Cyberbullying: an Update on Intimidation in the Digital Playground

By Arshya Vahabzadeh, M.D.

Follow @VahabzadehMD

American Psychiatric Association Leadership Fellow

Resident Physician in Child and Adolescent Psychiatry at MGH/McLean/Harvard Medical School

What is cyberbullying?

Cyberbullying is bullying, intimidation, and harassment that happens with the aid of electronic technology. Cyberbullying can happen through text messaging, social media, and emails. The boundaries of cyberbullying continue to expand as new communication technologies emerge.

Cyberbullying is emerging as a major problem, with new research from the Bureau for Justice Statistics revealing that 9% of teenagers aged 12-18 have reported being cyberbullied in a given year.

Female students are more likely to experience cyberbullying. The most common forms of cyberbullying include harassment by text or instant messaging, or the posting of hurtful information on the internet. Despite the high levels of cyberbullying, an adult is notified in only a quarter of cases.

How is cyberbullying different than traditional bullying?

Cyberbullying can continue 24 hours a day and is not dependent on location. While traditional bullying often requires the physical presence of a bully, a child can be cyberbullied at anytime and anywhere they are in contact with communication technology, including their own cell phone. There may be no “safe” zone and this may intensify the level of distress that the cyberbullying can produce.

Material such as digital pictures, text messages, or social media posts designed to hurt an individual can be rapidly distributed to a large group of people. Often it is difficult to find out the source of the information, giving a degree of anonymity to the cyberbully.

Harassing and intimidating material, once distributed through digital means are also much more difficult to remove. Often videos or pictures may stay indefinitely available through digital means.

What are the effects of cyberbullying?

People who are cyberbullied are thought to be at risk of the same consequences of traditional bullying. These effects include increased depression, decreased self-worth, hopelessness, and loneliness. There is some evidence to suggest that being cyberbullied may result in suicidal feelings in 20% of teenagers, a higher rate than in traditional bullying.

What can we do about cyberbullying?

Promote Good Digital Habits

• Keep your children informed about the risks of the technology they are using.
• Engage your children in a discussion on how to best deal with cyberbullying by formulating a plan for dealing with text messages or other digital content that is upsetting to them. Children should be made to feel as comfortable as possible in discussing their experiences with trusted adults.
• Review and teach them about privacy settings for digital media. Talk to them about limiting the amount of private information they share about themselves.
• Tell children to keep their passwords safe and not to share them with friends or people they don’t know.

Take Action

• Approach a child if you notice signs of changing behavior, especially if it is happening when they are using the computer, their cell phone, or any other communication device.
• Consider discussing the situation with the suspected bullies’ parents, the child’s school, and other organizations they may be involved in.
• Identify and archive the cyberbullying material, it may be useful when contacting the Internet service provider, cell phone company, or in severe circumstances, the police.
• Consider closing down targeted social media accounts or changing cell phone numbers.
• Some cyberbullies thrive on obtaining a reaction, avoiding replying to messages or engaging with the cyberbully may also be useful in some situations.

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Where can I get more information?

More on cyberbullying from stopbullying.gov and girlshealth.gov  and onguardonline.gov

More on bullying

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Part 2: What I wish I knew when my daughter was first diagnosed with autism

Guest post by Carolyn Chambers

As the mother of a 9-year old daughter with autism (Kellie was diagnosed with autism in January of 2008 at the age of 4), I’ve learned some things through networking and making friends with other parents who have kids with autism. Now I want to share more tips with you.

Just because a school district (or Early Intervention) says that a certain program is most appropriate for your child doesn’t mean that it is. As I mentioned in the first part of my blog post, doing your own research is key. Here’s a helpful website about special education law and advocacy for children with disabilities: http://wrightslaw.com. If you don’t agree with your child’s school recommendations, request independent evaluations to help determine what is most appropriate. 

 

Treat each professional (school and medical) who works with your child with respect and as an integral part of your child’s “team.” If you feel that someone is challenging, find someone more appropriate to join the team.

As you are proactively communicating with your child’s team of doctors and teachers, make sure they are communicating with each other about treatment. Is everyone aware of what the other one is doing? This is especially important if your child responds to something particularly well in a session. Share that information with every team member. This will make your child’s programming much more effective! And, if something isn’t working for your child, be sure to let everyone know that as well.

Use your child’s “quirks” or obsessions as motivators for therapy sessions. My daughter went through a Super Mario phase, so we incorporated Super Mario into her sessions as much as possible which was successful.

Another tip for parents who are married: don’t forget your marriage! You and your spouse need quality alone time whenever possible. Autism can be extremely stressful on a marriage. Often parents get overwhelmed; there is simply too much going on in their day-to-day lives, and “date night” loses priority. This is another reason why connecting with parents who have children with autism is essential. They can recommend child care providers and share their advice for focusing on marriage while raising a child with autism.

While you make time for your marriage, you also need to carve out some “me time.” Time to go out with friends or do something you enjoy by yourself that isn’t autism OR child-related. Maybe that means going to Starbucks with a good book.

Families of children with autism need to budget for out-of-pocket expenses for therapies and treatments, so speaking to other, more experienced parents helped me. Unfortunately, many of the therapies are not covered by insurance. I still have a hard time getting health care benefits for my daughter’s speech therapy, which is what she needs the most. However, there are some creative, legitimate ways to get needed therapies covered and/or reduce your out-of-pocket expenses. Here are excellent resources: http://health.groups.yahoo.com/group/autism_insurance_information and my all-time favorite: www.tacanow.org/family-resources/autism-on-a-budget-series.

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What I wish I knew when my daughter was first diagnosed with autism

Guest post by Carolyn Chambers

Greetings! My name is Carolyn, and I’m the mother of two daughters, Kirsten (10 years old) and Kellie (9 years old). Kellie was diagnosed with autism in January of 2008 at the age of 4. My first marriage ended shortly after my daughter got her diagnosis. I ventured into single mom-hood while navigating through the often overwhelming unknowns of what to do when you have a child with autism. There was no “Autism for Dummies” book back then, though after doing a quick Google search, I see there’s one available now. I ultimately had to figure out how to best help my daughter mostly on my own and began researching, reading, networking, and engaging with other parents as well as picking the brains of the many professionals who I had the honor to work with thanks to autism.

The best parent connection that I made was with a former friend from high school who later became my wonderful and supportive husband! One of our mutual friends advocated that we “reconnect” through Facebook since we both have daughters on the autism spectrum.

Which brings me to one of the top tips I can offer to parents who have recently gone through having a child diagnosed with autism: get connected with other parents, so you can learn from their experiences.

Join a parent support group like TACA (Talk About Curing Autism). Personally, this has been my #1 and what helped my daughter the most. I learned so much from other parents’ advice on best therapy providers, doctors, school districts, behavioral-type of programs, treatments, interventions, problem solving, etc. And, as a bonus, I made some life-long friends through the support groups.

You should also attend autism conferences; that’s where you’re going to discover the newest cutting edge treatments and therapies as well as learn about the latest research in development. It’s your chance to be immersed with experts and professionals (and another opportunity to network with parents!).

But be prepared to be confused with all of the conflicting information and advice that’s out there. Researching and consulting with experienced parents and doctors will prove priceless.

Paying close attention to your child’s diet is another helpful tip I’ve received and wanted to share with you. You are what you eat! Learn about all of the special diets out there that are said to benefit children with autism and ADHD. At the very least, cut out the junk food, processed, and artificial ingredients. This is something all parents and caregivers should do for their kids regardless of an autism diagnosis. Understand how the digestive system is connected to what goes on in the brain. There’s plenty of science-based knowledge out there supporting the importance of nutrition. Be sure to ask other parents about what diets have been most successful for their children with autism.

Be wary of “miracle cures.” The curse of being proactive when it comes to researching possible interventions for your child is being exposed to all the countless “treatments” that make too good to be true promises and drain your wallet. Me being an information junkie, I don’t mind reading about some of these “treatments” with a grain of salt. But before considering any treatment, even the ones that are less “out there,” remember to research them thoroughly and speak with as many parents as possible who have tried that sort of treatment. Any treatment you proceed with should be done under an experienced doctor’s guidance.

I have more tips to share, so, please come back next week to read the second part of my post.

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Teaching Kids Gratitude & Generosity

By Faith Rowland, M.D.

Happy New Year! Are you working on your 2013 resolutions? A popular one is being more thankful (like starting a daily gratitude journal). There is definitely a link between thankfulness and mental wellness. I hope to encourage you to not only focus on gratitude in your life but also help you inspire your kids to do the same. If you were raised by parents who valued this quality, you might just smile as we reflect on how to teach our children and teens to be more thankful in 2013.

Let’s review some timeless parental guidance passed on to me by my wise mom and dad.  

     “Say Thank you”

I remember the excitement of getting Christmas gifts from my grandmother’s co-workers in addition to those from my parents and other family members. I’d open and shake each card, smile from ear to ear, set it aside and rush to rip open the next one. My mother would ask me, “Who gave you that gift?” I would never know because I had opened the card too quickly. My mother would make me collect every envelope that I’d impulsively ignored and sit at the dining room table to write thank you cards to every person who took their time and hard-earned money to be kind to me. The question “Do I have to?” crossed my mind (but not my mouth), and I’d write individual notes to each person. Eventually, I actually understood the joy that others received when reading my notes and the value of saying “thank you.” This lesson helped me to understand and appreciate the generosity of others.  

     “Please take care of what you have.”

Moms and dads who demonstrate good stewardship and encourage their kids to do the same will eventually get good results.  We forget that children have to actually be taught how to care for their things. There is no substitute for a parent who is a good example in the area where they want their child to grow. Explaining the value of stewardship and complimenting children when they take care of what they have helps to instill a sense of organization and responsibility. Kids who value what they have will one day become adults who do the same.

     “Save your money if you want it.”

This old-school principle is time-tested and works wonders. There is something about paying for an object ourselves that makes us respect hard work and develop a proper appreciation for money.  I will never forget that my first paycheck as a teenager went to pay for a dental retainer I’d lost. Although I first felt sad about “wasting” my money on a boring retainer, I also realized the lesson my parents wanted to teach me. When MY hard-earned cash went to replace something so mundane, I was sure to take better care of my belongings and recognize all that my parents provided for me.

     ** “Share, serve, and give to others.” **

I saved the most important advice for last; this one puts the previous three into perspective. Showing kids the significance of sharing your resources and serving others remind them that “wants” and “needs” are completely separate. Developing an attitude of service and generosity enhances our mental wellness. Teach your children and teens by being a role model and making service work and donating family traditions (volunteering together at shelters, participating in toy and clothing drives).  

Remember that gratitude and generosity are traits we can and should teach our children. Wishing you and your family a happy and thankful year!

Faith Rowland, M.D., is a child and adolescent psychiatry fellow at the University of Pittsburgh Medical Center/Western Psychiatric Institute and Clinic where she completed her adult psychiatry residency.

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Tips for Talking to Children about the Connecticut School Shooting

By David Fassler, M.D.

Parents and teachers are faced with the challenge of discussing the recent tragic school shooting in Newtown, Connecticut with young children. Although these may be difficult conversations, they are also important.

There are no "right" or "wrong" ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

• Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready.
• Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.
• Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.
• Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
• Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.
• Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends or siblings when going to school.
• Let children know that lots of people are helping the families affected by the recent shooting.
• Don't let children watch too much news coverage with frightening images. The repetition of such scenes can be disturbing and confusing.  

Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

Children who are preoccupied with ongoing questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include sleep disturbances, intrusive thoughts or worries, or recurring fears about death, leaving parents or going to school. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events. They'd rather play ball, climb trees, or ride bikes.

Senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents, teachers and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont. He is also a clinical professor in the Department of Psychiatry at the University of Vermont, College of Medicine.

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Safety Tips for Children with Autism Who Wander

By Arshya Vahabzadeh, M.D. Follow @VahabzadehMD

Resident Psychiatrist and Research Assistant, Emory & Marcus Autism Centers

With 1 in 88 children in the United States having autism, an increasing number of parents and caregivers face the challenges of caring for an autistic child. One of the most difficult areas is dealing with a child who repeatedly wanders away. This can be particularly dangerous for children with autism, as they may have little understanding of their own safety and have a limited ability to communicate to others for help.

Close to half of children with autism have attempted to wander away from a safe situation, and many parents report "near misses" that could have easily resulted in their child drowning or being injured by a vehicle. Sadly, injuries to children with autism are all too common.

In this post, I'll share several ways to help keep your child with autism safe when dealing with wandering behavior.

Understand what causes your child to wander away

This is much easier said than done! Look for subtle clues in their environment. Is the wandering / running aimed at going towards something your child is interested in, like a toy or place; or is your child escaping from situations like a room with many people, a loud TV, or something which is unfamiliar to them? Also look at the response of other people to the behavior -- if wandering / running away results in your child getting something he or she wants, like a candy bar, then this "rewarding" may cause the behavior to happen again.

Increase awareness and identification

Other family members and neighbors should know to get help if they see your unaccompanied child wandering. Some parents give their children medical ID bracelets or plastic wristbands with their child's information and condition. Parents may also use monitoring devices for their child like a personal GPS tracking device.

Keep the house safe

Many parents invest in extra locks and safety latches for the house. Some install window locks and have fencing around their yards. Especially important, because of the risk of drowning, pools and other water containing structures should be fenced or emptied if possible.

Talk to the school and local police

Make school staff aware of your child's risk for wandering or running away so they can keep a closer eye on your child. If possible, attend field trips or make a special plan with the school. Informing local police about your child's condition makes it easier for them to take action if they see him or her walking around unaccompanied. You should carry around a recent photo of your child and pay close attention to what your child is wearing on a daily basis in case you need to describe his or her clothing to a third party.

Sleep is important too

Parents often worry about what could happen to their child when they are asleep. This may be a bigger problem if their child is staying awake during the night. Decreasing the amount of caffeine your child drinks can help. Setting a sleep routine and avoiding daytime napping may also be useful. Sleeping disorders are common among children with autism. If your child's sleep continues to be a problem, talk to your family doctor or see a specialist.

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Tips for Talking to Children about Aurora Shooting

By David Fassler, M.D.

Parents and caretakers are faced with the challenge of discussing the recent tragic shooting in Aurora, Colorado with children. Although these may be difficult conversations, they are also important. There are no “right” or “wrong” ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

• Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready. 

• Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.

• Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.

• Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.

• Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate. 

• Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends when going to the movies or other public areas.

• Let children know that lots of people are helping the families affected by the recent shooting. 

• Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

• Don't let children watch too much television / news coverage with frightening images. The repetition of such scenes can be disturbing and confusing. 

• Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

• Children who are preoccupied with questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include ongoing sleep disturbances; intrusive thoughts or worries; recurring fears about death, leaving parents, or going out to public areas. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

• Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events.  They'd rather play ball, climb trees, or ride bikes.

A senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont.  He is also a clinical professor in the Department of Psychiatry at the University of Vermont College of Medicine.

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