Pediatrics
June 2016, VOLUME 137 / ISSUE 6
http://pediatrics.aappublications.org/content/137/6?current-issue=y

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Review Articles
Learning Problems in Children of Refugee Background: A Systematic Review
Hamish R. Graham, Ripudaman S. Minhas, Georgia Paxton
Pediatrics Jun 2016, 137 (6) e20153994; DOI: 10.1542/peds.2015-3994
Abstract
CONTEXT: Learning problems are common, affecting up to 1 in 10 children. Refugee children may have cumulative risk for educational disadvantage, but there is limited information on learning in this population.
OBJECTIVE: To review the evidence on educational outcomes and learning problems in refugee children and to describe their major risk and resource factors.
DATA SOURCES: Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Education Resources Information Center.
STUDY SELECTION: English-language articles addressing the prevalence and determinants of learning problems in refugee children.
DATA EXTRACTION: Data were extracted and analyzed according to Arksey and O’Malley’s descriptive analytical method for scoping studies.
RESULTS: Thirty-four studies were included. Refugee youth had similar secondary school outcomes to their native-born peers; there were no data on preschool or primary school outcomes. There were limited prevalence data on learning problems, with single studies informing most estimates and no studies examining specific language disorders or autism spectrum disorders. Major risk factors for learning problems included parental misunderstandings about educational styles and expectations, teacher stereotyping and low expectations, bullying and racial discrimination, premigration and postmigration trauma, and forced detention. Major resource factors for success included high academic and life ambition, “gift-and-sacrifice” motivational narratives, parental involvement in education, family cohesion and supportive home environment, accurate educational assessment and grade placement, teacher understanding of linguistic and cultural heritage, culturally appropriate school transition, supportive peer relationships, and successful acculturation.
LIMITATIONS: Studies are not generalizable to other cohorts.
CONCLUSIONS: This review provides a summary of published prevalence estimates for learning problems in resettled refugee children, highlights key risk and resource factors, and identifies gaps in research.
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State-of-the-art Review Articles
Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach
Tina L. Cheng, Sara B. Johnson, Elizabeth Goodman
Pediatrics Jun 2016, 137 (6) e20152467; DOI: 10.1542/peds.2015-2467
Abstract
Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.