Age Determination Practices for Unaccompanied Alien Children in ...

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marking the date an age determination was made, the result, andthe information used to reach a decision. This is a commendablebest practice by some field personnel that ICE should consideradopting on a more widespread basis.RecommendationWe recommend that the Assistant Secretary for U.S. Immigrationsand Customs Enforcement:Recommendation #2: Update and release guidance that clarifieshow DRO field offices are to conduct age determinationsfollowing the TVPRA based on HHS’ guidance. ICE’s fieldguidance should be consistent with HHS’ procedures, addresschallenges, identify best practices for establishing age, and includerequirements for documenting the age determination process.Radiographic Exam Results Need to Be Properly DocumentedICE officers rely on the medical professionals who conductradiographic exams to interpret exam results. ICE requires medicalprofessionals who conduct radiographic exams to complete andreturn a two-page worksheet. The worksheet includes entries forinformation such as (1) whether the examined individual is 18 yearsor older; (2) the medical professional’s degree of certainty regardingthe age determination, which should be in the form of a percentage;(3) an explanation of the medical professional’s conclusion; and(4) the research and materials that formed the basis for theirconclusion. It requires a practitioner to indicate whether he or she isa physician, dentist, or forensic anthropologist. ICE also permitspractitioners to generate their own report.ICE uses these worksheets and reports to help make and documentits age and custody determinations. Therefore, it is important thatworksheets (1) not oversimplify or overstate the results of aradiographic exam, (2) are based on up-to-date scientific research,and (3) identify underlying reference materials and any limitationsof the materials or methods used. Age estimation reports thatconsistently provide ICE with such information can help ICEofficers weigh the results of a radiographic exam alongsideadditional evidence.The quality and extent of documentation ICE receives onradiographic exam results varies. Most radiographic reports thatwe reviewed included a combination of data such as an averageAge Determination Practices for Unaccompanied Alien Children in ICE CustodyPage 17
age for individuals with equivalent tooth development as thesubject, an age range or standard deviation, and a percentageprobability on whether the individual had attained his or her 18thbirthday. Specific medical professionals who provided multiplereports to ICE reported results in a consistent format; however, theproviders differed among themselves on the types of data providedto ICE, and the presentation format. Some used ICE’s worksheetwhile others did not. Some providers furnished an age range whileothers included the average age of individuals with equivalentdevelopment and the probability that the individual had attained 18years of age. In several cases, the provider furnished minimalinformation other than the estimated age and the degree ofcertainty in that conclusion.Radiographic exam reports prepared by medical professionals alsodo not always include full reference information regarding thespecific studies used as a basis for their age determination, whichis a requirement in ICE’s 2004 guidance. In our sample of A-files,professionals who provided information cited three separatesources, but provided a full citation from only one case. In anotherinstance, one dentist consistently cited a study based on whitemales and females, even though subjects of the age determinationsappeared to be Hispanic.ICE needs to ensure the quality of its radiographic exam results byobtaining the citations for studies that physicians used to determineage. By receiving more complete information on the type of studyused to make an age estimation, the underlying scientific data andmethods that support its age determination can be based on morecurrent research and reflect the appropriate ethnicity of theindividual.ICE Needs to Prioritize Use of Providers with SpecializedExperienceICE’s approach for selecting physicians to conduct radiographicexams for age determinations is inconsistent. ICE’s 2004 guidancerequires field offices to consult with Public Health Service (PHS)staff when selecting a medical professional to conduct aradiographic exam. In practice, most juvenile coordinators wespoke to said that they schedule appointments for dental radiographswith the same dentists used by their predecessors. Field officejuvenile coordinators did not know how professionals were initiallyselected and were unaware of any list of practices that ICE or PHShad released to the field. Some juvenile coordinators added that ifthey needed a dental radiograph, they chose providers based theirAge Determination Practices for Unaccompanied Alien Children in ICE CustodyPage 18
Page 3: Table of Contents/AbbreviationsExec
Page 8: Figure 1. Age Determinations in DHS
Page 12 and 13: process and indicated that notice o
Page 14 and 15: According to ICE’s guidance, sour
Page 16 and 17: do not use radiographic exams, othe
Page 18 and 19: In response to the TVPRA, HHS relea
Page 22 and 23: proximity to the office. Other coor
Page 24 and 25: that reflects age determination pro
Page 26 and 27: Appendix BManagement Comments to th
Page 28 and 29: Appendix CMajor Contributors to Thi
Page 30: ADDITIONAL INFORMATION AND COPIESTo

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