Age determination in refugee children: A narrative history tool for use in holistic age assessment.

Aim: To present the rationale for using a narrative history tool as part of a holistic age assessment of accompanied refugee children with age uncertainty by exploring cultural narratives of age.

Methods: Seven small group, semi-structured interviews with 24 humanitarian entrants (10 male, 14 female) recruited from Afghan, Bhutanese and Burundian communities in Adelaide, Australia were conducted. Interviews were performed with interpreters present, audio-recorded, transcribed verbatim and thematically analysed.

Results: Four themes emerged: the significance of age; ways of remembering age; the refugee experience and its effect on age recall; and the reliability and permissibility of documentation. Age was significant, but understood and remembered differently with knowledge of an exact date of birth not required for functioning in participants' home societies. Information regarding age was embedded in narrative accounts, related to events and other people. Birth was not always registered, with birth and age-containing documentation obtained later in life. These documents often reflected cultural ideas regarding age, rather than recording true chronological age. The refugee experience profoundly affected the ability of people to remember their age by disrupting methods used to recall specific events, including birth.

Conclusion: Narrative history provides valuable information regarding age in accompanied refugee children with age uncertainty, and allows for age to be located within a range that approximates true chronological age when age documentation is absent or clearly erroneous. The Age Assessment Tool questionnaire provides health professionals with a framework for conducting age assessment interviews.