Research In Action

A new study (Oncioiu et al) published in this month’s issue of Pediatrics found nearly two-thirds of youth ages 6 to 17 reported peer victimization during elementary and/or middle school. This is a disturbingly high incidence rate of bullying, particularly considering victimization has been linked to issues related to social-emotional development, peer relationships, and school engagement. However, there are significant ways supportive adults can intervene, even outside of school settings.

In an accompanying commentary co-authored with my CHOP colleagues Brooke Paskewich, PsyD and Nathan Blum, MD, we explore the vital and unique role pediatricians play in curbing bullying. Screening during well-child visits for elementary and middle school-aged patients can include brief questions related to peer friendships, social conflicts, and peer victimization. For example – What is school like for you? How do you get along with other kids? Do you ever feel that other kids treat you poorly? As appropriate, clinicians can obtain additional details and the impact of these experiences in school and at home. In addition to providing resources and referrals when peer victimization is identified, physicians can also help families understand different forms of peer bullying (physical, verbal, relational, and cyber) and identify incidents of victimization.

Here at CHOP, since 2015 we’ve incorporated a network-wide bullying screen as part of our Electronic Health Record (EHR), making asking about bullying and victimization a standard part of the care that many of our patients receive. If a screen is positive, providers can access and provide patients and families with up to eight evidence-based fact sheets. In 2019, nearly 110,000 CHOP patients received bullying prevention screenings and referrals, identifying over 2,000 victims and bullies. Of note, CHOP providers have anecdotally reported an increase in their awareness of bullying due to having the screening questions embedded within their work templates.

Risk Factors for Chronic Victimization

In the Oncioiu et al study, the authors also identified early risk factors for chronic victimization. These include:

• Boys and children with high levels of externalizing behavior – such as hitting, biting, or kicking – at age 5 or younger
• Paternal history of antisocial behavior

If pediatricians can identify these risk factors early on and provide patients and families with necessary supports (for example, connecting parents with parent training or appropriate behavior therapy), providers can help to change these trajectories and better protect children from victimization down the road. Trajectories of victimization can change over time, and pediatricians, teachers, and parents can play an important role in supporting positive change.

Click here to read more about the commentary in CHOP News.
Click here for additional information on bullying in schools.