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Beschreibung

This book summarizes and explains the main approaches to age estimation in the living, defining when a parameter may be of use and raising awareness of its limitations. This text ensures that practitioners recognize when an assessment is beyond their area of expertise or beyond verification depending upon the clinical data available. Each key approach to age evaluation has been allotted a single chapter, written by an international leader in the particular field. The book also includes summary chapters that relay readily accessible data for use by the practitioner, and includes important "ageing milestones."

This book is indispensable where problems of immigration and legal standing, juvenile vs. adult criminal status, and responsibilities of law enforcement to protect vulnerable persons are key issues on a daily basis.  Medical practitioners, forensic practitioners such as pathology, odontology, anthropology and nursing, lawyers, and police would find this book incredibly useful.

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Contents

Foreword

Preface

Glossary of Abbreviations

1 AN INTRODUCTION TO THE HISTORY OF AGE ESTIMATION IN THE LIVING

ANDREAS SCHMELING AND SUE BLACK

1.1 INTRODUCTION

1.2 DENTAL DEVELOPMENT

1.3 SKELETAL MATURATION

1.4 SECONDARY SEXUAL DEVELOPMENT

1.5 CONCLUSION

REFERENCES

2 IMMIGRATION, ASYLUM SEEKERS AND UNDOCUMENTED IDENTITY

HEATHER LAW, LORRAINE MENSAH, SUE BAILEY AND JULIA NELKI

2.1 ASYLUM SEEKER TO REFUGEE

REFERENCES

3 CLINICAL AND LEGAL REQUIREMENTS FOR AGE DETERMINATION IN THE LIVING

PHILIP BEH AND JASON PAYNE-JAMES

3.1 INTRODUCTION

3.2 CONTRASTS BETWEEN AGE ASSESSMENT IN THE LIVING AND THE DECEASED

3.3 REASONS FOR AGE ESTIMATION OF BODIES AND HUMAN REMAINS

3.4 REASONS FOR AGE ESTIMATION OF LIVING INDIVIDUALS

3.5 ASSESSMENT TECHNIQUES

3.6 HOW AGE MAY BE SPECIFICALLY DOCUMENTED

3.7 BIRTH CERTIFICATES

3.8 IDENTITY CARDS

3.9 DRIVING LICENCE

3.10 PASSPORTS

3.11 AGE VERIFICATION CARDS

3.12 OTHER DOCUMENTS

3.13 MEDICAL ISSUES

3.14 COMMUNICATION

3.15 SUMMARY AND CONCLUSIONS

REFERENCES

4 LEGAL IMPLICATIONS OF AGE DETERMINATION: CONSENT AND OTHER ISSUES

GEORGE FERNIE AND JASON PAYNE-JAMES

4.1 INTRODUCTION

4.2 PRINCIPLES OF PRACTICE

4.3 DUTIES OF THE EXAMINING PRACTITIONER

4.4 CRIMINAL ISSUES IN AGE DETERMINATION IN THE LIVING

4.5 PRACTICAL IMPLICATIONS

4.6 SUMMARY

REFERENCES

5 THE CHALLENGES OF PSYCHOLOGICAL ASSESSMENTS OF MATURITY

JULIA NELKI, PETE GRADY, SUE BAILEY AND HEATHER LAW

5.1 INTRODUCTION

5.2 NEED FOR DETERMINATION OF MATURITY

5.3 PSYCHOLOGICAL MATURITY AS A CONCEPT

5.4 CURRENT PRACTICE

5.5 SUGGESTIONS FOR A FRAMEWORK FOR GOOD PRACTICE

5.6 SUMMARY AND CONCLUSION

APPENDIX 5.A PROPOSED FRAMEWORK, BASED ON COMMON ASSESSMENT FRAMEWORK (DEPARTMENT OF SCHOOLS FAMILIES AND CHILDREN, 2007)

REFERENCES

6 PRINCIPLES OF PHYSICAL AGE ESTIMATION

SUE BLACK AND GEORGE MAAT

6.1 INTRA-UTERINE GROWTH AND DEVELOPMENT

6.2 BIRTH AND INFANCY

6.3 CHILDHOOD

6.4 JUVENILE

6.5 ADOLESCENCE

6.6 ADULT

6.7 SENESCENCE

6.8 SUMMARY

6.9 GROWTH STUDIES

REFERENCES

7 GROWTH, MATURATION AND AGE

NOËL CAMERON AND LAURA L. JONES

7.1 GROWTH, MATURATION AND AGE

7.2 ASSESSMENT OF MATURATION

7.3 SECULAR TRENDS

7.4 WORLDWIDE VARIATION IN THE TIMING OF MATURATION

7.5 FACTORS ASSOCIATED WITH THE TIMING OF MATURATION

7.6 SUMMARY

REFERENCES

8 PRACTICAL IMAGING TECHNIQUES FOR AGE EVALUATION

ANDREAS SCHMELING, SVEN SCHMIDT, RONALD SCHULZ, ANDREAS OLZE, WALTER REISINGER AND VOLKER VIETH

8.1 INTRODUCTION

8.2 RADIATION EXPOSURE IN X-RAY EXAMINATIONS FOR THE PURPOSE OF AGE ESTIMATION

8.3 RADIOLOGICAL EXAMINATION OF THE HAND

8.4 RADIOLOGICAL EXAMINATION OF THE TEETH

8.5 RADIOLOGICAL EXAMINATION OF THE CLAVICLES

8.6 SUMMARY AND CONCLUSIONS

REFERENCES

9 EXTERNAL SOFT TISSUE INDICATORS OF AGE FROM BIRTH TO ADULTHOOD

ANIL AGGRAWAL, PUNEET SETIA, AVNEESH GUPTA, AND ANTHONY BUSUTTIL

9.1 GROWTH PATTERNS

9.2 ANTHROPOMETRIC PARAMETERS IN CHILDREN

9.3 PUBERTAL CHANGES

9.4 AREAS OF NEW RESEARCH

REFERENCES

10 AGE EVALUATION AND ODONTOLOGY IN THE LIVING

JANE TAYLOR AND MATTHEW BLENKIN

10.1 INTRODUCTION

10.2 OVERVIEW OF THE DEVELOPMENT OF THE DENTITION

10.3 TECHNIQUES OF DENTAL AGE ESTIMATION

10.4 THE SUB-ADULT DENTITION

10.5 THE ADULT DENTITION

10.6 SUMMARY

REFERENCES

11 AGE EVALUATION FROM THE SKELETON

S. LUCINA HACKMAN, ALANAH BUCK AND S. BLACK

11.1 BACKGROUND

11.2 FETAL AGE

11.3 BIRTH

11.4 JUVENILE/CHILD

11.5 AGE ESTIMATION FROM THE SKELETON IN LIVING ADULTS

11.6 MEDIAL CLAVICLE

11.7 STERNAL RIBS AND COSTAL CARTILAGES

11.8 PELVIS

11.9 SKULL SUTURAL CLOSURE

11.10 LARYNGEAL CARTILAGES

11.11 OTHER GENERAL AGEING FEATURES

11.12 SUMMARY

REFERENCES

12 AGE EVALUATION AFTER GROWTH CESSATION

ANIL AGGRAWAL, PUNEET SETIA, AVNEESH GUPTA AND ANTHONY BUSUTTIL

12.1 BACKGROUND

12.2 CONSENT

12.3 RADIOLOGY

12.4 ODONTOLOGY

12.5 SOFT TISSUES OF FACE

12.6 GENETICS IN AGE ESTIMATION

12.7 PHYSIOLOGICAL AND BIOCHEMICAL PARAMETERS FOR AGE ESTIMATION

12.8 AREAS OF FUTURE RESEARCH

12.9 CONCLUSION

REFERENCES

13 THE PRESENTATION OF RESULTS AND STATISTICS FOR LEGAL PURPOSES

DAVID LUCY

13.1 INTRODUCTION

13.2 EVIDENCE AND INTELLIGENCE

13.3 STATISTICAL METHODS IN AGE ESTIMATION

13.4 CLASSICAL, OR FREQUENTIST, APPROACHES

13.5 BAYESIAN APPROACHES

13.6 THE RELEVANCE TO AGE ESTIMATION

13.7 LIKELIHOOD RATIO APPROACHES

13.8 ERRORS OF INTERPRETATION

13.9 CONCLUDING COMMENTS

APPENDIX 13.A AGE-RELATED DATA FROM GUSTAFSON (1950)

REFERENCES

14 KEY PRACTICAL ELEMENTS FOR AGE ESTIMATION IN THE LIVING

SUE BLACK, JASON PAYNE-JAMES AND ANIL AGGRAWAL

14.1 THE FOUR PILLARS OF AGE ESTIMATION

14.2 CONCLUSION

Index

This edition first published 2010, © 2010 by COPYRIGHT HOLDER

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Library of Congress Cataloging-in-Publication DataBlack, Sue M.

Age estimation in the living: the practitioners guide/Sue Black, Anil Aggrawal and Jason Payne-James.p. cm.Includes index.ISBN 978-0-470-51967-7 (cloth)1. Physical anthropology. 2. Anthropometry. 3. Human growth. 4. Human body–Composition–Age factors. 5. Forensic anthropology. 6. Dental anthropology. I. Aggrawal, Anil. II. Payne-James, Jason. III. Title.GN51.B555 2011599.9–dc222010024536ISBN: 978-0-470-51967-7

A catalogue record for this book is available from the British Library.

Set in 10/12 Sabon by Aptara Inc., New Delhi, India.

Professor Anil Aggrawal wishes to dedicate this text to – my son Tarun, nephew Nitin and niece Khushboo for believing in me.

Foreword

Most people in the developed world, if asked, would be able to say how old they are. This would be hearsay information, of course, as none of us can speak to this from our own knowledge. We have to depend on others to tell us when we were born. But family tradition, supported by information carefully recorded in the appropriate public register, enables us to fill this gap and, when this is needed, to satisfy the relevant authorities.

But there are a surprisingly large number of situations where people are either unable to tell the authorities when they were born or wish to persuade them that they are older or younger than they in fact are. For much of ordinary day-to-day living this does not matter. But time and time again the complex legal systems in which we live require this information to be given and require that the information provided is accurate. Age is a significant factor as to the way people are treated by the criminal law, by the social services and by asylum and immigration law, to take just some examples. Many asylum seekers arrive in this country without documentary evidence of their age and identity. An increasing number of them are claiming to be under the age of 18. No doubt this is because they have been advised to seek the special treatment, including the provision of accommodation by a local authority, that our legal system gives to persons under that age. Local authorities are under a statutory duty to provide accommodation for any child in need within their area. The statute says that a child for this purpose means a person under the age of 18.

As this book shows however, there is a significant difference between the assumption about information as to a person’s age on which legislation of this kind is based and what can actually be achieved in practice where there are no records or where the recorded information cannot be relied upon. In a recent case1 the UK Supreme Court held that, in enacting provisions of this kind, Parliament intended that the question of a person’s age was for determination ultimately by a court. This was because age, for the purpose of these provisions, is a question of objective fact. The statute proceeds on the basis that it will be possible to determine precisely when a person moves from one age group to another. That can readily be done, of course, in cases where the information can be supplied by the production of a birth certificate. Providing the answer with that degree of precision where, because reliable information of that kind is lacking, professional opinion has to be relied upon instead is much more difficult.

The value of this book lies as much in the advice that it gives as to what ought not to be done in that situation as in the guidance that it gives as to what can. It warns that formal age evaluation must never be put in the hands of the inexperienced practitioner. The expertise of a forensic specialist is essential and, as various methods may have to be used in what is often a multi-disciplinary exercise, it may be necessary for specialists with the relevant expertise to consult with one another before an answer is reached. It aims to be authoritative and comprehensive. By raising awareness as to the limitations of the main approaches to age estimation, it encourages an approach which is careful and well-grounded in a proper understanding of the relevant disciplines. It may not be possible to achieve the precision that can be found by examining a person’s birth certificate. But in the right hands, and with an informed understanding the methods that can be used to achieve this, age estimation can get very close to it.

The editors and their contributors are to be congratulated on producing such a fascinating and well-researched textbook. It deserves to be in every practitioner’s library.

By

The Rt Hon Lord Hope of Craighead KT

1R(A) v Croydon London Borough Council [2009] UKSC 8, [2009] 1 WLR 2557.

Preface

Most healthcare practitioners are inexperienced in even the most approximate estimation of the age of living individuals – and may rely on little more than simple guesswork. Whilst this approach may be appropriate in situations where accuracy may have little relevance, there are situations where a ‘rough estimate of age’ may have far-reaching implications on the manner and nature of the response of the state or judicial system to that individual. In particular, minor differences in age may represent the difference between classification as an adult or a child and can result in major implications for the rights of the individual, such as in relation to accommodation and care and also in the tariffs for criminal offences.

Individuals may have lost, or never had, documentary evidence of their age, or may be genuinely unaware of their chronological age, or they may wish to conceal their true age for a variety of reasons. It therefore becomes incumbent upon the court or other bodies to obtain a formal estimation of their age.

In recent years, with increasing movement of individuals between countries – perhaps as a result of refugee movement, migration or even human trafficking the need to determine the age of a living individual has gained increasing medico-legal importance and cases requiring mediation or investigation occur with increasing frequency. Different jurisdictions approach the concept of estimation of age in varying ways. In addition to inter-jurisdictional differences there may also be substantial intra-jurisdictional differences, many of which may be tested by legal process. For those professionals called upon to provide an estimation of age in the living individual it is right that those requesting such estimations should be provided with as far as possible, valid, reproducible and interpretable estimates.

The available analytical expertise includes odontology, radiology, anthropology, psychology and clinical assessment which require input from a number of specialist practitioners and it is important that all those involved are aware not only of the appropriate techniques and their inherent strengths and weaknesses, but also the ethical and legal frameworks in which they must operate. Age-estimation requires a multi-professional skill set and all those involved should understand and respect how these frameworks may sometimes appear to conflict.

This book is intended to identify and explain the main approaches to age estimation in the living – and to define when a parameter may be of value and to raise awareness of its limitations. There is no simple test for age estimation, and the best available options for each assessment should be used. Each of the key approaches to age estimation is allotted a single chapter written by those with particular skills and expertise in that field. It is in the interests of all parties and in the interests of justice that practitioners aim to estimate age reliably and realistically whilst ensuring that the best interests and rights of both the individual and the needs of the court are served. It is hoped that this book brings together a corpus of knowledge that will assist both those seeking age estimations and those called upon to provide age estimations in the living individual. We are particularly grateful to Fiona Woods and Nicky McGirr from Wiley for their support, patience and enthusiasm for this project. We hope it achieves its aims in ensuring that this complex issue is approached in an independent, scientific and evidence-based manner.

Sue BlackJason Payne-JamesAnil AggrawalDundeeLondonNew DelhiJuly 2010

Glossary of Abbreviations

AGFAD

Arbeitsgemeinshaf fur Forensische Altersdiagnostik (Study Group on Forensic Age Diagnostics)

BASW

British Association of Social Workers

BMI

Body Mass Index

CDC

Centers for Disease Control

CRL

Crown–Rump Length

CT

Computerized Tomography

EDC

Endocrine Disrupting Chemicals

FSH

Follicle Stimulating Hormone

GH

Growth Hormone

GMC

General Medical Council

GnRH

Gonadotrophic Releasing Hormone

HPG

Hypothalamic Pituitary Gonadal axis

ID

Identification

IDP

Internally Displaced Persons

LBW

Low Birth Weight

LMP

Last Menstrual Period

MRI

Magnetic Resonance Imaging

PP

Precocious Puberty

PR

Parental Responsibility

PROS

Pediatric Research in Office Settings

RCPCH

Royal College of Paediatrics and Child Health

SES

Socio-Economic Status

SGA

Small for Gestational Age

UASC

Unaccompanied Asylum Seeking Children

UKBA

UK Border Agency

UNHCR

United Nations High Commissioner for Refugees

UNODC

United Nations Office on Drugs and Crime

WHO

World Health Organization

1

AN INTRODUCTION TO THE HISTORY OF AGE ESTIMATION IN THE LIVING

Andreas Schmeling1 and Sue Black2

1Universitätsklinikum Münster, Institut für Rechtsmedizin, Röntgenstraße 23, 48149 Münster, Germany

2Centre for Anatomy and Human Identification, University of Dundee, Dundee DD1 5EH, UK

1.1 Introduction

Despite the alleged use of the eruption of second molars by the ancient Romans to evaluate readiness for military service (Müller, 1990), age estimation (sometimes known as age evaluation, age determination, age diagnostics or age assessment) in living individuals is a relatively recent area of applied research within the forensic sciences. Its value and importance as an assessment tool has risen exponentially as the needs for an informed opinion on the age of an individual have assumed increasing importance for the assessment of both criminal culpability and legal/social categorization. Age is an important classifier in most cultural and judicial hierarchies, and the absence of credible legal documentation often demands that authorities must seek the expertise of the scientist and the clinician for guidance and assistance in this regard.

There are many areas in which the evaluation of age in the living has become relevant but the most prevalent concern issues pertaining to refugee and asylum seekers, criminals and their victims, human trafficking and child pornography (UNHCR, 2004; Lee, 2007; O’Donnell and Milner, 2007; Cattaneo et al., 2009). Age evaluation is also required for adoptive children from countries without birth registration (Crossner and Mansfeld, 1983; Melsen et al., 1986; Fleischer-Peters, 1987). An additional category is age evaluation in competitive sports to ensure that athletes are competing within an age appropriate banding for the sake of both fairness and health protection (Braude, Henning and Lambert, 2007; Dvorak et al., 2007a, 2007b; Houlihan, 2007). Parents have also been known to falsify the ages of their children, particularly of their sons, to obtain preferential educational opportunities (Chagula, 1960). While it is undeniable that the majority of issues raised concerning age evaluation are predominantly within the juvenile aspect of the human age range, there are issues of legality in relation to the elderly, for example those which relate to matters of eligibility for state-funded pension support or retirement law (Ritz-Timme et al., 2002).

The assignment of age to address appropriate and fair processing of asylum and refugee seekers is influenced heavily by issues pertaining to international human rights. These issues are largely governed by the UN Convention on the Rights of the Child (1989) and the UNHCR Guidelines on Policies and Procedures in Dealing with Unaccompanied Children Seeking Asylum (1997). Both documents follow the guiding principles that the best interests of the child take precedence and that the child should be given the benefit of the doubt if their chronological age remains uncertain (UNHCR, 1997). For most countries that recognize the 1989 United Nations Convention on the Rights of the Child, the legal age of maturity is accepted as 18 years of age and this is largely supported by the modern legal framework of most nations. If an individual claims to be younger than 18 years of age, and there is some doubt, then there may be a statutory obligation that the receiving nation is required to offer asylum and support to that minor until age is established to the satisfaction of the authorities. Therefore, the demarcation between 17 and 18 years is a key milestone with regards to both legal and social responsibility – from the perspective of both the state and the individual.

Human trafficking is concerned with the recruitment, movement and sale of people for exploitative purposes. Trafficking has been recognized and in some respects tolerated if not indeed condoned by many countries throughout history. While slave labour, prostitution and organized crime are the trademarks of human trafficking, it shares a blurred boundary with the crime of human smuggling, which seeks to extort money from criminalizing migrants (UN, 2000). Each of these crimes trespasses into the juvenile age spectrum and does so particularly boldly in the areas of slave labour and prostitution, as witnessed by the increasing prevalence of juvenile sex tourism, particularly in the Far East (Singh, 2002; Lindstrom, 2004).

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