As heartrending stories of young children being taken from their immigrant parents at the U.S.-Mexico border became known, child welfare experts became increasingly alarmed.

How would the children — about 2,500 of them —  fare in foster care? What would the long-term repercussions be? What about their mental well-being and their emotional development?

The situation is still unfolding, and it will be a long time before anyone has answers to those questions.

Elizabeth Dowdell
Elizabeth Dowdell

We recently sought the perspective of Elizabeth B. Dowdell, a professor at the Villanova University M. Louise Fitzpatrick College of Nursing and an expert on childhood development, toxic stress, and youth risk behaviors.

As a pediatric nurse, what were your biggest concerns when you learned that children were being taken from their parents at the border?

Child safety and all that that encompasses. Not just physical safety, but also emotional safety, psychological safety, and health needs. I would suspect the children at the borders may have arrived with health needs. In this country, there are federal and state health requirements for children, such as immunizations and dental care. Health promotion safety nets are built into our system and linked with access to public education. I would suspect that some of the children coming across the border may not have had access to what we know as preventive health. Also, they may have had exposure to illnesses that are not very common here.

>> READ MORE: Thousands of older children also were separated at the border. What happens to them?

Psychological needs are going to be dependent on the age of the children and their family story. Everyone would agree that a 3-year-old has very different developmental needs than an 8-year-old, and both are different from a 12-year-old.

What I suspect — because we see it when children go into the hospital — is that young children regress. You have a 7-year-old who hasn't sucked her thumb in years, but starts again when she is in hospital. That's a normal regression, going back to a behavior that gives comfort. It shouldn't last long, but if it does, that's a concern. If a child has a transitional object — a doll, a blanket, a teddy bear — something that gives them a sense of stability, then that transitional object stays with the child. That child can't control mom or dad going away, but he or she can control that teddy bear.

Is it likely they are being traumatized simply by being taken away?

I think we can all say we have great concern about what's going on at the borders. I would assume that the decision for a family to leave their country of origin is made by the adults for a reason. Trauma is experienced and defined individually. For the children we must ask, what is the child and family's previous experience? That's what we really don't know. If a child comes from a place where men come and take family members away, and those family members never come back, then they come here, and the border personnel take the parents away. Does the child think that mom and dad are gone, never to return, because that's what happened with their uncle? Or is it perceived as something different? Children have only been in this world for a limited time. They know only what they have experienced. Maybe it's not a surprise to the children to be told, "Mom and Dad go here, kids go here."  But after a week, children are certainly going to ask, "where are my parents?" Their reaction to being separated from their parents will depend in part on what the adults are telling them and their developmental stage.

What about while they are being held in facilities away from their parents?

I would hope their physical needs are being met — three meals a day, clean sheets, soap, showers, nutritional needs, health. But, developmentally, what is being done to keep them occupied, to keep them engaged? Is there any learning, any playing? If they're just in warehouses and their play needs or psychological needs or emotional needs are not being met, that's a concern.

When we think of a young child, we think of them as being energetic, enthusiastic, shy, but also very bubbly. When we see children whose psychological and emotional needs are not being met, we can see a dulling.  They will pull into themselves. They are not as energetic, not as lively; they're not skipping around or singing. They can be withdrawn. That's okay for a day or two, but we don't want to see that weeks and weeks on end. Children are resilient, probably more so than the parents, and best practice is to support that resiliency.

Although the situation is still unfolding, what are the long-term implications for these children?

I'd love to know how the children who apparently were separated from families at the border as far back as 2014, are doing today. They have the experience that we could learn from about what works or does not work as well as psychological outcomes. As for eventual reunification, we must ask: What did the parents experience, what did the children experience, combined with what the experience was in the country they left?  I think it's certainly beyond the scope of the border control officials or ICE — Immigration and Customs Enforcement — to deal with the long-term outcomes. They can do the physical reunification, but the psychological aspect is unknown, especially if they return to their country of origin.

Looking at U.S. children who have been through traumatic events, we know that some are very resilient, able to adapt and do OK. Others are able to adapt with support — developmental, educational, or psychological support — and then they do okay.  And we see another group that will need much more intensive support.

Is this at all similar to what children go through here when they are taken from their parents by child welfare authorities?

No. Here, in the U.S., children go into foster care because of a family situation. There is maltreatment or abuse, drug use, or the parent died. Events occur, and it becomes a child safety issue. The child is removed from the parent(s) and put into foster care or kinship care — with another family member. Children placed into a single or a group home have access to services such as health care, education, and social services. The goal is to provide stability as well as meeting the child's health and psychology needs.

At the border, children are separated because of the circumstance. The family came into the country illegally. I suspect that, at the border, they're not looking at the individual. They are looking at aggregates. They're looking at the large group. What does it mean for those children? I suspect that for some children, having three meals a day and running water and a place to sleep, might be OK. I'm not certain what services or supports these immigrant children are getting, but they are not receiving equivalent supports as found in the foster care system.

My concern is that for the families at the border who experience separation, what will be the outcome for these individuals? Will the children become fearful or aggressive, unable to move forward developmentally? Will there be a lasting uncertainty, and what will be the cost?