A doctor's response to bullying

Kelly as a toddler

We recently shared a blog written by Children’s patient Kelly Rock, who for years was bullied and excluded as a result of a medical condition. Kelly is an amazing young woman, and her blog post spurred a great deal of conversation on our Facebook page.

In response to Kelly’s story, Peter Raffalli, MD, FAAP, director of Children’s Hospital Boston’s BACPAC (Bullying and Cyberbullying Prevention and Advocacy Collaborative) has written a companion blog exploring bullying’s affect on health and provides advice for parents on behaviors to look out for if you fear your child may be a bullying victim.

Reading Kelly’s account of her childhood experience with bullying, I am truly struck by her courage. She also brings insight on the impact bullying has on its victims and the potential protective influences family and friends can provide. Bullying is such a common and age-old problem, but sometimes I marvel at how overlooked it can be. However, in the last decade we have seen a groundswell of attention to the scourge of bullying.

Kelly clearly had one important weapon in the battle against bullying: a strong, supportive, loving family. Studies show that one of the protective influences in bullying dynamics is a strong supportive family and a good friendship network. Communication between family members is important. Victims of bullying are very reluctant to report it or talk about it. If communication with your child is poor to begin with, then the chance of detecting the bullying is poor.

Peter Raffalli, MD, FAAP

Parents who have endured the tragedy of losing a child to bullying tell us that it is of utmost importance that parents, schools and pediatricians familiarize themselves with the warning signs of bullying from their child, either as the victim or aggressor. A parent should think of bullying as one of the possible causes of any change in their child’s functioning or behavior. Examples include a change in grades, depressed mood, a change in sleep patterns, an increase in physical complaints (headaches, stomach upset, etc…) or perhaps a new attitude of school avoidance. As with many other public health problems, early detection and intervention of bullying can have a huge impact on outcome.

Another insight we gather from Kelly’s story involves the way in which she was bullied. Kelly experienced shunning, otherwise known as exclusion. Shunning is one of the more prevalent forms of bullying. As human beings, we are all sensitive to being cast out of the group. Being socially isolated is painful. Shunning tactics are also more stealth and difficult to detect than physical bullying, like pushing, hitting or kicking. Again, a good friendship group can help insulate your child from shunning. Keep tabs on how well your child is doing with regard to making and keeping friendships. Ask your child who he/she eats lunch with. Who does he hang out with at recess? Does she get invited to afterschool events like birthday parties? If you conclude that your child is, in fact, not doing well socially, this does not by itself mean that he or she is being bullied. But it should alert you to the fact that your child may be at risk. This will help you to be more vigilant and to pick up on bullying sooner rather than later should it occur.

Shunning is bullying but can be harder to detect than physical contact

If you are concerned that your child is being bullied, then you will likely need guidance as to the next step in helping your child. For this reason, I started BACPAC – the Bullying and Cyberbullying Prevention and Advocacy Collaborative – here at Children’s Hospital Boston. The BACPAC webpage has many useful links with information for parents, schools and health care providers.

It is important that we always remember that both the bully and the victim are kids who are still developing (teens included). Though it’s not talked about as often, studies have shown that the bully is also at increased risk for mental health and legal trouble later in life. We need to be devoted to helping both bully and victim, and the earlier we intervene in the developmental process, the better the outcome. We keep in mind that our efforts need to be more therapeutic than punishing. However, there will be more severe situations involving criminal behavior where law enforcement will need to be involved. It is of utmost importance to protect the victim and to remember that bullying is a form of abuse. Bullying is NEVER the victim’s fault.

Kelly’s story is inspirational. Fortunately, she had the fortitude to focus on what was important to her, including her loving family and her dedicated medical team. It’s important that we remember, however, that many children do not make it through their bullying experiences so well intact. Many suffer long term psychological and medical effects including depression, sleep disorder, academic underachievement, poor self-control, inattention and headache, to name a few.

We are all aware of the tragic cases of bullying-related suicides that have captured national attention in recent years. Unlike some public health problems, we won’t see a vaccine developed for bullying. Knocking this public health problem down will require good ol’ fashioned vigilance, detection, early intervention and follow-up on a case-by-case basis. It will require a coordinated effort with parents, schools and pediatricians all working together. As with any public health effort, education about the problem, its warning-signs and the potential avenues of help is an important first step.

Questions? Contact BACPAC at Children’s Hospital Boston: www.childrenshospital.org/BACPAC



One thought on “A doctor's response to bullying

  1. Such an important issue – good to hear a doctor’s perspective, too. My kids are just entering school and I’m remembering the levels of violence that can happen and feeling worried.

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