Doctors should tell parents to talk to their children about bullying, teach children how to resolve conflicts, and promote respectful relationships in dating, the policy says. It also suggests doctors volunteer to talk about the topics at schools, churches, and youth organizations.

The doctors’ group has published educational materials on bullying and dating before, but this is the first time the policy has addressed the issues in detail.

“Violence is a public health problem that needs to be dealt with in the context of health care,” said Dr Joseph Wright of Children’s National Medical Center in Washington, D.C. Dr Wright heads the academy’s violence prevention committee and helped write the recommendations.

Studies suggest children’s early home life, if stimulating and emotionally supportive, can protect them from being victims of bullying later in life, Wright said.

“Having meals with your child, watching television with your child” are among ideas that doctors can share with parents at “every single visit between birth and age 21,” Dr Wright said. The AAP’s Connected Kids protocol provides more detail on what doctors should address.

The policy also says a European program that emphasizes the role of bystanders in preventing bullying in schools could be a good model for prevention efforts in the United States..

Dr Robert Sege of Boston Medical Center, who also helped write the policy update, said the Olweus Bullying Prevention Program teaches children that bullies are kids with problems and bystanders can protect victims.

Schools that use the program teach children that “we take care of our own,” Dr Sege said. Kids learn “even if you have freckles or wear glasses, it’s our job to include you in the social environment.”

According to SafeYouth.org, the National YouthViolence Prevention Resource Center, almost 30% of youth in the United States (or over 5.7 million) are estimated to be involved in bullying as either a bully, a target of bullying, or both. In a recent national survey of students in grades 6-10, 13% reported bullying others, 11% reported being the target of bullies, and another 6% said that they bullied others and were bullied themselves.

Bullying can lead the children and youth that are the target of bullying to feel tense, anxious, and afraid. It can affect their concentration in school, and can lead them to avoid school in some cases. If bullying continues for some time, it can begin to affect children and youth’s self-esteem and feelings of self-worth, the agency reported.

It also can increase their social isolation, leading them to become withdrawn and depressed, anxious and insecure. In extreme cases, bullying can be devastating for children and youth, with long-term consequences. Researchers have found that years later, long after the bullying has stopped, adults who were bullied as youth have higher levels of depression and poorer self-esteem than other adults.[

To prevent dating violence, pediatricians should tell teenagers that respect is important in relationships, Dr Sege said.

He said his personal approach is to ask teens how they make decisions with their boyfriends and girlfriends. He also asks if they are ever afraid on dates.

“I make sure the young lady knows she deserves to be treated with respect and she doesn’t need to put up with a boyfriend who’s so jealous he tries to control what she’s doing,” Dr Sege said.

SafeYouth.org concurs that health care professionals can play a crucial role in the prevention of youth dating violence. They can begin by talking with young patients about how to demonstrate caring, show respect, and resolve conflicts nonviolently.

They can also provide patients with information on how to prevent dating violence or respond if violence occurs. This information can be provided through discussions with patients, in posters or brochures in a waiting room, or through articles in newsletters. Health care professionals can also do presentations throughout the community to educate groups of youth, parents, educators, and youth workers about the problem of youth dating violence.

They can initiate or participate in the development of community-wide or school-based dating violence prevention programs. Health care professionals also have a responsibility to identify those who have experienced dating violence and to offer assistance. Medical and mental health professionals should routinely screen adolescents for dating violence and be aware of appropriate referral sources.