1. Childhood Bullying: What We Know – and Can Do Stuart Green, DMH, LCSW, MA Behavioral Scientist/Medical Education, Overlook Hospital Associate Director, Overlook Family Medicine Residency Director, NJ Coalition for Bullying Awareness www.njbullying.org

2. OLWEUS  A tragedy driven field  Dan Olweus, PhD

3. TRADITIONAL VIEW  Lord of the Flies  normal, inevitable, 'rite of passage', the nature of children  'bad' families/communities, innocent schools

4. MODERN VIEW  Bullying at school (Willie Sutton)  Environmental (school).  Adults as primary factors.

5. DEFINITION  A pattern of negative acts toward a child by a peer, in which there is an imbalance of power so that the child who is bullied has a difficult time defending himself or herself, and there is an intent to harm on the part of those bullying.  Direct (to the bullied child): e.g., hitting, name- calling, texting/emailing.  Indirect (to others, impacting a targeted child): relational aggression, isolation, exclusion, rumors - emailing about, webposting  Gender differences: boys more

6. THE BULLYING CIRCLE  The bullying child/children  The bullied child  Bystanders: o Active o Passive o 'Activated'

7. PREVALENCE  One of the most common serious problems of the school-age child  Wide worldwide range  Varies by gender  Gender identify and expression, and obesity most targeted.  Middle school years the peak  Prevalence is 100%?

8. CYBERBULLYING  Electronic/digital  A 'better' way (for violence): o wider potential 'audience' o anonymity o easier, safer (for those bullying) o no escape (for the bullied) o no adults.  New but growing (bigger than 'offline'?)

9. CYBERBULLYING continued...  Different than offline: o more bully/victims o more girls o self-harm 'support'  Same as it ever was: o bullied offline and online o still mostly school-based

10. EFFECTS (BULLIED CHILDREN) Added injury o obesity o (inhibited) gender identity and expression o race/ethnicity, immigrant status, lower SES, being new in a school o being shorter, less physical strength or agility/athleticism o developmental disorders/conditions (CP, autistic spectrum disorders)

11. EFFECTS (BULLIED CHILDREN) continued... o shyness, less assertive, isolated, lonely, no ‘buffer’ (friends) o more victimized or maltreated in the community or family o 'sensitive'/emotionally expressive o Tourettes, eczema, cleft lip and palate o chronic abdominal pain, IBS, IBD, special health needs o learning differences, ADHD o cancer

12. EFFECTS (BULLIED CHILDREN) continued... Source of problems o school absence o anxiety (into adulthood), depression, low self-esteem (into adulthood) o suicidal thoughts o lower school performance o health symptoms and doctor visits o impaired diabetes self-management o worrying by parents and siblings

13. EFFECTS (BULLIED CHILDREN) continued... Source of problems o lack of help-seeking/self-identification in hard- of-hearing youth o low body satisfaction o inactivity, obesity/disordered eating o gang affiliation, weapon-carrying at school o dysfunctional voiding - enuresis/ encopresis o PTSD

14. BUT...  stigmatization, isolation, decreased popularity  developmentally normal or common  difficult to change  children without these characteristics also bullied.

15. BULLYING CHILDREN o alcohol and tobacco use o lower academic achievement o aggression and anti-social behavior o ADHD, impulsivity o less empathic o family problems (authoritarian)

16. BUT...  good self-esteem  adequate academics  good social skills  popular or leaders BULLY / VICTIMS: Tend to have more problems

17. SPECULATIONS o Garbarino - teen pregnancy as a 'side- effect' o bullying as a key negative impact on schools  'white flight'/adult-risk-taking

18. WHAT WORKS - Overview  Whole school - or 'systemic' - model  Goal: Change school climate  All adults/groups involved, including parents  Interventions at level of school, classroom and individual.  Ongoing, at least 3 years.  Increased support for vulnerable/targeted children.  Activate positive bystanders.  Efficacy 0% to 50% (!) (Rigby)

19. WHAT CAN SCHOOLS DO? Change School Climate (prepare the soil)  positive relations and shared understanding between staff  increase positive staff-student interactions  not favor some groups over others (e.g., diverse clubs)  staff-student/community 'match' (complementary diversity)  clear/consensus expectations ('how we do things here').

20. WHAT CAN SCHOOLS DO? Systematic Work/All Levels Schoolwide   school survey, pre- mid- post -  anonymous reporting system, ongoing  effort to identify all incidents/relationships  coordinating group/ staff discussions/ training  administrative support  supervise high-risk areas/situations: (schoolyard, lunchroom, locker room, team activities, school bus, cyberspace)  consistent rules and sanctions well known (students, staff, parents).

21. WHAT CAN SCHOOLS DO? Classroom  regular meetings  proactive work on relationships  parent involvement (barriers/myths - kids don't want them? parent behav?)  collaborative learning (‘jigsaw’) (Aronson)  topic integration (all subjects, classes).

22. WHAT CAN SCHOOLS DO? Individual meeting with each child who bullies  4 questions: did? harm? problem? plan! apply consequence (invariable/escalating/ reasonable) call parent/s

23. WHAT CAN SCHOOLS DO? meeting with each child bullied o call/see parent/s o apologize/take responsibility o absolve bullied child (DV) o commit to f/u.

24. WHAT CAN SCHOOLS DO?  increased support for targeted/at-risk kids:  proactive/creative  activate child bystanders (eg., friendship circles, telling)  follow-up/protect - address retaliation

25. Proactive, Preventive, Ongoing

26. What can schools do about cyberbullying?  Include cyberbullying in all anti-bullying programs/materials.  Monitor computer/device use, restrict access/use.  Establish an electronic anonymous reporting mechanism.  Train staff and educate students.  Accept that cyberbullying is a school responsibility.

27. What can parents do about bullying?  Good relations/communication with children.  Inform yourself.  Expect/ ask/ demand adequate school action.  Expect/ ask/ demand that owners of social networking sites and internet providers address bullying.  Ask your child how children treat other children at school (and how your child is treated); listening is more important than advice.

28. What can parents do about bullying?  When you hear children speak badly of another child, gently express discomfort, and empathy for the scorned child.  Be present at your child's school; don't wait to be invited, ask to volunteer.  Take action with other concerned parents.  Meet (as a group) with school leaders; ask specifically about school’s approach.

29. What can parents do about bullying?  Never ignore bullying, don't walk by; if you can't intervene directly, report it.  Support bullied kids in every possible way.  Seek legal advice and government support.  Don't accept leaders who bully, including teachers; speak out, insist on change.  Consider changing schools, if possible, as a last resort.

30. What Can Pediatricians Do?  Screen for bullying involvement, consider bullying as a factor or even cause of presenting problems.  Call on the school for corrective action, emphasize support for child/family.  Have a bullying-aware office.  As community leaders, expect schools to address bullying, raise parental expectations.

31. OLWEUS: Our moral obligation to help bullied children.

32. KEY REFERENCES Cyberbullying and Cyberthreats, Nancy E. Willard, Research Press, 2007. http://cyberbully.org Schools Where Everyone Belongs: Practical Strategies for Reducing Bullying, Stan Davis, Research Press, 2003. www.stopbullyingnow.com, stopbullyingworld.com Bullying at School, Dan Olweus, Blackwell, 1993. NJ Coalition for Bullying Awareness and Prevention. www.njbullying.org. Stuart Green. StopBullyingNow.org. HRSA. Susan Limber. Arseneault L, Milne BJ, Taylor A, Adams F, Delgado K, Caspi A, Moffitt TE. Being Bullied as an Environmentally Mediated Contributing Factor to Children's Internalizing Problems: A Study of Twins Discordant for Victimization Arch Pediatr Adolesc Med, Feb 2008; 162: 145-150. _____________________________________________________http://cyberbully.org