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A Question I Should Have Asked

November 15, 2022

In the novel "The Bone Clocks," author David Mitchell’s main character exclaims, "Being born's a hell of a lottery." Indeed. Children can be born into some very unfortunate situations. We know this, but do we really know this?

When asked if I would consider publishing a review article on caring for children of incarcerated parents, I could not recall whether Pediatrics in Review (PIR) ever covered this topic. Typing “Incarceration” into the PIR website search engine brings up mostly articles on hernias, but there are a few articles on incarcerated youth.  Current American Academy of Pediatrics President, Dr. Moira Szilagyi, mentions incarcerated parents in a 1998 PIR article on foster care.1 But there are no articles devoted to caring for a child or adolescent whose parent or parents are incarcerated. So, I agreed to review a submission on the subject and am glad I did.

In this month’s PIR issue, Drs Martoma, Kelleher, and Kemper mention the high numbers of children who have had a parent incarcerated and the ill-effects such incarcerations can have on these children. What strikes me most in their manuscript is this sentence: “While many children and caregivers conceal relationships with an incarcerated family member, surveillance questions may help identify children at risk for significant trauma.” Most children, adolescents, and parents prefer to hide any family history of incarceration. Most children, adolescents, and parents are reluctant to reveal any family history of incarceration if asked to do so. You have to be compassionate but purposeful to find such a history. You have to ask.

I never asked.

When I was in practice, I never asked.

I never even thought of asking.

It is reassuring to know that Drs Martoma, Kelleher, and Kemper encouragingly state that “many children of incarcerated parents are resilient and flourish despite profound adversity,” yet they point out some do not.

Before you read “Caring for Children of Incarcerated Parents,ask yourself how well you care for children who have a parent who is incarcerated. Chances are fair to good you are unaware, through no fault of your own, that some children in your practice have an incarcerated parent. Drs Martoma, Kelleher, and Kemper give wonderful tips for finding out if children have a parent that is incarcerated and offer resources for helping those children and adolescents develop resilience, while giving dignity to your patients and to your practice.

Check out that poster in the article (10.1542/pir.2021-005466) that enheartens children and adolescents who have an incarcerated parent.

Change the outcome for the better of many a child’s lottery.

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