COVID-19 pandemic: The impact on vulnerable children and young people in Australia.

The COVID-19 pandemic and associated system disruptions are impacting all children and young people (CYP) in Australia. For vulnerable groups of CYP, who already experience poorer health and well-being, these impacts are amplified. Challenges include reduced access to usual services, reduced community supports, financial instability, unemployment and other life circumstances that threaten to widen pre-existing inequities. This article aims to present the reasons for vulnerability of CYP during the pandemic, and to focus on actions by health professionals that mitigate additional challenges to their health and well-being. Using a rapid review of the literature and team-based discussions, eight vulnerable groups were identified: CYP with disabilities, mental health conditions and chronic diseases; CYP facing financial hardship; within the child protection system; Aboriginal; migrant and refugee; in residential care; rural; and isolated CYP. Recommendations for action are required at the level of governments, health professionals and researchers and include enhancing access to health and social supports, prioritising vulnerable CYP in resuming health activity and elevating the voice of CYP in designing the response. The pandemic can be conceptualised as an opportunity to create a more equitable society as we document the inequities that have been exacerbated. Vulnerable groups of CYP must be recognised and heard, and targeted actions must focus on improving their health outcomes during the pandemic and beyond.

Do no more harm: the psychological stress of the medical examination for alleged child sexual abuse.

AIM: Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination. METHODS: We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables. RESULTS: Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports. CONCLUSION: Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.

International collaboration on prevention of shaken baby syndrome - an ongoing project/intervention.

Caring for young infants can be stressful. Non-accidental brain or head injury (shaken baby syndrome) is a result of parental stress, and a lack of knowledge of how to respond to a crying infant and the dangers of shaking a child. This article demonstrates the value of international collaboration in projects to prevent child maltreatment. It includes reports of prevention of shaken baby syndrome programmes in Australia, Hungary, Greece, Brazil and Turkey.