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IRMHP Newsletter - September 2024
Supporting Refugee Children: Addressing Trauma and ADHD in Educational Settings

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Supporting Refugee Children: Addressing Trauma and ADHD in Educational Settings

By Dr. Redab Al-Janaideh, PhD, Developmental Psychology, Ontario Institute for Studies in Education, University of Toronto

September is an important time in the school calendar. It is the beginning of a new academic year for school-aged children. For this month’s feature, we discuss the overlapping symptoms of trauma and ADHD among refugee children and what educators and service providers can do to support these learners.

Population of interest:
Refugee children, particularly those from conflict-affected regions, who may be experiencing trauma and/or attention-deficit/hyperactivity disorder (ADHD) symptoms.

The need:
Refugee children face unique challenges when adjusting to new educational settings. Many have experienced trauma due to war, loss, or forced migration. Additionally, some exhibit behaviors associated with ADHD, which can make it difficult to distinguish between trauma responses and ADHD symptoms. Therefore, it is important to provide educators and settlement workers with strategies for supporting these children effectively, as they may not have mental health expertise but work closely with these families.

Overlapping ADHD and Trauma Behaviors:
Some behaviors of children with ADHD and those experiencing trauma may look similar, making it harder to distinguish between the two. ADHD behaviors may include trouble focusing, impulsivity, and hyperactivity. Children might struggle to sit still, complete tasks, or regulate their emotions. Trauma-related behaviors, such as emotional outbursts, withdrawal, or being easily startled, can also overlap with these ADHD symptoms. For example, a child with trauma may have trouble concentrating due to heightened anxiety, which can resemble the inattention seen in ADHD. Then, it is important to note these overlaps so that both trauma and ADHD are considered when supporting refugee children.

Challenges in Identifying ADHD in Refugee Children:

  1. Stigma

    Stigma surrounding ADHD can prevent parents from seeking help. This stigma may exist both within the refugee community and in society. In many cultures, ADHD might not be well understood, leading to misconceptions that ADHD is a sign of poor parenting or bad behavior. Refugee parents, dealing with multiple stressors, might hesitate to engage with professionals out of fear of judgment. It is crucial for settlement workers, educators, and mental health professionals to recognize and address this stigma, ensuring parents feel safe and supported when seeking assistance for their children.

  2. Cultural barriers

    Cultural barriers between mental health professionals, educators, and refugee families can affect the accurate diagnosis of ADHD. For instance, certain behaviors considered symptomatic of ADHD in Western cultures might be seen differently in other cultures. Refugee families may not recognize behaviors like hyperactivity as signs of a disorder, viewing them as normal childhood behavior. Additionally, mental health services might not always be culturally sensitive, which could lead to misunderstandings between families and professionals. To bridge this gap, it’s important to provide culturally sensitive assessments and education to both families and teachers.

  3. Language Barriers

    The inability to communicate fluently adds another layer of complexity. Both educators and mental health professionals need access to translation resources and culturally relevant strategies to help overcome these barriers. Refugee families may not have the language to describe their child’s behavior in ways that align with Western understandings of ADHD or trauma, leading to misdiagnosis or lack of diagnosis.

Cultural Considerations in Supporting Refugee Children:

  1. Cultural Sensitivity:

    Integrating cultural factors into interventions is critical. For example, understanding the cultural context of parenting practices can help professionals better communicate with families about ADHD and trauma. In some cultures, strict discipline might be common, and parents may not understand how ADHD affects behavior. Educators and settlement workers should acknowledge these practices and gently introduce alternative strategies that accommodate ADHD behaviors while respecting cultural values.

  2. Community Engagement:

    Engaging refugee communities can help to reduce stigma and ensure that interventions are relevant. Schools and community organizations can involve cultural mediators or leaders from the refugee community to act as bridges between professionals and families. This engagement helps families feel more comfortable with the support offered, knowing it aligns with their values.

  3. Integrated Approach:

    An integrated approach that combines cultural sensitivity with mental health interventions provides more holistic support for refugee children. By considering cultural background alongside mental health needs, educators and mental health professionals can offer tailored care that addresses the unique challenges refugee children face.

Recommendations for Supporting Refugee Children in Schools:

  1. Educational Strategies

    Schools should develop effective strategies that take into account both trauma and ADHD when supporting refugee children. This includes creating inclusive learning environments that accommodate different learning and behavioral needs. For instance, allowing for movement breaks or creating quiet spaces can help children who struggle with focus or anxiety.

  2. Teacher Training

    Educators must be equipped with specialized training to understand the challenges refugee children face and how to address trauma and ADHD. Providing teachers with skills to recognize and respond to these challenges is essential for creating a supportive learning environment.

  3. Involving Parents and Communities

    Collaboration with parents is crucial. Educators can work with community leaders to build trust and open communication with refugee families. By fostering these relationships, schools can ensure that parents feel comfortable sharing their concerns about their child’s behavior and seeking help.

About the Recommendations:

These suggestions focus on identifying the overlapping symptoms of trauma and ADHD, understanding cultural and language barriers, and engaging with refugee communities. They emphasize creating inclusive educational strategies, teacher training, and the involvement of parents and communities to ensure that refugee children receive the mental health and educational support they need.

What's Promising?

  • Recognizing the overlap between trauma and ADHD behaviors allows educators to better support refugee children in educational settings.
  • Engaging with communities and addressing cultural sensitivities are important steps toward creating a welcoming environment for these children.
  • Supporting educators and settlement workers with practical strategies improves the overall outcomes for refugee children.

Key Takeaway:
Refugee children are highly resilient but require tailored educational and mental health support to address the effects of trauma and ADHD. Schools and educators must understand the cultural, linguistic, and psychological needs of these children to help them succeed in their new environments.

About the Organization:
This initiative is based on research and insights shared during the 2024 Metropolis Conference in Montreal, Quebec, to offer guidance for educators and communities working with refugee children. A manuscript detailing how ADHD affects refugee children’s reading skills is currently under review. This data comes from a study based on Dr. Al-Janaideh’s completed doctoral thesis, which is available in full on her Google Scholar profile.

Resources and training on ADHD in the classroom and trauma-sensitive schools

  • Inclusive Education, The Alberta Teachers’ Association:
  • Helping Traumatized Children Learn organization:
  • What is Trauma Trauma-Sensitive Schools:
Community of Practice

Available for course participants, the Community of Practice (CoP) is a virtual community where service providers who support immigrant and refugee mental health can stay up-to-date on new events and resources. 

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Disclaimer: The views expressed in the webinars are those of the presenter(s) and do not necessarily represent those of the Immigrant and Refugee Mental Health Project, CAMH, our funders or partners. Information provided in the webinars is for professional development and educational purposes only.

 

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