Paediatricians urged to tackle bullying with a one-minute intervention

A Vanderbilt University paediatrician says clinicians can spot the health effects of bullying early and support children through a brief, structured response involving families, schools and follow-up care.

Bullying can leave lasting marks on a child’s health, which is why paediatricians should treat it as a clinical issue rather than a rite of passage, Seth J. Scholer said at the American Academy of Pediatrics National Conference & Exhibition in San Diego. Scholer, a professor of paediatrics at Vanderbilt University Medical Centre, said doctors who see children regularly are well placed to spot problems early, offer support and help families act before harm escalates. The American Academy of Pediatrics has similarly said paediatricians are often among the first professionals able to identify bullying and connect children with schools, families and community supports.

Scholer said the consequences can affect both children who are targeted and those who bully others. Victims face higher risks of depression, anxiety, sleep problems, poorer school performance, lower lifetime earnings and suicidal thoughts, while children who bully are more likely to develop later aggression, conduct problems, antisocial behaviour and criminal offending. Children’s Hospital Colorado and other paediatric guidance resources also link bullying with truancy, falling grades, anxiety and depression, underlining that the issue can quickly become a broader mental health and safety concern.

Rather than relying on a direct question about whether a child is being bullied, Scholer recommends a more systematic approach. He advises clinicians to look for warning signs such as stomach aches or headaches, repeated absences from school, slipping grades, behaviour changes and suicidal thoughts. For children who may be bullying others, signs can include verbal or physical aggression during conflict, blaming other people for their actions or taking belongings that do not belong to them. He also recommends screening tools such as the AAP Bright Futures questionnaires and the HEEADSSS assessment, while using open-ended questions about school life because some children do not understand the word “bully” or may be reluctant to use it.

If bullying is suspected, Scholer said the next step is to learn more about how it is affecting the child socially, physically and academically, and to assess what may be increasing risk. That includes factors that make the child stand out from peers, as well as protective influences such as strong parental support and a positive school climate. The American Academy of Pediatrics has also encouraged paediatricians to work with school staff and act as community resources, reflecting a broader view that bullying is best addressed through coordinated care rather than a single office conversation.

To make intervention more practical in a busy clinic, Scholer has developed a one-minute response. He said it should include reassurance, encouragement to involve the school, provision of resources and a planned follow-up within one to two months. At that return visit, paediatricians can screen for and refer children if anxiety, attention-deficit/hyperactivity disorder, poor social skills or autism may be contributing. If time allows, Scholer recommends coaching children on how to respond firmly, such as saying “stop”, and helping them identify a trusted adult to contact. For parents of children who bully, he stresses positive role-modelling and avoiding corporal punishment. He also suggested martial arts and sport as healthy outlets, and said practices can help prevent bullying by offering anticipatory guidance, supporting the AAP Family Media Plan to reduce cyberbullying and screening for unhealthy parenting behaviours linked to childhood aggression.