By Suman Kasturia

There are many voices dominating the conversation on immigration that we, living in the US, hear through news media on a daily basis. One year ago, we heard a recording of children crying just after being forcibly separated from their families at the border—painful, and striking, it called our collective attention to the voices we rarely hear.

With support from a generous donor, Stanford and the University of Texas at Rio Grande Valley (UTRGV) were given the opportunity to support the work of immigration attorneys who visit with and hear directly from these children.

“The goal of this project is to provide attorneys who will be interviewing detained children with the special requirements of speaking with children who have experienced significant trauma,” says Paul Wise, MD at Stanford.

Under the 1997 Flores Settlement Agreement, named after 15-year-old Jenny Flores from El Salvador, the US government is required to uphold minimal standards for the detention, care and release of immigrant children in US custody. A small group of expert lawyers, bolstered by volunteer attorneys, is tasked with interviewing detained children to ensure their safety, documenting the conditions of their detention, and advocating for their immediate needs.

To meet demands caused by an increasing number of children in custody, the Flores team of attorneys rely on volunteer immigration attorneys to assist them in site visits. On short notice, volunteers join in the grueling visits to facilities—some centers hold hundreds of children—where they screen and interview children in the limited time allotted. The children they meet, ranging from infants to adolescents, are frequently in poor health, some having endured multiple traumatic events, culminating in separation from caregivers and prolonged detention. Volunteers, while trained in law, frequently have little background in how to conduct trauma-informed interviews and are in need of training specifically for working with this vulnerable population of children.

The service these lawyers provide is invaluable. Many of these children have been found to require urgent medical or psychological care; many facilities, such as the Ursula facility in McAllen, TX, and the facility in Clint, TX, have been found in violation of even the most basic provisions of the Flores Settlement Agreement.

“There are hundreds of immigration attorneys working with detained child immigrants across the country, but also children who have been released to their families and continue to fight their asylum cases,” says Dr. Marsha Griffin. “Almost all of the attorneys state that they had little to no training in working with children, much less trauma-informed interviewing of children.”

Digital MEdIC’s role

Digital MEdIC, an initiative from the Stanford Center for Health Education, is committed to improving health worldwide through knowledge. Engaging in this effort was of particular importance to our mission: we saw the opportunity to leverage our expertise in online education, combined with Stanford’s psychiatric resources, to fill a very clear education gap for attorneys, which could potentially lead to better physical and mental health for these children.

We began with facilitating conversations between frontline attorneys, pediatricians and Stanford experts in childhood trauma to determine high-priority best practices for these interviews. Concurrently, we employed human-centered design practices to pinpoint knowledge gaps and identify fitting instructional design methods. We created and evaluated draft materials through focus groups and surveys with attorneys, in consultation with childhood trauma experts. Based on our findings, we are developing a condensed curriculum of high-priority advice from experts, brought to life through filmed interview footage, soundtrack & illustrations. This compact and engaging video series will be disseminated early this fall to pro bono child immigration legal teams and will be available to other professional organizations providing services to this highly vulnerable population.

Child advocates at Stanford and in the field

In developing this series, we took a glimpse into the world of the amazing, dedicated people who have, for years, centered their lives on advocating and caring for immigrant populations at the US-Mexican border. We met with Marsha Griffin, a professor of pediatrics at UTRGV and the director of Community for Children. Marsha’s insights into how to compassionately build relationships with children come from years of caring for recently immigrated families at the border.

Dr. Griffin shares insights on how to compassionately build relationships with children.

We also heard from Jodi Goodwin, an attorney featured on an episode of This American Life & an Atlantic documentary, who shared real-world advice on developing the trust required to connect with children and families who’ve undergone layers of traumatic experiences.

Jodi Goodwin, immigration attorney, shares advice on developing trust with children and families who’ve undergone trauma.

Hope Frye, who has championed this work for decades as one of the original counsel on the Flores case, and a number of attorneys including Warren Binford, Virginia Corrigan, Christine Brigagliano, Ines Vargas Fraenkel, and Shay Fluharty have been instrumental in evaluating materials and guiding us towards the right focus.

Finally, we have relied on the guidance of our Stanford faculty, several of whom have traveled to border towns to take part in this effort: Paul Wise MD, MPH, Professor of Pediatrics and, Ryan Matlow, Clinical Assistant Professor of Psychiatry and Behavioral Sciences, Nancy Ewen Wang, MD, Professor of Emergency Medicine and Pediatrics, Victor Carrion, MD, Professor of Child and Adolescent Psychiatry, and Fernando Mendoza, MD, MPH, Professor of Pediatrics.

It’s easy to feel like there’s not much we, as lay people, can do to mitigate a large-scale human rights crisis, even when it’s so close to home: we can donate, we can support, we can speak about these issues, but we are often left feeling powerless. In this situation, we at Digital MEdIC have been grateful to be able to play a small part in supporting these frontline humanitarian attorneys.

Illustration from Digital MEdIC’s new educational video series.