Open Communication and Education Are Key to Bullying Prevention

School is back in session. Kids are back interacting with other kids. And concerns about bullying, particularly cyberbullying, are back on the minds of parents. October is National Bullying Prevention Month, a time to help raise awareness of bullying’s harmful effects on children.

There are four main types of bullying—verbal, social, physical, and cyberbullying—and kids of all ages may experience one form or another during their school years or beyond. Verbal bullying is name-calling, insults, or threats. Social bullying is spreading rumors, excluding someone on purpose, or embarrassing someone in public. Physical bullying is any form of physical aggression toward another person. Cyberbullying is using digital platforms to harass, threaten, or humiliate someone.

The prevalence of cyberbullying is on the rise, according to Stanford Medicine Children’s Health pediatrician Nadereh Varamini, MD. “It can amplify bullying through anonymity and 24/7 accessibility,” she explained.

With this type of bullying, “it’s very important for parents to have digital literacy and monitor the online behavior of their children, while also respecting their privacy,” Dr. Varamini said.

While parents may think that taking away their child’s phone is the answer, teenagers think that their phone is their life, so it’s not a good idea to take it away, she said.

“It’s better to block the platforms we don’t want them to be involved with and supervise and monitor them.”

With all types of bullying, open communication with a parent, counselor, teacher, or other trusted adult is key. Children need to feel that they are being listened to without judgment.

While any child could be at risk of being bullied, those at higher risk are children who appear different from their peers, either by appearance, behavior, or socioeconomic status, or who are perceived to be shy or weak. Kids who are less popular or have fewer friends also can be targeted.

“I see bullying with my patients as early as in kindergarten, and cyberbullying around age 9 or 10 if they have a smartphone,” the pediatrician said.

For the younger kids, Dr. Varamini talks to them about bullying, what type of bullying they may have suffered, and what they did about it. She then role-plays with them, playing the role of the bully, and explains what to do to feel safe and what to say if they don’t feel safe.

“You should hold your hands up, say, ‘Stop, I don’t like this.’ With a strong voice, stand as tall as you can and then turn your back,” she explained.

For teenagers, she asks, “Did you report the bullying to a parent, guardian, or school authority?”

“We need to encourage open dialogue, without blame, without pointing a finger, and make sure they know we have 100% unconditional love for them,” she said. “And we need to make sure they don’t feel guilty.”

At appointments, “I assess any signs of stress and changes in behavior that might indicate bullying. I offer support and refer them to a counselor if I see severe anxiety and depression (because of the bullying),” she added.

“Checkups are good opportunities, especially for teenagers who are not open to talking to parents as much as before … that they have a trusted pediatrician who has often known them since they were little,” Dr. Varamini said. “The way you talk to them can put them at ease. I tell them this office is a sanctuary. You can talk about anything you want to, and I will keep what you say private.”

She does clarify, however, that she will talk to their parents if they discuss hurting themself or someone else. Also, once a child reaches age 12, she gives them a questionnaire at each checkup where several questions focus on their emotional health to access any signs of anxiety or depression.

Besides their emotional health, physical complaints such as stomachaches, headaches, or a change in sleep pattern or appetite, as well as decreased academic achievement or avoiding social situations, are additional signs of bullying that Dr. Varamini or parents can look for with their older child. For younger children, there could be a sudden change in behavior or in their mood, unexplained injuries, or losing a personal item.

“Our role as pediatricians and parents is to emphasize that bullying is harmful, and it’s not a rite of passage to get bullied,” Dr. Varamini said. “Some victims might become aggressive or turn to being a bully themselves as a defense response.”

Dr. Varamini, along with about 20 other parents, created a bullying-prevention program when her daughter was in middle school. The monthly presentations made a big difference in decreasing bullying incidents at the school, she recalled.

They taught the implications of sharing information online; the importance of online etiquette; that once something is posted online it is there forever, anybody can see it, and they have no control over the post; about using privacy settings to control who sees their posts and profiles; how to report an incident of abusive behavior on social media platforms, and to block the offenders; and finally, how to be empowered to act if they witness bullying, particularly cyberbullying.

It’s all about “education and awareness,” Dr. Varamini said. She also discusses bullying in a HealthTalks podcast.