December 13, 2013

When a Date is a Threat — Violent Romance

A disturbing number of teenagers experience physical violence in their dating relationships, a situation that can lead not only to physical injury, but depression, eating disorders, academic problems and other harms.

As discussed on, a recent study published in the Journal of School Violence reported that 1 in 10 U.S. high-school students reported being hit or otherwise physically harmed by a dating partner within the last year.

The incidence of being hit, slapped or otherwise physically hurt was nearly equal between males and females who participated in the survey. But there were racial differences: There was a statistically significant increased rate of dating-violence among blacks (nearly 13 in 100) and multiracial youths (about 12 in 100) compared with whites and Asians (8 in 100) or Hispanics youth (about 1 in 10).

The study analyzed data from 100,901 students who participated in the Youth Risk Behavior Surveillance System survey (YRBSS) from 1999 to 2011. It concluded that more than 9 in 100 U.S. high school students have been "hit, slapped, or physically hurt on purpose" by a boyfriend or girlfriend in the last year, a rate that has not changed significantly in the last 12 years despite efforts to curb dating violence in the last decade.

The researchers, from Boston University’s School of Public Health (BUSPH), called the incidence of youth hurt by dating partners a serious public health concern because its consequences can include depression, eating disorders, injury and in the most severe cases, death.

"While 9 percent may sound low, this figure puts dating violence on par with many of the other public health issues that we tend to view as serious problems, such as obesity, frequent cigarette smoking or driving after drinking," Emily Rothman, associate professor of community health sciences at BUSPH, said in a news release. "The real concern here is that the rate has not gone down at all in the past 12 years, while the rate of physical fighting with peers has decreased significantly.

"That means that whatever headway we have made in reducing youth violence does not extend to people in dating or sexual relationships."

Malcolm Astley, the father of one girl who was murdered by her boyfriend, said parents, teachers, school counselors and legislators must grasp the extent of the problem of dating abuse and address it. The risk is most extreme during break-ups, and it’s up to adults to help kids understand and handle their feelings.

Which, like bullying, speaks to the necessity of parents knowing what’s going on in their childrens’ lives, even if the kids resist. It can be a matter of life and death.

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October 4, 2013

How Bullying Makes Kids Sick

According to a new study published in the journal Pediatrics, children who are bullied suffer more than just psychological and social problems; their risk of physical health problems might be about double that of kids who aren’t bullied.

The study findings, discussed on, weren’t surprising, as all the individual studies included in this meta-analysis (several separate studies examined in conjunction with each other) had shown higher rates of health complaints in bullied versus nonbullied children, and in nearly all of them, the differences were statistically significant.

The data pooled from six studies involved more than 3,900 children. They looked at complaints such as headache, disordered sleep and abdominal pain in kids who reported being bullied at school compared with those who didn’t report being bullied.

Another set of data derived from 24 different studies was similar; those studies involved more than 200,000 children.

The studies occurred throughout the world, in the U.S., China, India, Mexico, Turkey and many nations in Western Europe. The follow-up ranged from nine months to 11 years.

The researchers used studies that reported incidences of physical symptoms other than traumatic injuries in children who reported bullying or no bullying. The determination of whether or not one had been bullied was that of the interviewed children, or in reports by parents or teachers. Voluntary, self-reporting can skew study results because it’s subject to mistakes or misperceptions in recalling the events. But meta-analyses such as this one provide more persuasive results because of their size and scope.

The study’s authors recommended that pediatricians consider bullying as a cause when their patients present with headache, respiratory and eating problems and insomnia. "Any recurrent and unexplained somatic symptom can be a warning sign of bullying victimization," the researchers wrote.

They also said that physicians should review the potential symptoms of bullying with parents because children are often reluctant to talk openly about bullying episodes. If your child complains of something like a headache or stomach ache that has no apparent or logical explanation, consider the possibility that he or she is being bullied, and treat it as the health issue it is.

For more information about conditions that might invite bullying, see our blog “A Profile of Kids at Risk of Being Bullied.” Also, consult, an initiative of the U.S. Department of Health and Human Services.

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March 8, 2013

The Perils of Underage Use of Social Media

It’s a techno world, we just live in it. As much as parents want to give their children everything they need for learning and having fun, the adoration many kids have for social media poses important boundary issues.

Writing on, pediatrician Natasha Burgert recalls a visit from a 10-year-old patient who had a completely age-appropriate love for dancing, gymnastics and horseback riding, and, as Burgert saw it, a wholly unacceptable involvement in Pinterest, a photo-sharing website where users create and manage thematic posts based on their interests and events.

Burgert was discomfitted to learn that not only was the child active on Pinterest, but that her mother had helped her set up the account. Said mom: “[T]he stuff she looks at is OK. She likes arts and crafts, and looking at hairstyles. Sometimes she shares ideas with me.”

Burgert clearly believes it is not OK for a 10-year-old to be surfing the web alone. She said there’s a common misconception by parents that social media sites are suggested for children older than 13, based on the network’s content, like a PG-13 movie.

By federal law, users of social media sites must be at least 13 years old.

The long-term consequences of a 10-year-old’s online activity are unknown. Do you really want to risk your child’s future?

Here are Burgert’s reasons for encouraging parents to enforce the age limit on social media:

1. A child younger than 13 (U13) is protected by the Children’s Online Privacy Protect Act (COPPA). Essentially, COPPA protects a child’s personal information from being collected and shared. Such protection is being updated to include online data tracking, location, photos, videos, and information available to third-party advertising networks.

Creating an account for a child U13 using a false date of birth circumvents the federal law. That means the social networks, and all the information your child shares, are completely out of your control.

(Some people believe that COPPA laws decrease a child’s protection online, arguing that without COPPA, fewer children would lie about their age, which would enable better online protection based on their true age. But it’s still the law.)

2. Kids know the U13 rule. If you, as a parent, falsify your child’s age to create an account, you are saying that it’s OK to lie on the Internet. You are saying that the rules don’t apply to your kid. Is that really what you want to do?

“Teaching appropriate boundaries and limitations on the Internet are of paramount importance,” Burgert writes. “Parents should be providing an example of ethical and responsible internet citizenship. This means enforcing the rules.”

3. Children U13 do not have the intellectual or emotional maturity to handle many social media themes. Pre-teens have enough trouble with real-life social interaction. Their reasoning skills are developing, and they’re vulnerable to online harassment, solicitation and cyber-bullying. “Allowing a child U13 on a major social site,” says Burgert, “is only prematurely increasing this risk.”

4. There are safer alternatives for children U13. Learning how to navigate and interact on social media sites is an important skill, and kids need to learn responsible Internet behavior. But some pre-teen social networks enable this education, they’re fun and they provide legal protection. For guidance in this realm, and a list of such sites, link to Common Sense Media.

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January 11, 2013

A Profile of Kids at Risk of Being Bullied

It’s no surprise that vulnerable kids are ripe for bullying. Two recent studies found that children who suffer from food allergies and those involved in weight-loss programs reported being bullied by their peers. But it might surprise that those who are victimized because of their weight are sometimes bullied by their parents.

Both studies were published in the journal Pediatrics, here and here.

In one study, nearly one-third of children with food allergies reported bullying or harassment specifically related to their allergy, often involving threats with food. In the weight study, nearly two-thirds of teens at weight-loss camps reported weight-related victimization.

Bullying can cause great harm. See our post about the connection between bullying and suicide. Less dire consequences include social isolation, poor academic performance, depression, anxiety and chronic health problems.

As described on, surveys of 251 food allergy patients ages 8 to 17 and their parents were analyzed at a single allergy clinic.

Forty-five in 100 of the kids and 36 in 100 of their parents reported bullying or harassment. Eight in 10 bullies were classmates, and 6 in 10 bullying incidents happened at school. Verbal teasing was common, as was waving the allergen in front of the child; 12 in 100 kids had been forced to touch the food to which they were allergic.

Most of the bullied kids said they had reported the bullying, but parents knew in only about half the cases. When the parents did know, the situation improved for the kids.

The weight study included 361 kids ages 14 to 18 surveyed online while they attended two national weight-loss camps. One-third of the respondents were in the normal weight range; nearly one-quarter were overweight and 4 in 10 were obese. The first group represents many kids who previously had lost significant amounts of weight and had returned to the program for maintenance.

The more the kids weighed, the better their chances at being bullied, although many of the normal weight groups remained at risk.

Bullying came in the form of teasing, relational victimization (behavior aimed at damaging relationships or one's social reputation), cyberbullying and physical aggression. The most common bullies were:

  • peers (9 in 10)

  • friends (7 in 10)

  • physical education teachers or sport coaches (4 in 10)

  • parents (nearly 4 in 10)

  • teachers (1 in 4)

The researchers said that some of the adults might have been well-meaning, but made clear that any bullying can be extremely damaging. As MedPageToday summarized, bullying has immediate and long-term effects, both physical and emotional.

The researchers concluded that pediatricians and other caregivers should become front-line interveners when a patient presents with symptoms or stories of bullying. That means helping kids and their parents anticipate and handle incidents, and teaching parents how to recognize bullying clues.

Even if your kid isn’t talking, sometimes you can recognize if he or she has been bullied. Physical clues include unexplained bruises, cuts and scratches; behavioral clues are avoiding school and social events, substance abuse, anxiety and depression. In addition, kids might have chronic headaches or stomach aches.

Simply realizing that if your child suffers from food allergies or excessive weight, he or she is particularly at risk; you can help him or her be prepared for what might occur.

If the bullying occurs at school and at home, the researchers said that "healthcare providers may be among their only remaining allies."

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December 21, 2012

The Harm of Sibling Rivalry and What to Do About It

What’s the No. 1 parents’ complaint about family life?

Somebody else is always hiding the remote?

Somebody never remembers to lower the toilet seat?

Somebody always returns the car with an empty tank of gas?

Wrong, wrong, wrong. According to researchers at Penn State, parents’ chief concern and complaint is sibling rivalry.
As reported on, the researchers studied 174 rural and urban families. Each family had one child in the fifth grade and one in the second, third or fourth grade. They collected data from the parents by questionnaire, and interviewed each sibling privately. They also videotaped family interactions.

Although siblings screaming at and competing with each other can drive parents to distraction, the researchers, from the Prevention Research Center for the Promotion of Human Development, said that a program they designed demonstrates that elementary school age kids can learn to get along. That’s not only a relief for fraught parents, it’s good for the kids’ health and well-being.

"Negative sibling relationships are strongly linked to aggressive, anti-social and delinquent behaviors, including substance use," research Professor Mark Feinberg said in a news release by Penn State. "[But] positive sibling relationships are linked to all kinds of positive adjustment, including improved peer and romantic relationship quality, academic adjustment and success, and positive well-being and mental health.”

The program developed by Feinberg, Susan McHale, director of the Social Science Research Institute at Penn State and their colleagues, is designed to help siblings learn how to manage their conflicts and avoid engaging in troublesome behaviors.

Called SIBlings Are Special (SIBS), it’s intended for families whose oldest children are on the brink of middle school. That’s the age when kids are more likely to be exposed to and involved in risky behaviors for the first time. The families participating in the study were randomly assigned to take part in SIBS or to be in a control group that wasn’t part of the program.
Among other elements, SIBs includes a series of 12 after-school sessions to teach small groups of sibling pairs how to:

  • communicate in positive ways;
  • solve problems;
  • devise win-win solutions;
  • see themselves as part of a team rather than as competitors.
"We found that the siblings who were exposed to the program showed more self-control and social confidence; performed better in school, according to their teachers; and showed fewer internalizing problems, such as depressive symptoms, than the siblings in the control group," Feinberg said.

But it wasn’t only the youngsters who were “trained”; SIBs offers parenting strategies that Feinberg said led to “significantly fewer depressive symptoms” among mothers in the intervention group than mothers in the control group.

It’s interesting that no effects of the program were seen for fathers regarding depression.

Parents interested in pulling the plug on sibling rivalry needn’t be involved in a specific program; many of SIBs’ lessons are available to all.

If kids are fighting, don’t intervene with a resolution—instead, help them discuss the problem calmly and let them resolve the problem on their own. It’s a matter of providing tools to fix something that’s broken instead of fixing it for them. Once kids experience success with the tools, they’re more likely to use them again when things get thorny.

Also, staying calm when the children aren’t, models behavior they can use. It shows them how discussion and resolution are more likely to occur when the atmosphere isn’t charged with anger.

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