Alicia F. LiebermanChild Trauma Research Project

University of California San Francisco

San Francisco General Hospital

Including and Serving Immigrant Families in

Early Childcare

What Is Unique About Immigrants?

• Linguistic discontinuity

• Unfamiliarity with institutions

• Lack of comfort with new social mores

• Different hierarchy of values

Childhood Adversity and Minority Status

• Minority children are more likely to be poor• Risk factors cluster around poverty• The impact of risk factors is cumulative• Minority children are more vulnerable to

traumatic event due to cumulative effect of risk factors and less access to services

(Oser & Cohen, 2003; Flor U.S. Surgeon General’s Report, 2001)

As a Result…

“American Indians, Alaska Natives, African

Americans, Asian Americans, Pacific Islanders, and Hispanic Americans bear a

disproportionately high burden of

disability from mental disorders.”

(The President’s New Freedom Commission Report, 2003)

When Systems Compound Risk: Child Welfare and

Foster Care• No race differences in abuse and neglect

reports

• Children of color are:- more often placed out of home - subjected to more placement changes- kept longer in foster care- less likely to be reunified with parents

(Casey Family Programs Child Welfare Fact Sheet, 2005)

When Systems Compound Risk:

Juvenile Justice Placement• Youth of color more likely to be arrested for same offenses as white

• Projected 10-year increase in juvenile justice placement- White 3%- American Indian 17%- African American 19%- Latinos 59%- Asian/Pacific Islander 74%

(Leiber, 2002; Snyder & Sickmund, 1995, 1999)

Our Children are Waiting…

What Can We Do?Take Action

• Early education: “Pre-K, starting at birth for

those who need it”*

• Inter-system coordination in early identification and mental health referral

(*Sam Meisels, 2006)

What Can We Do?Apply What We Know

• Early intervention is most cost-effective, regardless of immigration status

- school readiness: decreases in drop-out rates

- decreases in child abuse reports- decreases in unplanned pregnancies- increases in wage earnings- decreases in crime

(From Neurons to Neighborhoods, 2000; Karoly et al., 1998, 2005; Lynch, 2005; Olds, 2002)

What Can We Do?Adopt Helpful Public

Policies• Adopt policies that address the

educational and health disparities of minority children and their families, regardless of immigration status

• Fund to scale agencies and programs that address health, mental health childcare, education, family support, and child welfare regardless of immigration status

What Can We Do? Pursue Cultural

Competence• Community buy-in is crucial for success• Incorporate linguistic continuity• Understand the meaning of culturally

different childrearing practices• Hire staff that reflect the population

served• Fund training and leadership development• Include families/consumers from all

cultures in planning and implementation

What Can We Do?Begin at the Beginning

Babies can’t wait, regardless of immigration status!

Children aged birth-five are particularly vulnerable - 85% of child abuse victims- Majority of child abuse fatalities- Most frequent witnesses of domestic violence

What babies learn now can last a lifetime: Respect their culture to nourish their emotional health!