That schoolyard bully who pushes, punches, and threatens other children may in turn commit assault behaviors later, says a Washington-based pediatrician.

Bullying is a growing problem, with the average number of school-based violent events involving multiple victims increasing from one event per school year in 1992 to more than five events per year in 1998, according to a HELP Network fact sheet.

Studies have shown that the prevalence of bullying is about 30 percent in school-age children, says Joseph Wright, MD, associate professor of pediatrics, emergency medicine, and prevention & community health at Children’s National Medical Center. According to the National Youth Violence Prevention Resource Center, approximately 30 percent of youths are involved in bullying by either being the victim, the bully, or both.

Children May Learn Bullying by Example

Girl Bullies on the Rise

The researchers cited other studies that showed that at age 11, 25 percent of boys and 14 percent of girls report bullying others. And at least 22 percent of boys and 26 percent of girls report being bullied.

“While bullying once was seen as an activity of boys, there has been a burgeoning increase in the number of girls who bully,” Wright says. “Girls now threaten, use innuendos, and tease others about their clothes as ways to interact together. They are joining in. Many are bullying through the format of ‘cyber bullying’ through emails, instant and text messaging, and camera phones.”

Styles of bullying range from the direct of pushing, punching, spitting, and tripping to the more indirect of threats of teasing, spreading rumors, and shunning, he says.

Bullying is associated with higher rates of frequent fighting and injuries and weapon carrying, with the associations being stronger for bullies than targets, he told those attending the American Academy of Pediatrics National Conference and Exhibition.

“This isn’t a low-morbidity activity,” notes Wright. “Bullying behavior presents the risk of serious behaviors down the stream. Bullying is weapon carrying, frequent fighting, and injuries.”

Half of Kids Are Bullied, Study Suggests

Bullies More Likely to Carry Weapons

Previous studies have shown that children who were bullied at school and outside of school on a weekly basis were four times more likely to carry a weapon and 3.8 times more likely to bring a weapon to school, he says.

The chances of carrying a weapon were even higher in those children who bullied others weekly in school, he says. “Those who bullied children out of school were more than five times as likely to carry a weapon to school.”

Direct bullying also is linked with depression and suicidal ideation in girls, he says. “This fact seems to say that boys fight and get it over with, but girls become depressed.”

The American Academy of Pediatrics is attempting to attack the problem of bullying and other violent behavior through a program called Connected Kids: Safe, Strong, Secure. The program trains and provides the nation’s pediatricians with tools to help stop violent behavior both in families and children.

The new program provides more than 21 pamphlets for doctors to give their patients as well as education and information to doctors on how to query their patients and families about violent behaviors.

“This is an important issue,” Utah pediatrician R. Joe Jopling, MD, tells WebMD. “Kids have been bullying one another since back when I was a kid. But there is increasing awareness of the health and societal risks.”

The new AAP program will help combat bullying and other forms of violence, he says. “It’s a great tool to help both children and parents.”

Too Much TV May Make Kids Bullies

By Linda Little, reviewed by Louise Chang, MD

SOURCES: American Academy of Pediatrics. Joseph Wright, MD, associate professor of pediatrics, emergency medicine and prevention & community health, Children’s National Medical Center, Washington. R. Joe Jopling, MD, pediatrician, Salt Lake City. HELP Network Fact Sheet, HELP Network web site. National Youth Violence Prevention Resource Center web site.