A holistic approach to age estimation in refugee children

Abstract

Aim: Many refugee children arriving in Australia have an inaccurately documented date of birth (DOB). A medical assessment of a child’s age is often requested when there is a concern that their documented DOB is incorrect. This study’s aim was to assess the accuracy a holistic age assessment tool (AAT) in estimating the age of refugee children newly settled in Australia. Methods: A holistic AAT that combines medical and non-medical approaches was used to estimate the ages of 60 refugee children with a known DOB. The tool used four components to assess age: an oral narrative, developmental assessment, anthropometric measures and pubertal assessment. Assessors were blinded to the true age of the child. Correlation coefficients for the actual and estimated age were calculated for the tool overall and individual components. Results: The correlation coefficient between the actual and estimated age from the AAT was very strong at 0.9802 (boys 0.9748, girls 0.9876). The oral narrative component of the tool performed best (R = 0.9603). Overall, 86.7% of age estimates were within 1 year of the true age. The range of differences was -1.43 to 3.92 years with a standard deviation of 0.77 years (9.24 months). Conclusions: The AAT is a holistic, simple and safe instrument that can be used to estimate age in refugee children with results comparable with radiological methods currently used.