Understanding Childhood

Bullying: Our Roles

Florianne Feliza F. Valdes,M.D.,FPPS
Director, Center for Patient Partnership,The Medical City
Immediate President, Philippine Ambulatory Pediatric Association,Inc.

Be Empowered Against the Threat of Bullying

Depatment of Education
Pasig City Division
February 4,2014
Florianne Feliza F. Valdes,M.D.FPPS
OB.S. Psychology, U.P. Diliman
ODoctor of Medicine, University of the East Ramon
Magsaysay Memorial Medical Center
(UERMMMC)
OResidency in General Pediatrics, UERMMMC
OInternational Fellowship in Ambulatory Pediatrics,
Montefiore Medical Center, Albert Einstein College
of Medicine, Bronx, New York
OChild Protection Training, Montefiore Medical
Center
O Past President, PAPA( Philippine Ambulatory Pediatric Association,
Inc.),2011-present
O Secretary-elect,Board member, Society of Adolescent Medicine of the
Philippines,Inc.( SAMPI)
O Director, Center for Patient Partnership, The Medical City Hospital,2000-
present.
O Member, Section of International Child Health, American Academy of
Pediatrics, 2010-present
O Founding member,Secretariat Head, Asia Pacific Child and Family Health
Alliance for Tobacco Control
O Asst.Clinical Professor, Department of Pediatrics,UERMMMCI
O Faculty, Ateneo School of Medicine and Public Health
O Editor-in-Chief, CITYSCAN, official magazine of The Medical City
O Columnist. Talk to Doc, Philippine Star, 2009-2010
O Fellow, Philippine Pediatric Society (PPS)
O DiplomatePhil.Society of Adolescent Medicine
 Focus
O What is bullying?
O Who are the bullies?
O Who are the victims?
O Why do bullies bully?
O How do we know the signs and red flags?
O How do we address bullying?Intervention and
prevention
O The roles of clinicians, teachers, parents, the
community
 Bullying
O Inevitable part of growing up?

O US: 1 out of 5 ( 8-15 year olds) are bullied,

involved in bullying, target or both

O Victims and bullies experience long-term

health and behavioral consequences.
O Imbalance of power
O Age, strength, size,physically, psychologically
vulnerable
O Repeated,unwanted, ongoing pattern of
aggressionamong school aged childen
O Different from fighting, teasing\bullies,
victims, bystanders
 Common forms of bullying
TABLE 1CLOSE

Type of bullying Direct acts Indirect acts

Physical Hitting, kicking, spitting ,shoving, Enlisting a friend to assault
slapping, sexual grabbing, someone for the bully
destruction or theft of property

Verbal Taunting, teasing, racist remarks, Spreading rumors

sexual harassment, name calling,
insults,threats

Nonverbal and nonphysical Threatening or obscene gestures Exclusion from a group,

manipulation of friendships,
threatening notes or e-mails

Lynznicki,et al.Childhood Bullying:

Implications for Physicians AFP,Nov.2004
 Types of bullying
O Verbal
O Social
O Physical
 Characteristics of Children who
Bully
Impulsive, “hot-headed,” dominant personalities

Physically strong( big), with good or inflated self-

esteem, and feel little or no responsibility for their
actions

Easily frustrated; have difficulty conforming to rules

 Who are the bullies?
O May experience peer rejection and social isolation,
contributing to an increased risk of depression, suicide,
and antisocial personality disorder
O May experience or witness violence and abuse at home
(e.g., by parents or other caretakers)
O May experience lack of parental involvement,
supervision, and nurturing during childhood
O At increased risk for school failure and dropout, and
future problems with violence, delinquency, and
substance abuse; in boys, increased risk for multiple
criminal convictions in adulthood
 Who are the Bullies
O Expect others to pick on them; see threats where
none exist
O Antisocial; defiant toward adults
O Unable to understand the emotional experiences
of others
O Have a positive attitude toward violence
O May have psychiatric disorder contributing to
aggressive behavior (e.g., antisocial personality
disorder, attention-deficit/hyperactivity disorder)
 Who are bullied?
O Quiet, cautious, sensitive, insecure; may have difficulty
asserting themselves; appear to do nothing to provoke
attacks and are unlikely to retaliate if attacked or insulted
O May be perceived as being “different” or weak
O May be isolated socially and report feeling sad or lonely
O May experience psychosomatic symptoms (e.g., sleep
disturbances, enuresis, unexplained abdominal
discomfort, or headaches)
O Chronic bullying may interfere with social and emotional
development and academic performance
 Who are bullied?
O May become cynical if they think authority figures
let the bullying persist
O May accept that they deserve to be taunted, teased,
and harassed (similar to victims of domestic
violence and other forms of abuse)
O In rare cases, may harm themselves or others, or
even consider suicide rather than endure continual
harassment and humiliation
O At risk for depression and poor self-esteem later in
life
Extra vulnerable populations
O LGBT – 86% harassed,60% feel unsafe,1/3
absent at least one day in the past month, 4x
more likely to attempt suicide

O Children with disabilities or other special

health care needs

O Overweight/Obese/Different
Characteristics of Reactive Targets
of Bullying (Bully/Victims)
Are targets of bullying and also bully younger or weaker children
May be difficult to identify at first because they seem to be
victims of other bullies; a reactive victim may provoke a bully
into action, fight back, then claim self-defense
Hyperactive, quick-tempered, emotionally reactive children;
prone to irritating and teasing others to create tension; attempt to
fight back when insulted or attacked
At particular risk for persistent social and behavior problems,
including social isolation, failure in school, smoking, and
drinking
 Myths about bullying
O Bullies are unpopular
O Bullies have low self esteem
O Boys- violence, girls- words
O Bullying victims make themselves targets
O Adults make bullying worse
Recognizing the Clinical Signs
O Increases complaints of O Frequent headaches,
illness to avoid school stomach aches
O Change in eating habit O Anxiety, sadness,
O Significant weight depression
loss/gain O Withdrawing, acting
O Unexplained cuts, out, other changes
injuries O Suicidal
O Trouble sleeping
ideation/attempt
Effects of bullying:on the bullies
O Can be a sign of more serious antisocial and
violent behavior
O More likely to abuse alcohol,other substances
O Get into fights,vandalize,drop out
O Engage in early sexual activity
O Have criminal convictions, traffic citations as
adults
O Be abusive towards their partners, spouses,
children
Long term effects on the bullied
O Depression and anxiety
O Increased feelings of loneliness
O Sleep and eating pattern changes
O Loss of interest in activities theu used to enjoy
O Health complaints – psychosomatic( recurrent,
unexplained)
O Decreased academic achievement
O Miss, skip, drop out
Internet bullying/Cyber bullying

Megan Meier,13,committed suicide Oct 2006

Internet Bullying/Cyber bullying

Tyler Clementi,jumped off the bridge when his

roomamte posted a sex video of his on Twitter
 Cyber bullying
O Repeated use of IT( email, IM,blogs,chats,cell
phones, gamings) to harass, threaten,
intimidate, humiliate
O Anonymous
O 42%have been c bullied
O 35% threatened on line
Different types of cyber bullying
O Flaming
O Dissing
O Bash Boards
O Impersonation
O OutingTrickery
O Exclusion
Challenging Roles in Prevention
and Intervention
O Early detection of risk behaviors
O Teachers: sensitivity,care and concern,talk to them
O observe keenly,non judgemental, dialogue with
students, parents
O Role models
O Committees n schools,policies
O MAKIALAM
O Information drive
O Refer, confer- parents, other school authorities
 Teachers

O Respond in a positive and accepting manner, support

O Seek help from other school staff ( teacher/guidance counselor),
parents
O Be involved programs against bullying
O Ask the child for thoughts, teach how to respond
O Encourage a popular peer to help enforce the school no to
bullying policy
 Practical tips
O Strategies; get adult help
O Seek adult help if you feel threatened, get a
buddy
O Frustration epression, anger management
O Stand up for your classmates
O Hanging around and watching fights/bullying
makes you a bystander, co responsible
 Clinicians
O ask at every visit
O Do a thorough physical exam
O Be involved in schools( PTA), communities
O Be an advocate, engage colleagues
O Media resource
 Parents
O Be parents!
O Nurture
O Engage your children, be involved
O dialogue
O Positive outlook
O Non violent environment
O Encourage social skills development
O Speak up for your child
Different types of c bullying
O Harassment
O Happy slapping
O Text wars/attacks
O On line polls
O Sending malicious code
O Images/videos
O Griefing
O Recognize
O Be aware
O Be informed
O Intervene
O Protect
O Prevent