Pediatrics & Primary Care

Biography

Biography: Lucia Celesti

Abstract

In 2015 the Bambino Gesù Pediatric Hospital (OPBG), within the European project "Common approach for refugees and other migrant’s health-CARE", studied and drafted a protocol for determining age in unaccompanied minors using a multidisciplinary and holistic approach. Due to the increasing numbers of migrants arriving in Italy by sea, a useful tool to manage the phenomenon in the difficult context of hotspots was required. In fact, being or not identified as a minor constitutes a watershed for the fate of the foreigner. At international level experts affirm that age assessment must consider a number of physical, psychological, environmental and cultural factors and that, for this reason, the involvement of doctors-with auxological skills, child neuro-psychiatrists, developmental psychologists, social workers, intercultural mediators-specialized and trained is needed. Based on demonstrated feasibility of the project, OPBG is going to be implemented in collaboration with Rome Municipality– the holistic protocol on local context of city of Rome. The age assessment foresee three main steps: a social evaluation, aimed at collecting information regarding the child’s life, his/her previous sexual activities, reason for the migration and useful details about the present situation; a neuropsychiatric/psychological evaluation through mental state evaluation (a qualitative analysis aimed to verify the existence of a potential psychiatric risk) and modified mini-mental state examination (a test used to assess and monitor cognitive functions in child’s principal neuropsychiatric domain); a medical-auxological examination, collection of all useful parameters to determinate age, including the child’s pubertal development. At the end of multidisciplinary evaluations, the case manager report the conclusion indicating the presumed age with a minimum value and a maximum value (range) deriving from the biological variability and the methods used by the team. If doubts remain, the migrant is considered as minor.