Health Care Providers Can Help Prevent and Respond to Bullying

Recognize the symptoms of bullying:

• Physical injuries, headaches, sleep disturbances, or other physical symptoms that aren’t fully explained by a known medical condition.
• Depression, anxiety, self-harming behavior (common for girls) and anger, aggression, and engagement in risky and impulsive behavior (more common for boys). Children’s grades or test scores may be negatively impacted as well.
• Children who are both perpetrators and targets of bullying may have poor peer relationships, health problems, and aggression.

Discuss bullying during visits for well-child care, annual school or sports exams, and routine acute care. Because some children internalize victimization or emotional difficulties, the physical or emotional impacts of bullying on children – whether they are targets or perpetrators -- might not be readily apparent to family members, educators, or health care professionals. Clinicians might inquire about changes in behavior, appetite, and sleep, and about children’s attitudes toward school as ways of screening for involvement with bullying.