Nauru's president has blamed Australian advocates for the plight of refugee children detained on the island, a claim advocates have dismissed as false.
More than 100 refugee and asylum seeker children remain on the island, five years after they were sent there by Australia.
Doctors have said that self-harm and suicide attempts are common among the children, and many have been diagnosed with resignation syndrome -- a catatonic state induced by trauma.
Australian courts have also found that refugee children are unsafe on Nauru.
But in a series of tweets, the Nauru Government said children were being manipulated into self harm by their families, with support from refugee activists, in a bid to reach Australia.
It offered no evidence for this claim.
Nauru's president, Baron Waqa, repeated the assertion in an interview with Australia's Sky News, which was broadcast on Saturday.
"We tend to think that these kids are pushed into something that they're not aware of," said Mr Waqa. "It's a way of working the system and probably short circuiting it just to get to Australia."
But refugee advocates say the claims are outrageous.
Jana Favero is the campaigns director for the Asylum Seeker Resource Centre, which provides medical and legal advice to many of those on Nauru from its offices in Melbourne.
"That view is completely contrary to the view of medical professionals that we're getting," she said in an interview. "We are linking up unwell children directly to medical professionals in Australia who are making medical assessments."
"It is obvious that these children are sick and they're sick because they're on Nauru, they've been there for five years and they're suffering from trauma and traumatic withdrawal syndrome."
The Nauru government said the centres that initially held refugees have been closed, and that they are free to roam as they please.
But many of the families there live in a state of despair five years on, with little prospect for resettlement any time soon.
Australia refuses to budge on its policy towards asylum seekers who arrive by boat. The United States has agreed to resettle some of the refugees, but progress has been slow. Both Australia and Nauru have rejected an offer from New Zealand to resettle 150 of them.
It emerged this week that many of the children have been referred for medical treatment off island, but these have not been acted upon by the Australian Border Force, which has ultimate authority for offshore processing.
Nauru will next week host the region's leaders for the Pacific Islands Forum summit, amid criticism over media restrictions imposed by the government and its decision to ban Australia's ABC.
Australia's prime minister, Scott Morrison -- a former immigration minister who was responsible for the offshore detention policy -- will not attend.