Bullying

1. Bullying Florence Stevens MPH

2. Agenda • What is bullying • Characteristics of victims and bullies • Effects of Bullying • The Role of the Pediatrician in Connected Kids • Your Role as Community Leaders

3. http://youtu.be/6lL9-JRImMI

4. How big of a problem? • The CDC found between 20-56% of young people are involved in bullying annually. • In a classroom of 30 students, between 6 and 17 students are involved in bullying as the victim, the bully or both.

5. What is bullying? • Bullying is a form of aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort • Sometimes children argue with each other or make bad choices in their behavior- that is not bullying • American Psychological Association

6. What is bullying? Bullying can include: • Teasing • Threats of harm • Spreading rumors • Purposefully excluding peers from activities • Attacking physically or verbally

7. Cyberbullying • Bullying with electronic means such as computers, cell phones, social media etc • Examples: • Spreading rumors on twitter or text messages • Posting embarrassing images or information on the internet Cyberbullying can be done 24 hrs a day, shared with a large audience, and can be anonymous.

8. Risk Factors • Age • Ethnic, cultural, religious minority • Poor social skills • Sexual minority • Obesity • Health Conditions • Autism and learning disabilities • Peer shunning is common • 94% had experienced peer victimization • 75% had been hit by peers

9. How likely are children and youth to bully others? Graph at stop bullying.gov

10. Differences in the Types of Bullying Experienced by Boys and Girls (NCES, 2011)

11. More facts about bullies • Both boys and girls can be bullies. • Boys more likely to engage in physical bullying. • Girls more likely to engage in social / verbal bullying. • Bullying is not confined to classrooms, but also on the playground, and in the neighborhood while going between school and home

12. Children who are bullied

13. Common characteristics of children who are bullied • Perceived as different from peers • Perceived as weak or unable to defend themselves • Are less popular than others • Do not get along well with others • Specific groups of children may be targets, including obese or overweight, LGBT youth and children with disabilities or special health needs

14. Effects of being bullied • Depression • Anxiety • Headaches and stomachaches • Sleeping problems • Social withdrawal • Suicidal ideation

15. Academic Consequences of Bullying • Children and youth who are bullied are more likely to: – Want to avoid school – Have lower academic achievement • Several studies suggest that children’s experiences of being rejected by peers or bullied in other ways may lead to lowered academic achievement

16. Bullying and Risk of Suicide Suicide is the 2nd leading cause of death for youth 10-17 in the US Bullied children & youth are more likely than non-bullied peers to have: • Depressive symptoms • Harm themselves • High levels of suicidal thoughts • Attempted suicide (WISQARS CDC)

17. Children who bully

18. Concern for children and youth who bully Common characteristics of children who bully • Aggressive, easily frustrated, • Have less parental involvement or issues at home, • Think badly of others, • Have difficulty following rules, • View violence in a positive way, • Have friends who bully others.

19. Concern for Children and Youth who Bully Children and youth who bully others are more likely than their peers to: • Exhibit delinquent behaviors i.e. get into fights, vandalize property • Dislike school, drop out of school • Drink alcohol and smoke • Bring weapons to school • Think of suicide and attempt suicide • Engage in early sexual activity • Have criminal convictions and traffic citations as adults • Be abusive toward their romantic partners, spouses, or children as adults

20. American Academy of Pediatrics The Role of the Pediatrician

21. Role of the pediatrician • Anticipatory guidance – prevention of bullying • Identify children at risk • Help patients create a safety plan • Refer to mental health and community resources when necessary • Follow up

22. Connected Kids

23. Child-Centered Parent-Centered Physical Safety Community Connections Building Blocks Connected Kids centers on 4 overlapping themes of anticipatory guidance

24. Assessment • Key message: “You aren’t alone, it’s not your fault, and I can help.” • Asking the Right Questions • Have you been in any pushing or shoving fights? • What do you usually do to avoid getting into a fight? • Are you afraid of being hurt by any other children? • Do you feel bullied by other children? • If you see other children in fights or being bullied, what do you do?

25. Kids who are bullied These children may need help learning how to respond to bullying. • “Let’s talk about what you can do and say if this happens again.” • Teach them how to: - Look the bully in the eye. - Stand tall and stay calm in a different situation. - Walk away. • Teach them how to say in a firm voice:  • “I don’t like what you are doing.” • “Please do not talk to me like that.” • “Why would you say that?”

26. Kids who bully Often these students require support to change their behavior • Be a positive role model. • Use effective, nonphysical discipline, such as loss of privileges. • Develop practical solutions with others. • Ask for help. If you find it difficult to change the behavior, reach out to a professional, like a teacher, counselor or your child’s pediatrician.

27. How to find Connected Kids • American Academy of Pediatrics (www.aap.org) • Patient Education online (patiented.aap.org ) • Pediatric Care Online (www.pediatriccareonline.org) • HealthyChildren.org

28. The Role of Community Leaders

29. The Role of Community Leaders • Talk to kids about bullying • Train other leaders to prevent bullying • Partner together • Schools, mental health specialists, law enforcement officers, businesses, faith-based organizations, service groups • Build a strategy • Know where to get help

30. Universal Questions to Elicit Bullying • For parents: • Has your child been bullied or hit by others? • Has your child demonstrated bullying or aggression toward others?From Bright Futures • For children: • Do you ever feel afraid to go to school? Why? • Do other kids ever bully you at school, in your neighborhood, or online? • What do you do if you see other kids being bullied? • Who can you go to for help if you or someone you know is being bullied? From www.stopbullying.gov

31. Warning Signs a child is being bullied • Unexplainable injuries • Lost or destroyed clothing, books, electronics • Frequent headaches, stomach aches • Changes in eating habits • Difficulty sleeping or frequent nightmares • Declining grades • Sudden loss of friends • Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide

32. Signs a child is bullying others Kids may be bullying others if they: • Get into physical or verbal fights • Have friends who bully others • Are increasingly aggressive • Get sent to the principal’s office or to detention frequently • Have unexplained extra money or new belongings • Blame others for their problems • Are competitive and worry about their reputation or popularity

33. Key points in responding to bullying • Don’t blame the child for being bullied • Don’t encourage children to fight back • Telling the child to ignore the bullying may cause it to escalate • Bystanders may also be affected by bullying in that they don’t often know how to respond

34. When does a child need outside help? • A mental health professional may be needed if: • The child is experiencing severe mental health consequences (depression, anxiety, suicidality) • The child has particular difficulty in discussing the bullying • The child is experiencing severe impairment in daily activities

35. Likelihood of Reporting • 50-75% of children and youth do not tell school personnel, are a bit more likely to tell parents • Why do kids keep silent? • Negative messages about “tattling” or “snitching” • Gender stereotypes (boys are more reluctant) • Worried about retaliation • Lack of confidence in adult’s actions • Feel ashamed or powerless Stopbullying.gov

36. Provide Training in Bullying Prevention Adults must understand: • the nature of bullying • its effects • how to prevent bullying • effective policies and rules • the skills to: - Stop bullying on the spot - Follow up routinely with youth involved in bullying and, if warranted, with their parents

37. Focus on the Social Climate • Bullying prevention requires changes in social climates • Changes in attitudes, norms, and behaviors takes time and commitment • Creating safe and caring places for youth involves a comprehensive effort on the part of everyone

38. Coordinate and Integrate Prevention Efforts • Bullying prevention should be coordinated and integrated with other efforts • School groups, such as safety committees represent the entire staff, parents, community volunteers, and youth leaders • Community groups may include representatives from many disciplines and partnering agencies

39. Set Policies and Rules • Consider establishing and enforcing rules and policies that address bullying • Rules should apply to all children, set standards for expected positive behavior • Follow up with positive and negative consequences

40. Continue Efforts Over Time and Renew Community Interests • Bullying prevention should have no “end date” • Communities need to continually assess prevention needs and outcomes, revise strategies and programs, and champion the benefits in children’s lives and to the community

41. A Variety of Laws in the U.S. Address Bullying

42. Federal Laws and Bullying and Harassment • Schools that receive federal funding must address discrimination based on a number of different personal characteristics • Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, or national origin • Title IX of the Education Amendments of 1972 prohibits discrimination based on sex • Section 504 of the Rehabilitation Act of 1973 and Title II of the ADA (1990) prohibits discrimination based on disability

44. National Resources • Futures Without Violence www.futureswithoutviolence.org • It Gets Better Project- itgetsbetter.org • Teen web site about dealing with cyberbullying- www.thatsnotcool.com • Big Brother/Big Sister www.bbbs.org • Three Bold Steps for School Community Change: A Toolkit for Community Leaders- www.stopbullying.gov • Striving to Reduce Youth Violence Everywhere: Community Action Planning

45. Resources National Suicide Prevention Lifeline

46. THANK YOU! Your support allows the American Academy of Pediatrics to continue providing patient education resources for pediatricians and the families they serve.