Refugee and unaccompanied asylum seeking children and young people: age assessment and children in detention

 These pages were developed in partnership with the Child Protection Standing Committee and the Advocacy Committee to support paediatricians in the assessment and management of children and young people of refugee background, with links to key external information and resources.

Age assessment

Most refugee children and young people will not have a passport, although some may have been given a passport to help them to leave a situation where they are at risk.  Sometimes the child’s stated age may be disputed; with serious implications for the outcome of their asylum claim and for their ability to access health services, education and welfare support (Crawley, 2007). Adults indicating that they are children present a risk to younger cohorts if placed into accommodation together. However the converse is true and vulnerable young people should not be placed with adults.

The Home Office and the Association of Directors of Children’s Services have produced joint working guidance about how UK Visas and Immigration decide applications.

The Association of Directors of Children's Services have also produced age assessment guidance for assisting English social workers in conducting age assessments of unaccompanied children seeking asylum. This states that the process for age determination by the local authority should take place in the presence of an appropriate adult, by two qualified and one senior social worker, taking into account a number of social and other factors.  If in doubt the local authority should give the young person the benefit of the doubt as to their age.

Age assessment guidance has also been developed in Scotland and Wales.

In these situations, remember that there is no single reliable method for making precise age estimates and the most appropriate approach is to use a holistic evaluation, incorporating narrative accounts, physical assessment of teeth, puberty and growth, and cognitive behaviouraland emotional assessment (RCPCH, 2013).The use of radiological assessment is extremely imprecise and can only give an estimate of within two years in either direction and the use of ionisingradiation for this purpose is inappropriate (RCPCH, 2007). The British Society for Paediatric Endocrinology and Diabetes are clear that it is not possible to accurately assess a child’s age based on physical examination or bone age assessment (Dr Tabitha Randell). It is therefore important for paediatricians, when contacted, to explain to social workers that dental x-rays, bone age and genital examination will currently not add any further information to the assessment process however this may change in future with new evidence. 

A paediatrician has to be honest with the social worker when contacted regarding age assessment, explaining that dental x-rays, bone age and genital examination will not add any further information to the assessment process based on the current evidence available.

Some age assessments carried out by the Home Office have been subject to dispute with some young people subsequently assessed to be minors (Crawley 2007).  Further information about age disputes is available from the Coram Children’s Legal Centre, 2013.

Children in detention

Children and young people may be placed in detention centres; the Refugee Council have produced an information briefing which includes statistics on the number of children entering detention. 

There are significant safeguarding issues for children housed in detention centres. If a professional becomes aware of a minor in a detention centre, social services should be notified as soon as possible.