Lisa Uherick M.D. Carolinas Medical Center Grand Rounds March 24, 2004

2. Lisa Uherick M.D. Carolinas Medical Center Grand Rounds March 24, 2004

3. What is Bullying? • A form of aggression in which one or more children repeatedly and intentionally intimidate, harass, or physically harm a victim who is perceived as unable to defend himself or herself.

4. Direct Bullying • Active confrontation between the bully and the victim • Peter

5. Indirect Bullying • Shunning or ignoring the victim • Tonya

6. Passive Bullying • Other children provide support for the bully • Scott and Bill

7. What is the Extent of the Problem? • School Age Children • 15% are victims • 10% are bullies • 5% are both • Peak incidence at age 7 • Boys > Girls • Involves children of all races and classes

8. Is Bullying Normal? • Rite of Passage? • Innocent teasing? • Toughen kids up?

9. Why do we care? • School Shootings • Shooters suffered bullying and isolation • Violent Retribution

10. Luke Woodham • “I am not insane. I am angry. I killed because people like me are mistreated every day. I did this to show society: Push us and we will push back”

11. Our attitude toward bullying is critical because it sets the standard for the general level of aggression that is thought to be acceptable in society!

12. Bullies • Characteristics • Aggressive and violent • Little empathy for others • Physically strong • Crave power • CONFIDENT

13. Bullies • Rewards • Prestige • Power • Material possessions

14. Bullies • Consequences • Poor school performance, drop out • Peer rejection • Depression • Drink, smoke, fight • Criminal behavior as adults

15. Victims • Characteristics • Anxious • Insecure • Physically smaller and weaker • Cautious • Quiet

17. Victims • Consequences • Fear and anxiety • Poor self esteem • Social isolation • Depression • School avoidance • Physical harm

18. The Double Whammy

19. What is the Pediatrician’s Role? • 1. Identify the Problem! • Anticipatory guidance • Screening Questions

20. How are things going at school? • Have you ever been teased at school? • At recess, do you play with other children? • How many days have you missed school? Why?

21. What is the Pediatrician’s Role? • Know the signs for the victim • Depression • Behavior problems • Somatic complaints (Headache, Stomach Aches) • Enuresis • Sleep Difficulties

22. What is the Pediatrician’s Role? • Know the signs for the bully • Strong negative moods • Slow adaptation to new situations • Violent reactions • Parents who display violence

23. What is the Pediatrician’s Role? • 1. Identify the Problem • 2. Counsel • Parents • Children • School personnel

24. Counseling Parents • Victim • Role Play • Bully • Model aggression control • Do not tolerate violence • Both • Extracurricular activities • Mental Health Counseling

25. Counseling Victims • “WALK, TALK, SQUAWK!” • Walk away from the scene calmly (Not run) • Talk to the bully, looking him straight in the eye • Squawk to a teacher or parent!

26. Counseling School Personnel • Define bullying and it’s consequences • Involve parents and counselors • Encourage awareness and involvement • Increase adult supervision • Set a non-violent tone • “Peace at school day”

27. Caught in the Act • Remove the victim • Do not use aggression! • Tell the bully he will be dealt with later • Public or private or written apology?

28. Learning from our mistakes • Every bullying episode is a FAILURE • Bully fails to learn that it is unacceptable • Parents failed to teach the bully aggression control • Victim failed to assertive enough • School failed to protect the victim

29. One Exemplary School • 4 steps to create a violence free environment • 1. Identify the school’s core values • The 5 bee’s (be respectful, be responsible, be honest, be ready to learn, and be your personal best) • 2. Create consistent rules and consequences • 3. Model those values • 4. Eliminate inappropriate interventions

30. Bee Theme • The new school pledge • Teacher Training • Emphasis on name calling and teasing • “No Teasing,” “No Name Calling” signs • “Two put-ups for each put down” • Rewarded with the Beehive Café

31. Results of the 5 Bee’s • K-Grade 2 • 40% reduction in self-reported aggression • 19% reduction in self-reported victimization • Grades 3-5 • 23% reduction in self-reported victimization

32. What is the Pediatrician’s Role? • 1. Identify the problem • 2. Counsel • 3. Screen for psychiatric co-morbidities • Bully • Conduct disorder • Victim • Depression, anxiety or panic disorders

33. What is the Pediatrician’s Role? • 1. Identify the problem • 2. Counsel • 3. Screen for psychiatric co-morbidities • 4. ADVOCATE • The right of children to attend school and live free from the threat of violence by other children

34. What is Happening Locally? • Charlotte-Mecklenburg Schools • Student Rights, Responsibilities and Character Development Handbook • Assault, threatening or intimidating a student • Backpack Alert; “A Violent Age” • March 13 & 20 on

35. What is happening in • Bullies Don’t Belong Campaign • NC DJJDP, Center for Prevention of School Violence, Attorney General’s Office • Bullying; Stop the Bully without Becoming One • NCMS Alliance

36. To Report Bullying… NC Safe Schools Tip Line 1-800-960-9600

37. What is Happening Nationally? • 15 states have anti-bullying policies • “Take a Stand, Lend a Hand, Stop Bullying Now!” • National public health campaign

39. How Can We Advocate? • Help set the tone for a bullying-free community • Bullying prevention programs in our schools • School Board • State legislation • Vote, write or call your Representatives • Task forces

40. Who are our Representatives? • Mecklenburg 98:John W. Rhodes99:Drew P. Saunders100:James B. Black101:Beverly M. Earle102:Becky Carney103:Jim Gulley104:Constance K. Wilson105:W. Edwin McMahan106:Martha B. Alexander107:W. Pete Cunningham

41. Goals for NC Anti-Bulling Laws • Clear Definition • Require local school boards to develop bullying policy • Provide the local schools with research based prevention programs that work