Bullying can begin as early as kindergarten, and it can affect all children regardless of race, gender and socioeconomic status. About 25% of high-school students have reported being bullied, 13% of those students have considered suicide and 8% of those who considered suicide admitted to attempting suicide.1

Jessica Henderson Daniel, PhD, a psychologist at Boston Children’s Hospital, notes the multiple types of bullying. Physical bullying occurs when one individual gains power over another through kicking, punching, hitting or other physical attacks. In relational bullying, gossip or rumors may be spread about the targeted person, or the person may be excluded from social situations. Peer sexual harassment is characterized by unwanted and/or inappropriate sexual touching and/or language that creates a hostile and unsafe environment for the victim. In stereotyping, bullying takes place because of the victim’s race, ethnicity, religion, disability, sexual orientation or gender identity. Finally, cyber-bullying is delivered through email, text messages or such social networks as Facebook or Twitter.2

The American Academy of Pediatrics (AAP) offers some ideas that health-care providers can share with the parents or guardians of children who are being bullied:3

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Ask the child: “How are things at school? “Does anyone get picked on or bullied?”

Listen to the child’s fears and concerns.

Teach the child how to respond to the bullies. Have the child practice how to look a bully in the eye, stand tall, walk away, and speak in a firm voice. Teach him or her to make such statements as, “I don’t like what you are doing,” and “Please do not talk to me like that.” Also teach the child how to ask for help. 

Encourage the child to make friends. Children who are loners are more likely to get bullied.

Support activities that interest the child, such as sports, scouting, or music groups.

Notify school officials of any bullying problems and work with them to find solutions.

Help children’s self-esteem by letting them know that they are valued and cared for.

Health-care providers also can evaluate and educate the bullies themselves. Parents or guardians can help change their child’s bullying behavior by taking steps recommended by the AAP:

Set firm and consistent limits on the child’s aggressive behaviors. Make sure that the child knows bullying is not acceptable.

Be a positive role model for the child. 

Show the child that he or she can reach a desired goal without teasing, threatening, or hurting someone.

Use effective, nonphysical discipline with the child, such as loss of privileges.

Help the child understand how bullying hurts other children.

Develop practical solutions with others. Work with school officials, teachers, and the parents of the bullied child to find positive ways to stop the bullying.

Jeanne S. Sluk, BSN, RN, is a nurse practitioner student at Carlow University in Pittsburgh, Pa.


  1. Roehr B. “Bullying Doubles, Rape More Than Triples Risk for Teen Suicide.” MedScape News. Nov. 15, 2010.
  2. Daniel JH. “What Makes a Bully.” Pediatric Views. August 2006.
  3. American Academy of Pediatrics. “Bullying: It’s Not Ok.” HealthyChildren.org. Last updated: Jan. 4, 2012.
  4. All articles last accessed September 4, 2012.