The document discusses the psychological impacts of early childhood trauma on refugee children based on lessons learned from child protection research. It covers key topics like the importance of early development, theories of child development, outcomes of development, risk factors for poor outcomes, and the clinician's role in caring for refugee children. The clinician aims to promote optimal health, development, and family support for refugee children who face risks from their traumatic experiences.

1. Child refugees and the psychological impacts of early childhood trauma Lessons learnt from child protection Dr David Everett and Dr Deepa Jeyaseelan Department of Paediatrics, Flinders Medical Centre

17. Risk factors for child health outcomes More likely to have mother with less than high school education; be from single parent household or ESL household. Backgrounds of prenatal stressors, maternal mental health or substance abuse issues, poor family organisation.

25. States become Traits Especially if repeated, unpredictable, physically or verbally violent

27. Memory Cognitive Emotional Motor State Complexity Plasticity

34. Poor attachment

35. NEGLECT – effects of early intervention on brain growth are enhanced the earlier the intervention starts

36. social disadvantage perpetuates itself if intervention does not occur early Source: Inequality in the early cognitive development of British children in the 1970 cohort by Leon Feinstein, Economica, February 2003 High social class, high score at 22 months High social class, low score at 22 months Low social class, high score at 22 months Low social class, low score at 22 months Social background is a more powerful predictor of educational outcomes by age 10 than attainment at 22 months less able richer children overtake more able poorer children by the age of six 0 10 20 30 40 50 60 70 80 90 100 22 28 34 40 46 52 58 64 70 76 82 88 94 100 106 112 118 Age in months Average position in the distribution

55. Rickets - general osteopenia (bone thinning), rib fractures, irregular metaphyses, peri-osteal new bone formation, bowing

56. Enuresis

60. Holding Maneuvers

64. Voiding Disorders - Summary