This short article describes emerging research on the types of adverse childhood experiences (ACEs) that African-background refugee children experience and some common service gaps they encounter. It also outlines key considerations for services and practitioners in Australia who work with African-background refugee children and their families. The article is largely based on the author’s doctoral research (2024).

Introduction

Adverse childhood experiences (ACEs) are a significant social and public health concern due to their impacts on health, wellbeing and social functioning (Felitti et al., 1998; Larkin et al., 2014).

ACEs cover a broad range of traumatic events experienced before the age of 18, such as physical, sexual and emotional abuse, neglect, witnessing domestic violence, parental separation, substance misuse and mental illness within the household (Felitti et al., 1998). These experiences have been shown to elevate the risk of developmental delays, chronic diseases, mental health disorders such as depression, anxiety and PTSD, substance abuse and social challenges into adulthood (Burke et al., 2011; Herzog & Schmahl, 2018; Nelson et al., 2020).

Research consistently indicates that refugee-background children experience higher risks of ACEs when compared to the general population (Kasherwa et al., 2024; Wood et al., 2020). These children face unique challenges related to family experiences of armed conflict, persecution,¹ forced migration and resettlement, which can increase the risk of other ACEs such as abuse, neglect and family violence.

Recognising and addressing these ACEs early is critical for practitioners because early intervention can break the cycle of ACEs, reduce long-term social and economic costs and improve health outcomes for vulnerable children (Kasherwa, 2024; Zeanah et al., 2018).

However, research consistently indicates that refugee children and families affected by ACEs face unique barriers to accessing support services, including:

• personal factors such as fear, shame and mistrust
• cultural barriers such as stigma surrounding mental health challenges, differing understandings of trauma and limited availability of culturally responsive services
• structural challenges such as systemic discrimination, language barriers, lack of knowledge of existing services and service fragmentation (Kasherwa et al., 2024).

This article focuses on African-background refugee children due to their complex historical, social and migration-related experiences (e.g. Kasherwa, 2024; Kasherwa et al., 2025a). While the insights in this resource are specific to this group, some findings may also inform understandings of broader refugee experiences.

What adverse childhood experiences do African-background refugee children experience?

Refugee children, including those from African backgrounds, experience a unique, complex and cumulative set of ACEs that go beyond the standard definitions or assessments of childhood adversity. ACEs in this group are best understood as multiple, interconnected traumatic experiences identified in 3 distinct phases:

• Pre-migration trauma: Refugee-background children commonly face direct exposure to war, armed conflict, family separation, abduction, extreme violence, persecution and destruction of home environments prior to fleeing their countries of origin (Kasherwa, 2024).
• Migration-related adversity and trauma: As refugee-background children flee, searching for safer locations, they often face dangerous journeys (including travelling on unsafe boats/other transport), extended stays in refugee camps, immigration detention and deprivation of basic needs. They also commonly experience a heightened risk of child trafficking and sexual exploitation and a chronic risk of abuse and harm.
• Post-resettlement challenges: Upon arriving in Australia, refugee-background children often face racism, social exclusion, acculturation stress, intergenerational trauma, loss of social networks and systemic discrimination in schools, communities and health care settings, all adding to previous hardships and affecting their ongoing adjustment.

These adversities rarely exist in isolation; rather, they interact to deepen children’s vulnerability to multitype victimisation and psychological distress at rates far higher than those experienced by non-refugee peers or, even, other migrant groups (Kasherwa et al., 2025b). For practitioners, this means that assessment and case planning should routinely consider pre-migration, migration and post-resettlement factors.

What is unique about African-background refugee children is how this intersection of multi- phase forced migration trauma intersects with post-resettlement challenges such as racism and disproportionate criminalisation in Australia.

In particular, racialised assumptions that African-background young people are inherently 'violent' can intensify surveillance, school discipline, child protection responses and overrepresentation in the youth justice system. Such responses often overlook these African-background refugee children’s unique mix of ACEs, compounded by refugee trauma and resettlement challenges.

Children are affected not only by the ACEs they have experienced directly but also by parental stress from armed conflict, forced displacement and resettlement challenges. These often affect parenting capacity and family dynamics (Wood et al., 2020). This largely contributes to cyclical ACEs such as domestic violence, chronic poverty and intrafamilial child abuse, neglect and abandonment post-resettlement (Kasherwa et al., 2025a).

These ACEs are further exacerbated by the experience of racialisation and othering, bullying (including online bullying) and loss of pre-migration support networks among families (Kasherwa, 2024; Kasherwa et al., 2024).

How do African-background refugee families respond to ACEs?

African-background refugee families primarily respond to children's ACEs by drawing on support from extended family networks, community elders and church leaders, and through spiritual practices such as prayer and fasting. These culturally grounded approaches and supports are strongly preferred over formal services (Kasherwa, 2024). This preference stems from deep mistrust of public systems, rooted in fears of child removal and past experiences with corrupt authorities in countries of origin or transit.

There can also be clashes between Australian statutory expectations and origin-country parenting norms that emphasise addressing ACEs at the family level. In the absence of culturally responsive alternatives in the country of resettlement, parents often assume multiple roles as therapists, counsellors and spiritual guides for their children, reflecting both resilience and the profound limitations of available support (Kasherwa, 2024; 2026).

Forced migration and resettlement severely fracture support networks – separating families from overseas kin, disrupting church and community ties and leaving parents isolated and without traditional caregiving systems – which can force reluctant engagement with public services such as counselling, mental health support and child protection (Kasherwa, Fernandez et al., 2024). Siblings, who often share the same ACEs themselves, frequently step into critical support roles, providing emotional, psychological, social and, even, developmental support. However, this may risk the parentification² of siblings if it is not well supported by adult caregivers and professionals.

When families do access formal services, they commonly encounter cultural misunderstandings, inappropriate Western-centric assessment tools, language barriers and procedural intimidation that render these interventions unsatisfactory and reinforce withdrawal.

This cycle of initial reliance on informal networks, reluctant formal service use and dissatisfaction-driven retreat to stretched supports can result in delayed help seeking until the occurrence of crises within the family such as suicide attempts, or chronic child maltreatment (Kasherwa, 2026; Kasherwa et al., 2025a).

Some common gaps in service provision encountered by African-background children and families

Research suggests that mainstream services and practitioners often struggle to fully recognise the complex experiences of African-background children and how they are shaped by forced migration and resettlement challenges. These complexities can inadvertently create gaps in service provision, despite practitioners’ efforts to support families.

For example, in child protection and child welfare services, families can experience responses that feel more punitive than supportive, particularly when cultural misunderstandings and fear of child removal shape the interaction (Kasherwa et al., 2024). This unintentionally creates adversarial rather than collaborative relationships between parents and services.

For services in Australia to adequately understand the support needs of African-background children and their families, the research suggests they need to adopt holistic, trauma-informed and culturally responsive child and family intervention approaches. These should recognise children’s experiences across the entire migration journey, including pre-migration and transit, rather than focusing only on what becomes visible after arrival.

In particular, service design, assessment and support need to be informed by that history, with a greater emphasis on early intervention and on mitigating the impact of ACEs that began before resettlement (Kasherwa, 2024). Other general service gaps in child and family services (listed by Kasherwa, 2024) include:

• over-reliance on standardised child protection assessment tools
• one-size-fits-all case planning, often overlooking unique histories of forced migration and resettlement challenges
• lack of systematic monitoring and supervision tools to ensure practitioners consistently deliver trauma-informed care
• limited cultural responsiveness, with an overemphasis on western norms of child rearing
• language barriers and occasional reliance on family members (especially children) as interpreters instead of professional interpreters
• limited family participation and engagement in child-protection case planning
• a focus on immediate survival needs and limited focus on long-term goals.

More generally, the research suggests that services do not always consider the strengths, protective factors and positive childhood experiences that also exist among African-refugee background children and their families. Where this does happen, it can balance any tendency to focus on deficits and adverse childhood experiences.

Implications for policy and practice

To effectively address the complex and cumulative impacts of ACEs among refugee children, service systems need to be culturally responsive and trauma informed. This requires recognising both pre- and post-resettlement ACEs and the long-term effects of forced migration and systemic marginalisation. Some key considerations for improving support systems and outcomes for refugee families are listed below.

For practitioners and frontline workers

• Increase awareness and understanding of the unique ways in which ACEs affect refugee children (both pre- and post-resettlement) and the complex factors shaping their help-seeking behaviours and wellbeing.
• Prioritise collaborative approaches in child protection and child welfare: treat parents as primary supports and partners in identifying children’s needs, especially when they are non‑offending caregivers.
• Adapt ACE assessment tools to capture refugee experiences: incorporate items on forced migration, displacement, racialisation and structural harms that standard tools overlook (see Abdelhamid et al., 2024).
• Facilitate interprofessional and interagency collaboration to provide holistic support that integrates mental health, family support, education and resettlement needs within child protective services.
• Support community-led initiatives by enabling refugee-background people to co-design and deliver support services that reflect their cultural strengths and ways of knowing.

For policy makers and service managers 

• Implement system-wide requirements for culturally responsive, trauma-informed practice by ensuring that policies, standards, training, supervision and service frameworks explicitly address refugee children’s pre-migration, migration and post-resettlement experiences, not only their current experiences in Australia.
• Recognise and address the cumulative impact of ACEs compounded by forced migration, refugee trauma and racialisation in Australia.
• Develop funding and training systems that prioritise these adaptations within child protection/safety frameworks, health care, social services and education systems.

About the research this article is based on

This article primarily draws on the author's doctoral research (2024) exploring help seeking among African-background refugee families in New South Wales. This is an emerging field of research in Australia with little existing evidence. The author’s micro-ethnographic study used in-depth interviews, participant observation and focus groups with survivors of ACEs.

Further reading and resources

Refugee children, mental health and culturally responsive practice

What impacts refugee children's mental health? – Emerging Minds
This short article outlines the factors that impact refugee and asylum seeker children’s mental health and wellbeing.

Mental health: Refugee and asylum seeker children – Emerging Minds
This resource provides information about culturally informed ways to support the mental health of refugee and asylum seeker children.

Culturally responsive practice for children’s health and wellbeing
This series of 2 papers captures how using culturally responsive practice can support children’s mental health and wellbeing when working with families across different cultural backgrounds.

Practicing cultural curiosity when engaging with children and families – Emerging Minds
This paper provides an overview of some important considerations in relation to ‘culturally competent’, ‘culturally curious’ and child-focused practices when engaging with children and parents from refugee and migrant communities.

Key organisations for working with culturally and linguistically diverse families – Australian Institute of Family Studies
This resource sheet is a directory of key organisations and resources for practitioners and service providers working with families and children from culturally and linguistically diverse (CALD) backgrounds.

General information on trauma-informed practice

Trauma-informed practice in family mental health support services – Australian Institute of Family Studies
This practice guide summarises research and practice evidence about strategies for trauma-informed practice.

In focus: Trauma-informed care – Emerging Minds
This resource discusses the key elements of trauma-informed care.

Online trauma courses for practitioners – Emerging Minds
A learning pathway that contains courses and resources to help practitioners support children and families who have experienced trauma.

References

Abdelhamid, S., Kraaijenvanger, E., Fischer, J., & Steinisch, M. (2024). Assessing adverse childhood experiences in young refugees: A systematic review of available questionnaires. European Child & Adolescent Psychiatry, 33(12), 4043–4059.

Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 35, 408–413.

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V. et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258.

Herzog, J. I., & Schmahl, C. (2018). Adverse childhood experiences and the consequences on neurobiological, psychosocial, and somatic conditions across the lifespan. Frontiers in Psychiatry, 9, 420–428.

Kasherwa, A. (2024). Negotiating survival overseas: Exploring the help-seeking processes and support patterns of survivors of adverse childhood experiences from African communities with refugee backgrounds in New South Wales, Australia [Thesis]. UNSW Sydney. doi.org/10.26190/unsworks/30058

Kasherwa, A. (2026). Reimagining system responses to adverse childhood experiences in refugee-background children and young people. Centre for Asia Pacific Refugee Studies, University of Auckland.

Kasherwa, A., Fernandez, E., & Lenette, C. (2024). ‘This is not why we brought our children here!’: Tensions and challenges in responding to adverse childhood experiences in African-background refugee families. Child Abuse & Neglect, 158, 107101.

Kasherwa, A., Lenette, C., & Fernandez, E. (2025a). Adverse childhood experiences, social networks and help-seeking experiences of African-background refugee children: Towards a refugee children’s Network-Episode Model. Children and Youth Services Review, 170, 108146.

Kasherwa, A., Lenette, C., & Fernandez, E. (2025b). Breaking barriers or building walls? Strategies to overcome the barriers to help-seeking among adverse childhood experiences (ACEs) survivors from refugee backgrounds. In The Routledge handbook of child and family social work research (pp. 768–782). Routledge.

Larkin, H., Felitti, V. J., & Anda, R. F. (2014). Social work and adverse childhood experiences research: Implications for practice and health policy. Social Work in Public Health, 29(1), 1–16.

Nelson, C. A., Bhutta, Z. A., Burke Harris, N., Danese, A., & Samara, M. (2020). Adversity in childhood is linked to mental and physical health throughout life. BMJ, 1–9.

Wood, S., Ford, K., Hardcastle, K., Hopkins, J., Hughes, K., & Bellis, M. (2020). Adverse childhood experiences in child refugee and asylum-seeking populations. Public Health Wales NHS Trust.

Zeanah, P., Burstein, K., & Cartier, J. (2018). Addressing adverse childhood experiences: It’s all about relationships. Societies, 8(4), 4.

Ziersch, A., Miller, E., Baak, M., & Mwanri, L. (2020). Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: A qualitative study. BMC Public Health, 20(1), 1700.

¹In the context of ACEs, persecution refers to systematic mistreatment or oppression of individuals or groups based on their race, ethnicity, religion, political beliefs or other identity factors. This can include threats, harassment, violence, discrimination and deprivation of rights or freedoms, often leading to fear, trauma and social exclusion.

²Parentification refers to situations in which a child is forced to take on adult caregiving roles and responsibilities in the family, in ways that are developmentally inappropriate.