title: Children in difficulties.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. srivieng@kku.ac.th
authors.forename: Srivieng
authors.initials: S
authors.lastname: Pairojkul
authors.forename: Napa
authors.initials: N
authors.lastname: Limratana
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004501:Education, Medical; D005192:Family Health; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010819:Physician's Role; D012940:Social Problems; D013785:Thailand / Q000453:epidemiology; D035862:Vulnerable Populations