Giving children a voice

It has served her well in a 40-year career, the past 20 of which have specialised in helping abused and neglected children.

Dr Packer laments that policy settings developed for children, such as child care and schools, and even the modern Australian family unit, have lost sight of what's important for a child.

''In primitive societies, children were a precious resource and each child had four or five adults looking after them,'' she said.

''Now families are small and disconnected. We have children being handed around to different carers from infancy. They have one teacher for 30 kids at school. Parents are stretched by work commitments and often burdened by guilt at having to fit their children in ...

''The needs of the child can too often get sidelined in parents' priorities. And our education and child-care models are in many ways the cheapest economic model we can be persuaded to accept. They are far from best practice.''

Dr Packer believes children need certainty, security and recognition and modern life can compromise this, leaving them experiencing chronic stress.

And when isolated, stressed and confused parents are left on their own, children are most likely to suffer neglect or abuse.

Dr Packer, who was awarded Membership of the Order or Australia in 1999 for her contribution to child protection, is on the front line of services for children whose parents fail them. When the territory's child protection workers remove a child from their parents, Dr Packer one of four doctors in the ACT's Child-At-Risk Health Unit is often their first destination.

She must undress and intimately examine each child before writing a forensic report about their condition. She sees about 200 children a year.

But in the thousands of children she has seen over her career, only a handful have ever shown distress at the situation. The vast majority are passive.

''They have experienced unimaginable things. But they very rarely cry. They sit in my lap and tell me they love me. Because this is what they have learnt to do in order to survive a strategy that puts them at extreme risk.''

Dr Packer's experience and clinical detachment has its limits, and some cases ''nearly break my heart''.

But she believes a lot more can be done to prevent neglect and abuse from starting.

If she could affect government policy she would mandate more be spent on supporting struggling families before things get to the stage where children are better off in foster care.

''It is about having someone there long-term to support a family. Someone they trust, a person who can pop in regularly, model parenting, and can offer practical help with housework, meals and bills.''

Where there is entrenched abuse and violence, drug or alcohol addiction, and parents consistently put their own needs before their child's, Dr Packer wants more support for foster families, more recognition of the immense job they undertake, and more support for these children in school when their lives have been so damaged they simply cannot be expected to integrate quickly with mainstream, carefree classmates.

''We rightly provide extra funding to support children with disabilities or with autism, yet there is no similar recognition of the additional needs of a child who has suffered years of unspeakable treatment.''

Then there are ways to help children which are absolutely free.

''We can acknowledge children, talk to them, engage with them, look after them," she said.

''As a community, if all adults started to take notice of the children they encountered in their lives, children would be safer.

''If everyone made a decision to keep a weather eye on each other's children, they would be safer.'' Dr Packer points to Italy as a country she has visited where the status of the child is elevated.''In Italy, children are enjoyed and respected. Families are proud of their children and they take them out and show them off.

''Children are loved and considered special. In Australia, as a country, we seem to be forgetting how to delight in the child.''