50,000 students, parents, educators Student Letters


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  • Background

  • > 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


  • 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?




  • 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

  • jcaudle@lifebridgehealth.org

  • www.jennifercaudle.com





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