Department of Homeland Security

Office of Inspector General 

Age Determination Practices for 
 

Unaccompanied Alien Children 
 

- Update 
 

OIG-10-122 September 2010 
Office of Inspector General 

U.S. Department of Homeland Security 

Washington, DC 20528 

 September 27, 2010 

MEMORANDUM FOR: John T. Morton

Assistant Secretary

Immigration and Customs Enforcement

FROM: Richard L. Skinner 

Inspector General 

SUBJECT: Age Determination Practices for Unaccompanied Alien 

Children – Update

Attached for your information is our final letter report, Age Determination Practices for 

Unaccompanied Alien Children – Update. We incorporated ICE’s formal comments in 

the report.

Consistent with our responsibility under the Inspector General Act, as amended, we are 

providing copies of our report to appropriate congressional committees with oversight 

and appropriation responsibility over the Department of Homeland Security. We will 

post the report on our website for public dissemination. 

Should you have any questions, please call me, or your staff may contact Carlton I. 

Mann, at (202) 254-4205. 

Attachment 

September 29, 2010
Background 

Within the Department of Homeland Security (DHS), Immigration and Customs 

Enforcement (ICE) is responsible for apprehending, detaining, and deporting individuals 

who are not authorized to remain in the United States. Children who enter ICE custody 

require different treatment than adult detainees. ICE must ensure that they are not 

detained with unrelated adults and that they receive specified treatment and provisions 

while in custody. Unaccompanied alien children-individuals determined to be less than 

18 years of age who are unlawfully in the United States without a parent or other legal 

guardian-must be transferred to the Department of Health and Human Services (HHS), 

Office of Refugee Resettlement's (ORR) custody within 72 hours of determining such 

children are unaccompanied, to await deportation or transfer to a legal guardian in the 

United States. 1 

To separate unaccompanied children from adult's in ICE custody, ICE attempts to 

establish the date of birth for any apprehended person not readily identifiable as an adult 

or child. In those instances, ICE relies on various forms of information for age 

determination purposes, including interview statements and documentation such as birth 

certificates. When ICE officials have difficulty determining whether an individual is a 

child or an adult, they may also obtain a professional medical opinion based on dental or 

skeletal radiographs, commonly referred to as x-rays, to help make an age determination. 

ICE's use ofradiographs, however, has been criticized as unreliable by some in the 

medical and advocacy communities. 

Results of Review 

Use of Radiographs for Age Determinations Needs To Be Better Tracked 

To obtain a radiograph-based age estimation for a potential juvenile in custody, ICE uses 

medical or dental services outside of its network of detention facilities. ICE field 

personnel submit a Treatment Authorization Request (TAR) to ICE's Division of 

Immigration Health Services (DIHS) in Washington, DC. DIHS managed care 

coordinators generally review and approve the request within 24 hours. A TAR can also 

be submitted and approved retroactively when needed to allow ICE to make an 

immediate decision on an individual's age and, subsequently, the appropriate detention 

setting. 

From January to April 2010, ICE reported 43 requests for age determination radiographs, 

of which 2 were canceled. While DIHS can account for the number of TARs submitted 

for radiographs, ICE does not record the number oftiines that a radiograph was actually 

used in its age determination, and the resulting custody decision. ICE also does not track 

1 Homeland Security Act of2002 (Public Law 107-296), November 25,2002. See also, The William 

Wilberforce Trafficking Victims Protection Reauthorization Act of2008 (Public Law 110-457) December 

23,2008. 

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when the age determination and placement of an alien is reversed. Tracking such 

information could improve ICE's ability to evaluate age determination practices, 

including reversed age determinations and custody decisions involving radiographs, 

calculate the error rate of such decisions, and adjust policies accordingly. Such 

information could also help generate cost data on exams conducted each fiscal year and 

guide future decisions concerning the medical service providers ICE uses for age 

determinations. 

In our initial report, we recommended that the Assistant Secretary for ICEContinue to enhance the Juvenile and Family Residential Management Unit's 

(JFRMU) ability to collect and analyze data on the use ofradiographs for age 

determinations. At a minimum, enhancements should provide JFRMU with the 

ability to track (1) the number ofradiographs taken for age determinations, (2) 

date the results of the exam, and (3) age determinations and placement decisions 

that were later reversed. 

ICE concurred with our recommendation. In its August 2010 Mission Action Plan 

(MAP) update, ICE indicated that multiple updates to the Enforcement Case Tracking 

System will be made by November 2010. 

Guidance for Age Determinations Needs To Be Updated 

ICE guidance on making age determination and custody decisions was issued in 2004. 

The guidance lists a range of factors that may be considered, addresses the limits of 

radiographs in a comprehensive manner, and cautions officers not to make decisions 

based solely on radiographs. 

The William Wilberforce Trafficking Victims Protection Reauthorization Act of2008 

(TVPRA) includes language that charges the Secretary ofHHS, in consultation with the 

Secretary ofDHS, with developing age determination procedures. According to the law, 

DHS is required to follow those procedures. While the TVPRA does not set forth 

particular guidelines for making age determinations, it does allow the "nonexclusive use 

ofradiographs.,,2 HHS ORR, which oversees the placement of unaccompanied alien 

children, released program instruction on age determinations in March 2009; the acting 

director ofHHS ORR signed this guidance on September 15, 2009. 

In our initial report, we recommended that the Assistant Secretary for ICEUpdate and release guidance that clarifies how the Office of Detention and 

Removal Operations, recently renamed Enforcement and Removal Operations, 

field officers are to conduct age determinations following the TVPRA based on 

HHS' guidance. ICE field guidance should be consistent with HHS' procedures, 

2 The William Wilberforce Trafficking Victims Protection Reauthorization Act of2008 (Public Law 110­

457) December 23,2008. 

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address challenges, identify best practices for establishing age, and include 

requirements for documenting the age determination process. 

ICE concurred with our recommendation to update field guidance on age determinations 

and related custody decisions, but has not issued an updated version in response to HHS' 

signed program instruction. Before our initial report's publication, ICE indicated that it 

is waiting for HHS to release a final policy on age determinations, and did not 

acknowledge HHS' program instruction as final. Also, ICE has drafted guidance that 

generally mirrors the HHS/ORR guidance. ICE's guidance is under review. 

ICE Field Staff Would Benefit by Distributing a "Best-Qualified" Providers List 

While we did not question the actual age estimations ofmedical or dental professionals in 

our original report, we noted inconsistencies in how exam results were reported to ICE. 

Supporting data and studies cited by those providers varied in their depth and 

applicability to the different ethnicities ofthe individuals receiving the exam. Moreover, 

during our initial review, ICE officers were not always certain ofthe type ofmedical or 

dental professional who should be consulted when an individual's age is in question. 

Certifications and other credentials beyond standard medical or dental degrees can help 

ICE identify medical or dental providers who are most knowledgeable about making age 

estimations, as well as the limitations ofthis practice. 

In our initial report, we recommended that the Assistant Secretary for ICERelease guidance on the selection of "best-qualified" practitioners to conduct 

radiographic exams and report results when practical. 

ICE concurred with the recommendation, and indicated that it would work with DIHS to 

develop such guidance. The August 2010 MAP indicates that ICE has developed draft 

guidance, which is under review by DIHS. ICE expects to release a final version by 

December 31,2010. 

Management Comments and OIG Analysis 

We obtained written comments on a draft ofthe report from the ICE Acting Deputy Chief 

Financial Officer. We have included a copy ofthe comments in Appendix B. The 

Acting Deputy Chief Financial Officer reiterated ICE's commitment to close our initial 

report's recommendations by the dates identified in its MAP. 

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Appendix A 

Purpose, Scope, and Methodology 

We conducted this review at the request ofthe House Appropriations Committee and 

House Report 111-157 to review ICE practices for detennining the age of those in its 

custody and report any cases where ICE used bone or dental forensic examinations. We 

interviewed and held discussions with ICE and HHS officials, reviewed relevant 

documents, and analyzed ICE's MAP. We conducted our fieldwork from April to June 

2010. 

This review was conducted under the authority of the Inspector General Act of1978, as 

amended, and according to the Quality Standards for Inspections issued by the Council of 

the Inspectors General on Integrity and Efficiency. 

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Appendix C 

Major Contributors to this Report 

Deborah Outten-Mills, Chief I!!spector 

Andrew Schmidt, Senior Inspector 

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Appendix D 

Report Distribution 

Department of Homeland Security 

Secretary 

Deputy Secretary 

Chief of Staff of Policy 

Deputy Chief of Staff 

General Counsel 

Executive Secretariat 

Director, GAO/OIG Liaison Office 

Assistant Secretary for Office of Policy 

Assistant Secretary for Office of Public Affairs 

Assistant Secretary for Office of Legislative Affairs 

DHS Component Liaison 

Office of Management and Budget 

Chief, Homeland Security Branch 

DHS OIG Budget Examiner 

Congress 

Congressional Oversight and Appropriations Committees, as 

appropriate 

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ADDITIONAL INFORMATION AND COPIES 

To obtain additional copies of this report, please call the Office of Inspector General (OIG) at (202) 254-4100, 

fax your request to (202) 254-4305, or visit the OIG web site at www.dhs.gov/oig. 

OIG HOTLINE 

To report alleged fraud, waste, abuse or mismanagement, or any other kind of criminal or noncriminal 

misconduct relative to department programs or operations: 

• Call our Hotline at 1-800-323-8603; 

• Fax the complaint directly to us at (202) 254-4292; 

• Email us at DHSOIGHOTLINE@dhs.gov; or 

• Write to us at: 

DHS Office of Inspector General/MAIL STOP 2600, 

Attention: Office of Investigations - Hotline, 

245 Murray Drive, SW, Building 410, 

Washington, DC 20528. 

The OIG seeks to protect the identity of each writer and caller.