Children in Difficulties
Srivieng Pairojkul MD*, Napa Limratana MSc**
Affiliation : *Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Children in difficulties are characterized by: chronic neglect; disability; physical, emotional or sexual abuse;
HIV or one/both parents with HIV and/or limited socio-economic opportunities.
Objective : To review the current situation by reviewing the incidence of problems affecting children and exploring both
potential short-/long-term strategies, including the role of pediatricians.
Material and Method: The authors reviewed the incidence and situations of children in difficulties, did a synthesis of
guidelines and made recommendations.
Results : The fundamental causes of difficulties include: failed macro-economic policies; inadequate and inaccessible education
system; and weakness of the family unit, which is associated with: separation and divorce; violence between partners and/or
toward their children; neglect and abandonment; inappropriate child-rearing; and child exploitation, including trafficking.
Conclusion : GOs and NGOs need to work collaboratively for child protection. Pediatricians can play a vital role in
strengthening the family (a) by providing timely, strategic, informal education for parents on healthy child-rearing (b) by
being attuned to signs, symptoms and attitudes of children in difficulties from childhood through adolescence and (c) by
working interactively with children/teens, their families, teachers and communities. Medical schools need to revise the
curricula to include these crucial roles for pediatricians in child and family advocacy.
Keywords : Children in difficulties, child abuse and neglect, child labor, child prostitution, children in slum, street children, children in criminal justice system, children with disabilities
