Age assessment practices: a literature review & annotated ... - Unicef

acquired two or three years later. The process involves the acquisition of these stages in a
carefully defined order. However, the timing of the onset of puberty is extremely variable.
Girls may have the first signs at about the age of 8 or 9 years and boys at about 9 or 10
years. It is also the case that puberty can be delayed and the first signs may take place at
14 or 15 years in boys. The situation is complicated further by nutritional status and illness
which can further exacerbate the problem of pubertal delay so that a person may actually be
older than they appear from pubertal development. There are also ethnic differences in the
onset of puberty. For example, in the Indian subcontinent it is common for puberty to begin
slightly earlier so that, for example, a boy with extensive facial and body hair may appear to
be older than he actually is, according to Caucasian developmental norms (The King‟s Fund
and the Royal College of Paediatrics and Child Health, 1999:13).
The Royal College of Paediatrics and Child Health concludes that „overall, it is not possible
to actually predict the age of an individual from any anthropometric measure, and this
should not be attempted‟ (The King‟s Fund and the Royal College of Paediatrics and Child
Health, 1999:40).
4.2.1. Physical age assessments in practice
In practice, anthropometric or physical assessments are usually carried out by
paediatricians, who, in addition, may also carry out dental and bone examinations and social
and psychological assessments, depending on the experiences, skills and interests of the
individual paediatrician. However, there is also evidence of more „informal‟ physical
assessments being carried out by a range of different professionals and practitioners in
some countries which have little to do with anthropometric measurements and do not
consider the expertise of a medical practitioner to be necessary. These „assessments‟ are
often based on quick visual appraisals during the interview process for asylum seeking
children, as in the case in Germany, Austria and Greece (European Migration Network,
2010; Crawley, 2007). This raises particular ethical concerns in addition to concerns about
the reliability of such assessments.
In the UK there has been considerable debate about the weighting given to the relative
assessments of paediatricians compared to social workers. For example, at the beginning
of the decade the Immigration Appellate Authority and the High Court gave great weight to
medical reports, and if there was a difference between a local authority social worker and a
consultant paediatrician, they referred to the evidence of the latter. In the case of The
Queen on the Application of I & Another v. Secretary of State for the home Department 6 Mr
Justice Owen found that the report of an experienced consultant paediatrician derived
further authority from his extensive specialist expertise and that unlike social workers, he
was qualified to undertake dental examinations, giving an estimate age accurate to within
=+/- two years (Bhabha & Finch, 2006:62).
6 ([2004] EWHC 2297 (Admin)),
21