children are at risk to develop mental health problems, which have rarely been investigated in educational contexts. We conducted three studies in childcare programs for refugees in Germany. Children’s behavior was assessed by educators on site (n = 84) and online (n = 50) using a two-stage-cluster sampling and on site (n = 107) using complete samples. In Study 1 and 2, children showed elevated attention problems ranging from medium to large effect sizes, r = 0.2 and r = 0.5, respectively, and aggressive behavior problems ranging from small to large effect sizes, r = 0.1 and r = 0.5, respectively, when compared to norm data. In Study 3, children showed elevated peer-problems, r = 0.5. Future research needs to investigate whether these problems are a consequence of adapting to a novel context or a precursor of a psychopathology caused by risk factors in the context of forced displacement.
Footnotes
1
If Roma people have previously lived in EU countries, they are not classified as refugees or asylum seekers in Germany. According to the UNHCR, however, ‘a refugee is someone who has been forced to flee his or her country because of persecution, war or violence’ [16]. Roma from eastern European countries suffer from ethnic discrimination [12] and their risk of being poor is higher than that of refugees living in the same countries [17]. Therefore, in line with other studies (for example [18]), we define Roma people as refugees regardless of whether they come from EU or non-EU countries such as Serbia.
 
Literature
1.
go back to reference UNHCR. Global trends: Forced displacement in 2017. Geneva: UNHCR. UNHCR. Global trends: Forced displacement in 2017. Geneva: UNHCR.
2.
go back to reference Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379:266–82.CrossRef Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379:266–82.CrossRef
3.
go back to reference Reynolds AJ, Temple JA, White BAB, Ou S-R, Robertson DL. Age 26 cost-benefit analysis of the Child-Parent Center Early Education Program. Child Dev. 2011;82:379–404.CrossRef Reynolds AJ, Temple JA, White BAB, Ou S-R, Robertson DL. Age 26 cost-benefit analysis of the Child-Parent Center Early Education Program. Child Dev. 2011;82:379–404.CrossRef
4.
go back to reference Slone M, Mann S. Effects of war, terrorism and armed conflict on young children: a systematic review. Child Psychiatry Hum Dev. 2016;47:950–65.CrossRef Slone M, Mann S. Effects of war, terrorism and armed conflict on young children: a systematic review. Child Psychiatry Hum Dev. 2016;47:950–65.CrossRef
5.
go back to reference Bornstein MH, Hahn C-S, Haynes OM. Social competence, externalizing, and internalizing behavioral adjustment from early childhood through early adolescence: developmental cascades. Dev Psychopathol. 2010;22:717–35.CrossRef Bornstein MH, Hahn C-S, Haynes OM. Social competence, externalizing, and internalizing behavioral adjustment from early childhood through early adolescence: developmental cascades. Dev Psychopathol. 2010;22:717–35.CrossRef
7.
go back to reference Wiegersma PA, Stellinga-Boelen AAM, Reijneveld SA. Psychosocial problems in asylum seekers’ children: the parent, child, and teacher perspective using the Strength and Difficulties Questionnaire. J Nerv Ment Dis. 2011;199:85–90.CrossRef Wiegersma PA, Stellinga-Boelen AAM, Reijneveld SA. Psychosocial problems in asylum seekers’ children: the parent, child, and teacher perspective using the Strength and Difficulties Questionnaire. J Nerv Ment Dis. 2011;199:85–90.CrossRef
8.
go back to reference Nielsen SS, Norredam M, Christiansen KL, Obel C, Hilden J, Krasnik A. Mental health among children seeking asylum in Denmark—the effect of length of stay and number of relocations: a cross-sectional study. BMC Public Health. 2008;8:293.CrossRef Nielsen SS, Norredam M, Christiansen KL, Obel C, Hilden J, Krasnik A. Mental health among children seeking asylum in Denmark—the effect of length of stay and number of relocations: a cross-sectional study. BMC Public Health. 2008;8:293.CrossRef
9.
go back to reference Bean TM, Eurelings-Bontekoe E, Spinhoven P. Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med. 2007;64:1204–15.CrossRef Bean TM, Eurelings-Bontekoe E, Spinhoven P. Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med. 2007;64:1204–15.CrossRef
10.
go back to reference Montgomery E. Trauma and resilience in young refugees: a 9-year follow-up study. Dev Psychopathol. 2010;22:477–89.CrossRef Montgomery E. Trauma and resilience in young refugees: a 9-year follow-up study. Dev Psychopathol. 2010;22:477–89.CrossRef
11.
go back to reference Thabet AAM, Karim K, Vostanis P. Trauma exposure in pre-school children in a warzone. Br J Psychiatry. 2006;188:154–8.CrossRef Thabet AAM, Karim K, Vostanis P. Trauma exposure in pre-school children in a warzone. Br J Psychiatry. 2006;188:154–8.CrossRef
13.
go back to reference Bakker L, Dagevos J, Engbersen G. The importance of resources and security in the socio-economic integration of refugees. A study on the impact of length of stay in asylum accommodation and residence status on socio-economic integration for the four largest refugee groups in The Netherlands. J Int Migr Integr. 2014;15:431–48. https://doi.org/10.1007/s12134-013-0296-2.CrossRef Bakker L, Dagevos J, Engbersen G. The importance of resources and security in the socio-economic integration of refugees. A study on the impact of length of stay in asylum accommodation and residence status on socio-economic integration for the four largest refugee groups in The Netherlands. J Int Migr Integr. 2014;15:431–48. https://​doi.​org/​10.​1007/​s12134-013-0296-2.CrossRef
15.
go back to reference Federal Office for Migration and Refugees. Flüchtlinge (BAMF): Aktuelle Zahlen zu Asyl: Ausgabe Dezember 2016. Federal Office for Migration and Refugees. Flüchtlinge (BAMF): Aktuelle Zahlen zu Asyl: Ausgabe Dezember 2016.
17.
go back to reference Milcher S. Poverty and the determinants of welfare for roma and other vulnerable groups in southeastern Europe. Comp Econ Stud. 2006;48:20–35.CrossRef Milcher S. Poverty and the determinants of welfare for roma and other vulnerable groups in southeastern Europe. Comp Econ Stud. 2006;48:20–35.CrossRef
18.
go back to reference Walsh CA, Este D, Krieg B, Giurgiu B. Needs of refugee children in Canada: what can Roma refugee families tell us? J Comp Fam Stud. 2011;42:599–613.CrossRef Walsh CA, Este D, Krieg B, Giurgiu B. Needs of refugee children in Canada: what can Roma refugee families tell us? J Comp Fam Stud. 2011;42:599–613.CrossRef
19.
go back to reference Becker R, Tremel P. Bildungseffekte vorschulischer Betreuung, Erziehung und Bildung für Migranten im deutschen Schulsystem. In: Becker R, editor. Integration durch Bildung: Bildungserwerb von jungen Migranten in Deutschland. Wiesbaden: VS Verlag für Sozialwissenschaften/Springer Fachmedien Wiesbaden GmbH, Wiesbaden; 2011. p. 57–70. https://doi.org/10.1007/978-3-531-93232-3_3.CrossRef Becker R, Tremel P. Bildungseffekte vorschulischer Betreuung, Erziehung und Bildung für Migranten im deutschen Schulsystem. In: Becker R, editor. Integration durch Bildung: Bildungserwerb von jungen Migranten in Deutschland. Wiesbaden: VS Verlag für Sozialwissenschaften/Springer Fachmedien Wiesbaden GmbH, Wiesbaden; 2011. p. 57–70. https://​doi.​org/​10.​1007/​978-3-531-93232-3_​3.CrossRef
20.
go back to reference Becker A, Woerner W, Hasselhorn M, Banaschewski T, Rothenberger A. Validation of the parent and teacher SDQ in a clinical sample. Eur Child Adolesc Psychiatry. 2004;13(Suppl 2):II11–6.PubMed Becker A, Woerner W, Hasselhorn M, Banaschewski T, Rothenberger A. Validation of the parent and teacher SDQ in a clinical sample. Eur Child Adolesc Psychiatry. 2004;13(Suppl 2):II11–6.PubMed
21.
go back to reference Achenbach TM. Commentary: definitely more than measurement error: but how should we understand and deal with informant discrepancies? J Clin Child Adolesc Psychol. 2011;40:80–6.CrossRef Achenbach TM. Commentary: definitely more than measurement error: but how should we understand and deal with informant discrepancies? J Clin Child Adolesc Psychol. 2011;40:80–6.CrossRef
22.
go back to reference Busch J, Buchmüller T, Lembcke H, Bihler L, Leyendecker B. Building bridges to safe havens: transition of young refugee children to early childcare. Manuscript submitted for publication. 2018. Busch J, Buchmüller T, Lembcke H, Bihler L, Leyendecker B. Building bridges to safe havens: transition of young refugee children to early childcare. Manuscript submitted for publication. 2018.
23.
go back to reference Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms & profiles. Burlington: Asenbach System of Empirically Based Assessment (ASEBA); 2000. Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms & profiles. Burlington: Asenbach System of Empirically Based Assessment (ASEBA); 2000.
24.
go back to reference Achenbach TM, Rescorla LA. Multicultural Supplement to the Manual for the ASEBA Preschool Forms & Profiles: Child Behavior Checklist for Ages 1 1/2/-5, Language Development Survey, Caregiver-teacher Report Form; an Integrated System of Multi-informant Assessment; 2010. Achenbach TM, Rescorla LA. Multicultural Supplement to the Manual for the ASEBA Preschool Forms & Profiles: Child Behavior Checklist for Ages 1 1/2/-5, Language Development Survey, Caregiver-teacher Report Form; an Integrated System of Multi-informant Assessment; 2010.
25.
go back to reference Petermann U, Petermann F, Schreyer I. The German Strengths and Difficulties Questionnaire (SDQ). Eur J Psychol Assess. 2010;26:256–62.CrossRef Petermann U, Petermann F, Schreyer I. The German Strengths and Difficulties Questionnaire (SDQ). Eur J Psychol Assess. 2010;26:256–62.CrossRef
26.
go back to reference Goodman R, Scott S. Comparing the strengths and difficulties questionnaire and the Child Behavior Checklist: is small beautiful? J Abnorm Child Psychol. 1999;27:17–24.CrossRef Goodman R, Scott S. Comparing the strengths and difficulties questionnaire and the Child Behavior Checklist: is small beautiful? J Abnorm Child Psychol. 1999;27:17–24.CrossRef
27.
go back to reference Woerner W, Fleitlich-Bilyk B, Martinussen R, Fletcher J, Cucchiaro G, Dalgalarrondo P, et al. The Strengths and Difficulties Questionnaire overseas: evaluations and applications of the SDQ beyond Europe. Eur Child Adolesc Psychiatry. 2004;13(Suppl 2):II47–54.PubMed Woerner W, Fleitlich-Bilyk B, Martinussen R, Fletcher J, Cucchiaro G, Dalgalarrondo P, et al. The Strengths and Difficulties Questionnaire overseas: evaluations and applications of the SDQ beyond Europe. Eur Child Adolesc Psychiatry. 2004;13(Suppl 2):II47–54.PubMed
29.
go back to reference Niclasen J, Skovgaard AM, Andersen AM, Sømhovd MJ, Obel C. A confirmatory approach to examining the factor structure of the Strengths and Difficulties Questionnaire (SDQ): a large scale cohort study. J Abnorm Child Psychol. 2013;41:355–65.CrossRef Niclasen J, Skovgaard AM, Andersen AM, Sømhovd MJ, Obel C. A confirmatory approach to examining the factor structure of the Strengths and Difficulties Questionnaire (SDQ): a large scale cohort study. J Abnorm Child Psychol. 2013;41:355–65.CrossRef
30.
go back to reference Enders CK. A primer on maximum likelihood algorithms available for use with missing data. Struct Equ Model. 2001;8:128–41.CrossRef Enders CK. A primer on maximum likelihood algorithms available for use with missing data. Struct Equ Model. 2001;8:128–41.CrossRef
31.
go back to reference Vostanis P. Strengths and Difficulties Questionnaire: research and clinical applications. Curr Opin Psychiatry. 2006;19:367–72.CrossRef Vostanis P. Strengths and Difficulties Questionnaire: research and clinical applications. Curr Opin Psychiatry. 2006;19:367–72.CrossRef
33.
go back to reference Allansson M, Melander E, Themnér L. Organized violence, 1989–2016. J Peace Res. 2017;54:574–87.CrossRef Allansson M, Melander E, Themnér L. Organized violence, 1989–2016. J Peace Res. 2017;54:574–87.CrossRef
34.
go back to reference Abdi H. Holm’s Sequential Bonferroni procedure. In: Encyclopedia of research design. Thousand Oaks, CA: Sage. Abdi H. Holm’s Sequential Bonferroni procedure. In: Encyclopedia of research design. Thousand Oaks, CA: Sage.
35.
go back to reference Buchmüller T, Lembcke H, Busch J, Kumsta R, Leyendecker B. Exploring mental health status and syndrome patterns among young refugee children in Germany. Front Psychiatry. 2018;9:212.CrossRef Buchmüller T, Lembcke H, Busch J, Kumsta R, Leyendecker B. Exploring mental health status and syndrome patterns among young refugee children in Germany. Front Psychiatry. 2018;9:212.CrossRef
36.
go back to reference de Los Reyes A, Kazdin AE. Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull. 2005;131:483–509.CrossRef de Los Reyes A, Kazdin AE. Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull. 2005;131:483–509.CrossRef
41.
go back to reference Sirin SR, Rogers-Sirin L. The educational and mental health needs of Syrian refugee children: young children in refugee families. Washington, DC: Migration Policy Institute Press; 2015. Sirin SR, Rogers-Sirin L. The educational and mental health needs of Syrian refugee children: young children in refugee families. Washington, DC: Migration Policy Institute Press; 2015.
42.
go back to reference Seidman E, Allen L, Aber JL, Mitchell C, Feinman J. The impact of school transitions in early adolescence on the self-system and perceived social context of poor urban youth. Child Dev. 1994;65:507.CrossRef Seidman E, Allen L, Aber JL, Mitchell C, Feinman J. The impact of school transitions in early adolescence on the self-system and perceived social context of poor urban youth. Child Dev. 1994;65:507.CrossRef
43.
go back to reference Rimm-Kaufman SE, Curby TW, Grimm KJ, Nathanson L, Brock LL. The contribution of children’s self-regulation and classroom quality to children’s adaptive behaviors in the kindergarten classroom. Dev Psychol. 2009;45:958–72.CrossRef Rimm-Kaufman SE, Curby TW, Grimm KJ, Nathanson L, Brock LL. The contribution of children’s self-regulation and classroom quality to children’s adaptive behaviors in the kindergarten classroom. Dev Psychol. 2009;45:958–72.CrossRef
44.
go back to reference Ponitz CC, McClelland MM, Matthews JS, Morrison FJ. A structured observation of behavioral self-regulation and its contribution to kindergarten outcomes. Dev Psychol. 2009;45:605–19.CrossRef Ponitz CC, McClelland MM, Matthews JS, Morrison FJ. A structured observation of behavioral self-regulation and its contribution to kindergarten outcomes. Dev Psychol. 2009;45:605–19.CrossRef
45.
go back to reference Moffitt TE, Arseneault L, Belsky D, Dickson N, Hancox RJ, Harrington H, et al. A gradient of childhood self-control predicts health, wealth, and public safety. PNAS. 2011;108:2693–8.CrossRef Moffitt TE, Arseneault L, Belsky D, Dickson N, Hancox RJ, Harrington H, et al. A gradient of childhood self-control predicts health, wealth, and public safety. PNAS. 2011;108:2693–8.CrossRef
46.
go back to reference Panter-Brick C, Grimon M-P, Eggerman M. Caregiver-child mental health: a prospective study in conflict and refugee settings. J Child Psychol Psychiatry. 2014;55:313–27.CrossRef Panter-Brick C, Grimon M-P, Eggerman M. Caregiver-child mental health: a prospective study in conflict and refugee settings. J Child Psychol Psychiatry. 2014;55:313–27.CrossRef
47.
go back to reference King S, Laplante DP. The effects of prenatal maternal stress on children’s cognitive development: Project Ice Storm. Stress. 2005;8:35–45.CrossRef King S, Laplante DP. The effects of prenatal maternal stress on children’s cognitive development: Project Ice Storm. Stress. 2005;8:35–45.CrossRef
48.
go back to reference McMahon SD, Grant KE, Compas BE, Thurm AE, Ey S. Stress and psychopathology in children and adolescents: is there evidence of specificity? J Child Psychol Psychiatry. 2003;44:107–33.CrossRef McMahon SD, Grant KE, Compas BE, Thurm AE, Ey S. Stress and psychopathology in children and adolescents: is there evidence of specificity? J Child Psychol Psychiatry. 2003;44:107–33.CrossRef
49.
go back to reference Allwood MA, Bell-Dolan D, Husain SA. Children’s trauma and adjustment reactions to violent and nonviolent war experiences. J Am Acad Child Adolesc Psychiatry. 2002;41:450–7.CrossRef Allwood MA, Bell-Dolan D, Husain SA. Children’s trauma and adjustment reactions to violent and nonviolent war experiences. J Am Acad Child Adolesc Psychiatry. 2002;41:450–7.CrossRef
50.
go back to reference Keles S, Friborg O, Idsøe T, Sirin S, Oppedal B. Resilience and acculturation among unaccompanied refugee minors. Int J Behav Dev. 2017;42:52–63.CrossRef Keles S, Friborg O, Idsøe T, Sirin S, Oppedal B. Resilience and acculturation among unaccompanied refugee minors. Int J Behav Dev. 2017;42:52–63.CrossRef
51.
go back to reference Sirin SR, Ryce P, Gupta T, Rogers-Sirin L. The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation. Dev Psychol. 2013;49:736–48.CrossRef Sirin SR, Ryce P, Gupta T, Rogers-Sirin L. The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation. Dev Psychol. 2013;49:736–48.CrossRef
52.
go back to reference Crijnen AAM, Bengi-Arslan L, Verhulst FC. Teacher-reported problem behaviour in Turkish immigrant and Dutch children: a cross-cultural comparison. Acta Psychiatr Scand. 2000;102:439–44.CrossRef Crijnen AAM, Bengi-Arslan L, Verhulst FC. Teacher-reported problem behaviour in Turkish immigrant and Dutch children: a cross-cultural comparison. Acta Psychiatr Scand. 2000;102:439–44.CrossRef
53.
go back to reference Bongers IL, Koot HM, van der Ende J, Verhulst FC. The normative development of child and adolescent problem behavior. J Abnorm Psychol. 2003;112:179–92.CrossRef Bongers IL, Koot HM, van der Ende J, Verhulst FC. The normative development of child and adolescent problem behavior. J Abnorm Psychol. 2003;112:179–92.CrossRef
54.
go back to reference Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294:602–12.CrossRef Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294:602–12.CrossRef
55.
go back to reference Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365:1309–14.CrossRef Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365:1309–14.CrossRef
Metadata
Title
Mental Health Needs of Refugee Children in Specialized Early Education and Care Programs in Germany
Authors
Thimo Buchmüller
Hanna Lembcke
Francesca Ialuna
Julian Busch
Birgit Leyendecker
Publication date
01-02-2020
Publisher
Springer US
Keyword
Care
Published in
Journal of Immigrant and Minority Health / Issue 1/2020
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-019-00896-4

Other articles of this Issue 1/2020

Journal of Immigrant and Minority Health 1/2020 Go to the issue