AAP Voices Blog

One of the sorrows and realities of modern times is how readily almost anyone can bear witness to the global toll of suffering experienced by young children amid major world events. Modern news-gathering networks and social media make it altogether difficult to “just look away” — nor should we.

Just this week, I’ve seen images of a shockingly young child, perhaps 5 years old, walking across the Ukrainian border with Poland, clutching a bag containing his few belongings. While his parents may have sent him away to reach physical safety, far from the Russian assault on his country, he’s not completely safe. He was sobbing, seemingly alone, without comfort — and clearly psychologically traumatized.

This is not an isolated story. The United Nations has reported that over 2 million people have fled Ukraine in a mere 12 days, and about half a million of them are children. Children alone, seeking safety and security, is far too frequent an occurrence. In just the last few years, we’ve seen it in Syria and Yemen as war rages there, and we’ve also witnessed children left alone at the U.S. border with Mexico. For every unaccompanied child, there are parents who may be jailed, or unable to find their family, or are dead.

There is ample, solid evidence of the negative impact of young children being separated from their parents and other caregivers. Aside from rendering the practical aspects of child-rearing — providing food, shelter, clothing, and more — challenging, the very fact of separation is a direct and devastating blow to what is termed relational health, the health of the relationship between parent and child. It is abundantly clear that all children require safe, stable, and nurturing relationships in order to develop normally, let alone flourish and thrive.

“Toxic stress has significant, measurable impacts on the molecular, cellular, and behavioral levels, is difficult to treat well, and has lifelong, profound impacts.”

The recent armed conflicts in the world have a fallout that is not always discussed or taken into account — the fact that war, upheaval, and chaos impede, harm, and, in some cases, permanently destroy these all-important relationships for remarkably young children.
While older children also experience disruption — to their education, their mental health, and more — children under age 5 have limited developmental ability to understand what is happening or to comprehend the absence or remoteness of a familiar caregiver.
Moreover, young children have built only limited ability to use higher-level coping strategies for these extraordinary challenges, resulting in what we term toxic stress. Toxic stress has significant, measurable impacts on the molecular, cellular, and behavioral levels, is difficult to treat well, and has lifelong, profound impacts.

These phenomena know no bounds in time and space, and have affected children of all backgrounds, ethnicities, religions, continents, and languages, both now and in the past. We cannot ignore them, wherever and whenever they may occur.

We must recognize that young children can have these relationships fractured in a number of ways. They may be separated from their caregivers amid active warfare; they may be sent to physical safety while a parent remains to fight.

A caring adult may be jailed for exercising their right to free speech about a situation. A parent may be killed or psychologically traumatized in a manner that impedes their ability to show their love well. This list is not meant to be exhaustive, but to underscore how far-ranging the threat can be among so many populations, historically and currently, in all parts of the planet.

While I exhort the world’s adults to promptly develop solutions to bring lasting peace to all peoples and prevent societal-level toxic stress from repeatedly taking hold, I additionally urge those involved in response — short, medium, and long term — to bear in mind the psychosocial impacts on young children, no matter where they may be. All children deserve love and care by those who matter to them the most.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.