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Bullied children end up in school nurses' offices

Elementary school children who are victims of peer bullying - along with the bullies themselves - made more frequent visits to a school nurse's office with complaints of physical illnesses and injuries.

Bullied children end up in school nurses offices

Elementary school children who are victims of peer bullying - along with the bullies themselves - made more frequent visits to a school nurse's office with complaints of physical illnesses and injuries than their other classmates.

The message is that a child might be getting frequent stomach aches from being picked on.

The study revealed a useful strategy for detecting aggressive interactions among children that may otherwise go unrecognised. If a child is frequently showing up at the nurse's office with a fever or vomiting and no obvious illness, it might reflect the visit is related to victimisation and to some extent aggression.

The report is intended to prompt investigation into such cases to see whether school officials need to intervene to stop bullying.

Researchers studied 590 American children in classes 3 through 5, and identified a small but statistically significant number who were involved in bullying incidents in six primary schools. These students went to a nurse's office an average of 4.7 times during the 2000-01 school year.  It was found that aggressive interactions among children can hurt their health and do particular harm to the victimised child, who is likely to become socially withdrawn. About 45 percent of trips to the school nurse were for somatic, or physical, complaints such as headaches. Another 13 percent of visits were for illnesses with physical symptoms, while 42 percent were for physical injuries with no obvious reasons, based on nursing log notes.

The researchers used questionnaires to survey students on aggression and victimisation, asking them about abuse, which ranged from being kicked or grabbed in a mean way, to a child telling lies about a classmate. Because children often under-report their own aggression, they were asked to circle the names of classmates who hit, kicked, punched others or spread mean rumours, among other things. On average, boys scored higher than girls on peer-reported aggression, while scores on being victims of bullies did not significantly differ by gender.

The focus doesn't have to be on bullying, per se, but on developing the necessary skills to help children in situations where bullying might arise. A second approach is to change the classroom culture by hanging banners with anti-bullying messages, showing skits and plays that explore aggressive interactions, and training teachers to look for signs of bullying and send a message that it's not acceptable.

There are some successful outcomes from programmes that work to reduce aggression and victimisation in schools. Changing the overall climate is an approach that is effective and shows good results with elementary school children. However, further studies are needed to include rigorous measures of health outcomes, data from physical exams and medical diagnoses to further examine the relationship between bullying and child health.
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