50,000 students, parents, educators Student Letters

• Background

• Student Perspective

• > 50,000 students, parents, educators

• Student Letters

• Brick Public School District Brick, NJ

• Brookside Upper Elem School Westwood , NJ

• Central High School Davenport , IA

• Colonial Middle School Plymouth Meeting, PA

• Cunningham Elementary School Vineland , NJ

• Dennis Twp Elem. School Dennis Township , NJ

• Dionne Warwick Institute East Orange , NJ

• Drum Point Elementary Brick, NJ

• East High School Des Moines , IA

• Eisenhower Middle School Bridgewater , NJ

• Evergreen Ave. School Woodbury , NJ

• Florham Parks School District Florham Parks , NJ

• Franklin Elementary Schools Summit , NJ

• Gloucester Twp Middle Sch. Gloucester Twp , NJ

• Jersey City Public Schools Jersey City , NJ

• Kittatinny Regional High School Newton , NJ

• Lakeside Middle School Pompton Lakes , NJ

• Lincoln-Hubbard Elem School Summit , NJ

• Lindenwold High School Lindenwold , NJ

• Mary Bray School Mt. Ephraim , NJ

• Southern Reg. Middle School Manahawkin ,NJ

• Memorial Middle School Willingboro , NJ

• Fountain Woods Elementary School Burlington, NJ

• William Annin Middle School Basking Ridge, NJ

• Carl Sandburg Middle School Matawan, NJ

• Raymond Kershaw School Mount Ephraim, NJ

• Waterford Township Elementary Waterford, NJ

• Spruce Street School Lakewood, NJ

• Holly Hills Elementary Westampton, NJ

• Brimm Medical Arts High School Camden, NJ

• Walnut St. Elementary Woodbury, NJ

• Midstreams Elementary School Brick, NJ

• Lakewood High School Lakewood, NJ

• Boone Middle School Haines City, FL

• Part I

• Epidemiology
• Defining bullying
• Why is it important to discuss?

• Part II

• The Youth Perspective

• Part III

• How do we help our patients?

• Do You Remember a Bully?

• Test Your

• Bully IQ

• What percent of middle/high school students have experienced bullying?¹

• a) 10% b) 25% c) 33%

• 33%

• What percent of school-age bullies end up with criminal records?
• a) 15% b) 20% c) 25%

• 25%

• The National Resource Center for Safe Schools reports that by age eight, bullies are:
• 1) 6 times more likely than non-bullies to be convicted of a crime by age 24
• 2) 5 times more likely to have serious criminal records by age 30.

• How many students nationwide skip school on any given day to avoid being teased or picked on?¹

• a) 20,000 b) 80,000 c)160,000

• 160,000

Epidemiology

• Epidemiology

• Defining Bullying

• Why is Bullying Important to Discuss?

• “Boys will be boys…?”

• Bullying = Rite of Passage?

• Bullying has negative consequences for all involved

• In 1999, the US Dept of Education estimated that almost 1 million students 12-18 years of age were afraid of being attacked or harmed in the school vicinity during the previous six months.

• “The act of threatening to hurt or frighten someone. It may be physical, verbal, emotional, or sexual in nature”¹
• (emotional bullying= rejection, humiliation, exclusion, ranking based on race, ethnicity, sexual orientation, and isolation)
• Imbalance of power²
• Repetitive

• DSM IV- Criteria for Conduct Disorder

• Repetitive and persistent pattern of behavior in which either the basic rights of others or major age-appropriate societal norms or rules are violated
• Aggression to people and animals
• 1) often bullies, threatens, or intimidates others
• 2) often initiates physical fights
• 3) Has used a weapon that can cause serious physical harm to others

• Physical: Kicking, hitting, punching (boys)

• Emotional: exclusion, gossiping, silent treatment, slandering reputation, self-esteem attacks, “if you’re my friend, you can’t be her friend.” (girls)

• Cyberbullying: Facebook, email, MySpace, Cell phones: 3rd graders, 5000 text messages

• Bullies
• Victims
• Bully-Victims
• Bystanders

• 1) “Boys will be boys?”

• - Emotional, Safety, Academic, Health consequences

• 2) Bullying behaviors are detrimental to bullies, victims and bully-victims.

• 1) Emotional Impact

• Talk shows
• Effect on adults
• Effect on children, #1

• 2) Safety

• In 2000, the US Secret Service reported that 2/3 of all school shootings in the last decade have occurred by an attacker who felt “bullied, attacked, threatened, or persecuted.”¹

• 2) Safety, cont’d

• From 1994-1999, 220 school associated violent deaths occurred in the US. 172 were committed by students; these students were 2.6 times more likely to have been bullied than their victims.²

• 2) Safety, cont’d

• Suicide is 3rd leading cause of death among teens
• “Bullycide”
• A study involving 2,342 high school students demonstrated that bullies and victims were at a higher risk for depression, suicidal ideation and suicide attempts than those not involved.¹

• 2) Safety, cont’d

• Teen Violence: Columbine, Teen burned

• 3) Academic Performance

• A study of 204 Midwestern American middle / high school students found that 90% said they had a drop in grades…as a result of bullying¹.
• A small study conducted in elementary schools (Stanford Achievement Test scores found a significant association between low scores and being a victim of bullying².

• 3) Academic Performance cont’d

• A study surveying 3,530 third, fourth, and fifth grade students found that victims and bully-victims had achievement scores significantly lower than those of bystanders… and would endorse cheating if they could get away with it compared to bystanders¹.

• 4) Health

• Victims
• Psychosomatic complaints, experience social distress, marginalization and low self esteem.
• A study of 2766 students age 9-12 years old showed that victims were at greater risk for aggression, headache, sleeping problems, abdominal pain, bedwetting, feeling tired, anxiety, and depression than children not involved in bullying¹.
• Substance Abuse

• 4) Health, cont’d

• Bullies
• Increased anger, poor interpersonal relationships and poor quality of life.¹ Reports of depression.
• A 2002 study published in JAMA examined bullying among 6th-10th graders and found that bullies were more likely to drink and smoke.

• 4) Health cont’d
• Bully-Victims
• High Risk
• Most likely to display conduct problems, be least engaged in school, socially ostracized by peers and be lonely.¹ They are also noted to have psychosomatic complaints.

• 4) Health, cont’d

• A study of 2,540 boys in Finland followed bullies, victims and bully-victims from 8 years old until 18-23 years old.

• Bullies, victims and bully-victims experience long-term consequences.

• Studies; Self-reporting

• Crossover between categories: bully, victim, bully-victim

• Crossover: Characteristics

• Study of 1,985 predominantly Latino and Black 6th graders
• Bullies had fewest number of adjustment problems
• Bullies had high social status among classmates

• The Youth Perspective

• “Bullying: Stories from Our Young People”

• #2-7

• “The In-Crowd and Social Cruelty”

• (shown with permission from Films for the Humanities and Sciences)

• How Do We Help Our Patients?

• According to a 2004 American Family Physician article, “there is no one accepted psychological profile or assessment method to predict bullying behavior.¹”

• 1) Identify risk factors for violence
• 2) Ask children about bullying
• 3) Understand barriers
• 4) Talk with parents about bullying
• 5) Refer appropriately
• 6) Involve the School
• 7) Become advocates

• 1) Identify Risk Factors for Violence

• Hx of mental illness, domestic violence, substance abuse
• Family stressors
• Level of supervision and support systems
• Exposure to violence in the home or community
• Access to firearms
• Presence or signs of poor self-esteem or depression
• Poor school performance, physical, emotional or developmental disabilities

• 2) Ask children about bullying

• During routine physical exams
• When psychosomatic complaints are present (from child or parent).
• When a child has problems at school
• When a child shows signs of depression/ anxiety
• When parents have concerns
• Assess for bullies, victims and bully-victims.

• Questions to ask:
• Have you ever been teased in school?
• What kinds of things do others tease you about?
• What do you do when others pick on you?
• Have you ever told your teacher or other adult? What happened?
• Do you know of others who have been teased?
• At recess, do you usually play with other children or by yourself?

• Questions to ask, cont’d
• Do you tease or make fun of others?
• Do you ever hit or push others?
• Why do you act this way towards others?
• What do you do when you seen others being teased or picked on?

• 3) Understand Barriers:
• Ask questions
• Listen
• “Fear Factor”
• Give children “permission” to report. Let them know this is expected

• 4) Talk with Parents about bullying

• Educate parents
• “Sticks and Stones”
• #8

• 5) Refer appropriately:

• Mental Health Services:
• Psychiatry, Counseling, Family Therapy
• Social Work
• School Interventions

• 6) Involve the School
• Bullying laws
• > 40 states
• The Safe Schools Reporting Act of 2005 requires the Maryland State Department of Education to require reporting of bullying incidents against students in public schools.
• Maryland’s Model Anti-Bullying, Harassment, and Intimidation Policy requires school systems to submit copies of their anti-bullying policies to the State Superintendent for review.
• School-wide Programs
• Dan Olweus
• Lack of standard evaluation practices

• 7) Be an advocate
• http://stopbullyingnow.hrsa.gov
• www.aap.org/connectedkids
• www.safeyouth.org
• Public Awareness Campaigns
• Hope, #9

• Thank you

• [e-mail]

• www.jennifercaudle.com