Wide interhospital differences suggest that the predicament of limited access to health care of these groups of vulnerable medically uninsured children needs to be addressed through further research to inform policies and develop training.

Background: To help immigrant and refugee adolescents experiencing a severe academic delay cope with adversity, a school-based intervention combining drama workshops and language awareness activities was piloted in two classrooms. Method: A qualitative analysis of participant observations was performed and the Strength and Difficulty Questionnaire and its Impairment Supplement was administered before and after the intervention. The observations were carried out in two Montreal high schools serving an underprivileged neighbourhood of immigrants, involving two classrooms of underschooled adolescents (n = 27) and two classes of similarly underschooled adolescents chosen among other teachers interested in the intervention, who accepted to participate as a comparison group (n = 28). Results: The adolescents shared their experiences of adversity and felt empowered by the workshops. Self-reported impairment decreased in the intervention groups. Conclusion: The protective effect of creative language activities for immigrant and refugee youth should be further investigated. Key Practitioner Message:• Immigrant and refugee adolescents with learning difficulties may be at risk of feeling doubly rejected • School-based programmes are usually well-accepted by immigrant families • Language awareness activities paired with drama expression workshops may empower these youth • The acknowledgement of diverse languages and identities can help restore feelings of belonging

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.