Despite this, medical professionals at Cook Children’s Health Care System often hear from families concerned about bullying at their children’s schools. Lisa Elliott, Ph.D., a neuropsychologist at Cook Children's, works with children throughout North Texas. She helps equip children and their parents on how to deal with bullies.

“Bullies thrive on the perception of power and control over another person’s emotions,” Elliott said.

While many have heard the rhyme, “sticks and stones may break my bones, but words will never hurt me,” that is not how to respond to a bully. Elliott has developed a nearly foolproof method.

“It’s critical for children to respond to a bully, but how they respond is just as important,” Elliott said.

Do not feed the rat

She explains that it is about using one or two words and tone.

Words she suggests are:

• Okay
• Who cares?
• Whatever
• So what?
• Big deal

However, the tone is just as critical, she explains. The tone should not show negative emotion, pain, frustration, anger, or hurt.

“What that communicates to the bully is, ‘I’ve heard you, but what you’re saying does not bother me,’” Elliott said. “It’s really important for a child to respond to a bully in the appropriate way.”

She adds that this tactic works best for verbal, emotional, and social bullying. If a child is being physically bullied, adults need to take the appropriate steps and inform authorities immediately.

However, if verbal bullying continues and intensifies despite using this method, Elliott says it is time for parents to report it to the proper authorities.

“Texas schools are required to adopt anti-bullying policies, and they’re supposed to establish procedures for reporting those incidents,” Elliott said.

What should parents do?

Elliott encourages parents to have daily conversations with their children. She says being inquisitive and having constant dialogue with children helps build their self-esteem.

The questions she suggests are:

• How was your day?
• What is going on?
• Have there been any bullies?
• Have you bullied anyone?
• Have you seen bullying done to other children?
• How did that make you feel?
• How did that make the other child feel?

It is also an opportunity, Elliott said, for parents to teach lessons in kindness. She encourages parents to take the time to identify their children’s strengths, what makes them special and unique, and empower and develop those skills. Doing so will help build their confidence.

As parents, it is important to have self-awareness that one’s child could be the bully.

“We have to remember our kids may be a bully because they’ve been bullied, they’ve seen it from other kids, or they’ve seen it on the news or from family members,” Elliott said.

She emphasizes it’s not about blaming parents but using the moment to start the dialogue. What are the circumstances or thoughts that led them to this? Elliott says this can help to know how to address those issues.

It helps to lead by example.

“What we expose our children to, in terms of our behavior, what we expose them to in media, any kind of online activities,” Elliott said. “It is our responsibility to teach them how to act.”

She explains it is important for children to learn that everyone needs to be respected, valued, important, and significant, regardless of cultural identity.

“One of the best things we can do is teach our kids to be a positive bystander and how they can stand up for somebody who is being bullied,” Elliott said.

Beyond proactively fostering positive behaviors, parents should be vigilant in recognizing signs of distress in their children.

Parents should look for changes in behavior, like eating habits, trends, isolation, dropping grades, and irritability, and to reach out to their children’s pediatrician. Their doctor can make a referral, or parents can call Cook Children's Behavioral intake.

“A parent should never dismiss those behaviors,” Elliott said.

Addressing these potential warning signs directly, including open discussions about suicide, is a crucial step in ensuring children's safety and well-being.

She adds that no studies have found that discussing suicide leads to suicide; on the contrary, it can help prevent it. However, if a parent feels uncertain about having the conversation, they should speak to their pediatrician.

Ultimately, fostering resilience and providing access to professional help when needed are the most powerful tools parents have to protect their children and guide them toward a healthy and fulfilling life.

For Lisa Elliott, Ph.D., back to school means a full schedule of therapy sessions that all have a common topic – bullying. Dr. Elliott has been a psychologist at Cook Children’s for 28 years and says bullying now starts as early as Kindergarten.

“We see it moving down in years considerably,” Dr. Elliott said. “Parents need to understand, given our culture, that most children will engage in bully behavior because it is being modeled for them through programs on TV, news media and reports, online exposure and adult actors, sports figures and political figures.”

The pandemic has only made the bullying issue even worse.

“COVID, isolation and increased use of social media have definitely impacted bullying – the number of bully incidents have significantly increased, and the severity has also,” Dr. Elliott said.

Since children spend a large amount of their time at school, teachers have the opportunity to demonstrate inclusion and empathy toward others.

“The reality is that teachers are critical role players, and their kindness matters,” Dr. Elliott said.

Types of Bullying

Four types of bullying exist – physical, verbal, social and cyberbullying.

Physical bullying accounts for less than 1/3 of bullying incidents and more boys engage in this type. 

Verbal bullying is the most common form affecting an individual’s self-esteem and feelings for years, leaving scars that last a lifetime. This includes spreading mean rumors, making accusations that are not true, gossip, lies, spreading embarrassing private truths, name-calling, taunting, belittling and cruel criticism.

Girls have the highest engagement in social bullying – a difficult-to-detect form of bullying including ignoring, isolating, excluding or shunning. It is the most potent kind, especially in the middle school and high school years.

As soon as children have cell phones, cyberbullying comes into play.

“Cyberbullying is 24/7 and has a rapid transmission. It reaches the world in an instant,” Dr. Elliott said.

Five years ago, cyberbullying in schools was addressed with the enforcement of David’s Law in Texas which requires schools to notify the parent of an alleged victim of bullying within three business days of a report, rather than waiting for the findings of an investigation. The school also must adopt policies allowing students to anonymously report incidents of bullying and may expel or place a student in a disciplinary alternative education program.

Signs and Symptoms of Being Bullied:

• Does not want to go to school/skips school/gets into trouble at school
• Grades suffer
• Stops talking about peers and school activities
• Loses interest in activities
• Physical manifestations (sleep disturbances, withdrawal and wanting to be alone, complaints of pain or illnesses, appears tearful, displays victim body language such as keeping head down, hunching shoulders and avoiding eye contact)
• Emotional manifestations (appears sad, angry or irritable, withdraws and acts timid, becomes overly moody or anxious, exhibits aggressive behavior)
•  Social/behavioral manifestations (withdraws socially, changes friends, engages in self-mutilation, threatens violence to self and others, talks of running away or suicide, suddenly stops using the computer or other mobile devices)

Signs and Symptoms of Being the Bully:

• Suddenly stops using the computer/device or turns off the screen when someone comes near
• Appears secretive about what they are doing on the computer/device
• Appears nervous when using a computer/device
• Spends an excessive amount of time on the computer/device

“If your child is bullying others, react calmly and don’t blame yourself because there are so many influences in a child’s life. I commend parents who recognize their child could be a bully,” Dr. Elliott said.

Equip Your Child with a Foolproof Tool

When talking to children about peers, the growth mindset of appreciating and valuing differences of opinion should be addressed. Tell your child how to help a classmate who is being bullied such as spending time with them and encouraging them at school and outside of school, helping them get away from the negative situation and telling an adult. 

After researching various strategies to deal with bullies, Dr. Elliott created a response tool that has proven to stop the bully from coming back for more harassment.

“If you show pain, hurt, fear or anger it feeds the bully,” Dr. Elliott said. "Ignoring the bully still gives them the idea they are successful in hurting the victim which fuels the fire and motivates them to keep bullying. The fewer words you say, the better – use words such as ‘OK’ and ‘whatever’ before walking away.”

This strategy acknowledges the bully while at the same time showing him that the tactics are not effective.

“I’ve never had a child or teenager tell me that it doesn’t work,” Dr. Elliott said.

Proactive Tips for Every Parent

Modeling empathy needs to be at the forefront when raising children. Focusing on others’ needs and feelings will contribute to a child’s overall happiness.

• Openly talk about bullying all the time
• Ask questions like “Has bullying ever happened to you? How did it make you feel?”
• Role play and ask “How do you think this would make you feel?”
• Teach empathy and kindness – have child open doors for people, get involved in a service project

“Kids are naturally born with kindness and empathy,” Dr. Elliott said. "What changes over time is what gets modeled for them and what they see.”

On episode 9 of the Raising Joy podcast, hosts Wini King and Kristen Pyrc, M.D., speak with Lisa Elliott, Ph.D., a licensed neuropsychologist and manager of Cook Children’s Behavioral Health Clinic in Denton.

In this episode, Dr. Elliott discusses bullying and a research-based technique that kids and teens can use to stop harassment, as ignoring bullies rarely stops unwanted behavior.

Dr. Elliott also spotlights social media, video game addiction and what changes she has noticed in most children during the COVID-19 pandemic. In discussing these topics, she notes ways in which parents can serve as a model for behavior and help their children develop resiliency.

“Our kids are watching us navigate difficulties and ethical dilemmas,” she says. “If we approach things with honesty, fairness, respect and kindness, they’re more likely to do that, too. We are all better in power and strength if we work together.”

Raising Joy is part of Cook Children’s Health Care System’s JOY Campaign, a communications initiative aimed at preventing youth suicides. For more information about the JOY Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify, Google Podcasts and YouTube.

Bullying is an age-old issue. Generations old and new are familiar with the power plays of those that intentionally try to hurt another. It happens on the playground, in the classroom, by the locker, at the lunch table, on the bus, through social media networks and everywhere in between, and it can take a toll on a child or teen.

It’s important to understand the true definition of bullying. It is a conscious, intentional, hostile action towards another that is meant to hurt or create fear or terror, according to Lisa Elliott, Ph.D., psychologist and manager of the Behavioral Health Clinic at Cook Children’s in Denton. An act of bullying includes three elements—an imbalance of power, the intent to harm emotionally or physically and pleasure in witnessing the pain.

If you let them, bullies can plant seeds of rejection into your soul, some that can deceive you for a lifetime and create deep-rooted strongholds of confusion, fear, anger, bitterness, insecurity and thoughts of inadequacy, according to Cook Children’s mental health experts.

Research shows that adults who were bullied as a child have an increased risk of depression and anxiety; may suffer long-term negative consequences with jobs, income and relationships; and may experience poorer health. What’s worse, both those who bully and those who are bullied are more likely to exhibit suicide-related behavior.

“Being bullied can be a trauma for some kids because it overwhelms their ability to cope,” said Denise Coover, LCSW, a trauma informed care specialist at Cook Children’s Medical Center.

You Matter

As bullies target the insecurities of others, it can produce shame and guilt in the one being bullied. In the victim’s eyes, their perceived shortcoming or failure is validated by the bully. That’s when a wall goes up in many kids, and they retreat from those who can help them sift through the truth versus the lies.

“What someone says about you does not make it true,” Coover said. “And every negative thought that you have about yourself isn’t always true either. But when a bully hits on a particular insecurity, it’s hard for kids to put that into words so that someone can help them process it.”

On the flip side, those emotions are exactly what fuel bullies and their assaults. The pain bullies inflict on others is a direct result of emotions brewing within themselves, according to Coover. It’s a coping strategy, one that gives them a sense of control of their own perceived failures by elevating themselves over others.

“Kids will use behavior to say there is something wrong here,” Coover said. “And it’s up to a clinician, in-tune parents or a school system to figure out what the problem is because the behavior is telling us there’s something going on.”

It’s not that bullies bully because they are nothing but bullies. They bully because they don’t know who they are. Bullying gives them a sense of identity where they otherwise have no point of reference for purpose, belonging or intrinsic worth of themselves or others. Having a solid grasp on those things is like a coat of armor for kids against both becoming a bully and being negatively impacted by one. Establishing those values starts at home.

“We, as parents, can't be so unaware that we think that our child may not be the bully,” Dr. Elliott said. “It is absolutely critical that we not only talk about this with our children in order to protect them, but we also have to teach them how to be a good citizen.”

Dr. Elliott cautions that parents should not dismiss complaints about their child being a bully or bury their head in shame either. Address the issue. It’s a good opportunity to find out what may be behind the bully behavior, which you can then help your child overcome. Seize the moment to teach them about how to treat others with kindness and compassion. It could be an invaluable growth opportunity for your child and your relationship.

“What kids hear from you is what they will know about themselves,” Coover said about a parent’s role in building strong and resilient children.

Helping kids understand their intrinsic value as a created being can be like a shield from the flaming arrows of a bully. One way parents can plant and water the seeds of purpose and worth is by helping children identify what matters most about them and what is and isn’t true about themselves. They can also help frame their kid’s perspective by encouraging them in the journey of their endeavors, not just reveling in the outcome.

“When a kid brings home straight A’s, it’s a great thing to celebrate,” Coover explained. “But what’s more important for a parent to see and acknowledge is how hard the child worked, their dedication, how much they learned and the steps they took to achieve that. Kids need to hear that from parents, no matter the grade that resulted from their best effort and hard work.”

This helps reinforce competence, confidence and connection — as described in "Building Resilience in Children and Teens" by Kenneth R. Ginsburg, MD, MS Ed, FAAP. Resilience is the ability to bounce back from stress, trauma or hardship. It isn’t something we’re born with, but something learned. Oftentimes, through trial by fire, but also by watching others we love and respect bounce back from a difficult circumstance. Teaching kids to be resilient gives them a hopeful perspective.

The Rise of Cyberbullying

Bullies may use physical force, relentless verbal lashings or social exclusion to intimidate and control. But the rise of the internet and social media has added a new virtual venue where bullies seek to crush the spirit of their target. According to a 2018 Pew Research Study, 59% of teens have experienced some type of cyberbullying.

The pandemic made cyberbullying even easier as kids were forced out of classrooms and onto virtual platforms for learning and socializing. More time online translated to a 70% increase in hateful speech between kids and teens during online chats, according to a study conducted by L1GHT.

“This is a whole new world for parents and kids to navigate,” Dr. Elliott said. “Parents need to have controls. They need to have access to see what their kids are doing. It’s really important for parents to monitor what their kids are viewing, saying and sharing online.”

Cyberbullying can be extreme and pervasive, Dr. Elliott said. The internet is always open for business and provides harassers a direct line into the personal device of a victim. It’s fast, easy, far reaching, can be done anonymously and lives in infamy forever.

Cook Children’s experts shared these tips for protecting your child online:

• Continually educate yourself on the ins and outs of social media outlets. Do you know about TikTok, Instagram, YouTube and Snapchat, just to name a few? If not, you should. This is where your kids are hanging out. Educate yourself on how they work and how your kids are using them.

• Openly discuss bullying and cyberbullying with your kids on a consistent basis. These are conversations that need to be had more than once as your child matures. Ask your child if they have been bullied, how they handled the incident and how it made them feel. Talk to them about what they do when they see others being bullied. Are they being a good bystander? Teach them about empathy, and help them think through how to help others.

• To encourage kids to open up, have them write it, draw it or say it. If talking doesn’t come easy, kids who enjoy writing can journal their thoughts. Those with an artistic flair may prefer to illustrate them. Kids may be more receptive to talking if you strike up a conversation when engaging in an activity together, riding in the car or just having a casual discussion. Learn what communication tool works best for your child and embrace it.

When And How To Intervene

You may sense your child is being bullied if you see a change in their behavior. If they stop doing things they once loved, start spending lots of time alone in their room, are irritable and weepy or their grades plummet, you should take note that something may be wrong.

Sometimes parents need to intervene to stop a bully. Other times they simply need to problem-solve with—not for—their child. Coaching kids on how to respond appropriately on their own helps build confidence and resilience, and helps their brains develop problem-solving skills that benefit them for life.

“If we always do things for our kids, their brains don’t grow,” Coover said. So they become adults who can’t manage any kind of problem in life, because they’ve never had to do it. Someone has always stepped in to take care of it for them so their brain didn’t create those neural pathways to consider solutions.”

To know your role, Dr. Elliott says to start by determining what kind of bullying your child is experiencing. Are they being physically assaulted, verbally harassed or cyberbullied? How often is your child targeted?

If the bully is getting physical or threatening bodily harm, always report it to the proper authorities, be it school administration or law enforcement. In Texas, schools are required to adopt anti-bullying policies and establish procedures for reporting incidents. They must also notify parents and guardians of a reported incident and outline disciplinary actions for those who bully. To better understand the state’s bullying laws, check out tea.texas.gov and stopbullying.gov.

If the harassment is verbal in nature, it may benefit your child to take a different approach, one that equips them to respond to the bully themselves and helps them build life-long conflict management skills.

Don’t Feed The Rat

Knowing how to handle a bully can be the difference between a child suffering silently through relentless attacks versus a single incident that is stymied before it escalates to something more serious. It’s all about the balance of power, Dr. Elliott says, and ignoring a bully isn’t always the answer.

“Bullies thrive on a perception of power and control over another person’s emotions,” Dr. Elliott said. “Even when you ignore a bully, they still assume you are hurting inside. That perceived weakness keeps them coming back time and time again to satisfy their desire for power and control.”

Dr. Elliott has personally developed and tested a bullying response tool that she employs with her patients. Her method teaches kids to respond to bullies in a way that both quiets the harasser and builds resilience in the one being harassed. It essentially conveys a message to the bully that their opinion isn’t valued and, therefore, not offensive. She calls it The Rat Method. Click on the video below to hear Dr. Elliott explain her method in her own words.

There Is Hope

Your child can overcome either being a bully or being the victim of a bully. Together, you can create defenses against bullies, develop empathy for others and foster resilience to stop bullies and their bad intentions in their tracks. Your child’s short and long-term mental and emotional health will be better for it.

In today’s society, social media is a major part of life for all age groups. While some use the platforms to keep up with family and friends, others use the sites for networking and job hunting. For those 18 and younger, social media has changed the way young people communicate with each other, often leading to inappropriate use, and bullying among other things.

As part of Cook Children’s Joy Campaign, which aims to reduce the number of children and teens attempting suicide, we’re looking at the role social media plays in the mental well-being of young people.

Kristen Pyrc, M.D., medical director of Psychiatry Outpatient Services and the Partial Hospitalization Program at Cook Children’s, says the number of her patients dealing with anxiety and depression has significantly increased over the past year. She’s concerned that social media is playing a role, especially during the pandemic when young people are online more than ever.

“I have seen an increase in depression symptoms in teenagers who had not had them before,” Dr.Pyrc said. “So maybe I regularly see them for something like ADHD, and now they are showing symptoms of depression on top of that.”

Dr. Pyrc said she often hears complaints from parents that their children are ‘tied’ to their phones. She believes a major problem with that is a lack of exposure to seeing friends in person, and the opportunity for kids to feel left out when they see peers online having fun without them.

“I think online culture can worsen students’ feelings of loneliness and rejection because they see their friends doing things together without them in real time,” she explained. “Also we tend to post things that highlight what’s going well in our lives, but may not tell the full story of the times that we feel sad or inadequate. When teens are feeling down, seeing everyone else having fun without them can make them feel worse.”

Katie Greer, an internet safety expert, has spent the past 15+ years educating students, parents, law enforcement, and large companies across the country about the importance of online safety.

“I have seen social media used to bring out the best in humanity, but I have also seen it rip families apart in a matter of minutes,” she said.

Greer, who began her work as the director of Internet Safety with the Massachusetts Attorney General’s Office, believes social media has evolved in ways no one was ready for. Not so long ago, bullying was something that happened mostly at school. Now, young people are bullied online, in front of countless people. Even worse, a bully’s comments can be liked and shared by others.

“Kids were already spending a lot of time on their phones and online, then came a global pandemic. Now, they’re attending school online and relying on things like gaming online and social media platforms to connect,” Greer said. “There’s a lot more opportunity for cyberbullying and while it can start with one person, it can be a matter of seconds for others to jump in with a like or a comment and gang up on the victim.”

Situations like this increase a child’s chances of dealing with anxiety, depression, and self-harm.

“We know that developmentally, children’s brains aren’t fully formed,” she said. “When we put something in front of them as complex as social media, it’s almost as if we are asking for trouble.”

Greer also warns parents about the newfound TikTok culture.

“TikTok is a platform that has created unrealistic expectations about everyday life,” she explained.

She said children and teens see their peers or influencers having “perfect” lives and begin to feel as if they’re inadequate, or aren’t enough or worth it.

“Children have a desire to fit in and they want to have as much or more than their friends,” Greer said. “When children see their friends flaunt material things, or lavish experiences, that can make them spiral.”

Another issue putting kids’ mental health in danger is ‘sexting’ or the exchange of nude photos and videos, which has become quite prevalent.

“I recently was made aware of an incident where a girl sent a guy nude photos and he leaked them. Once they were leaked, so many people saw them, the young girl was humiliated,” Greer recalled. “The family reported that this led to the young girl untimely killing herself out of embarrassment and humiliation that her photos were leaked.”

Greer said, in cases like these, it is vital to remember that not only does suicide hurt a family, it also tears apart the people who loved and supported the victim.

Cook Children’s launched the Joy Campaign, which this story is a part of, to bring awareness to the increase in suicides and suicide attempts being seen at the medical center. In 2020, seven Cook Children’s patients died of suicide, making suicide the leading cause of traumatic death for the first time ever. The hospital has also seen record numbers of patients being admitted for suicide attempts month after month, most recently in March when 43 children and teens were treated for injuries. While the increase in suicide attempts cannot directly be tied to the pandemic, Dr. Pyrc said children need certain things to properly function in day-to-day life.

“Kids need in-person interactions. They need sunshine and exercise and all things encompassing,” Dr. Pyrc said. “Whenever your world is mostly virtual, it can hurt both your physical health and mental health.”

What does Greer suggest parents do? Stay alert and ask questions.

“A simple, “How was your day?” or “How are your friends doing?” can go a long way in opening the lines of communication,” she said.

She emphasizes knowing what your child is looking at online and know who they are talking to. If you are concerned about your child’s safety, there are measures you can take.

“While I am typically against this and wouldn’t always recommend it, there are ways parents can use apps that will mirror their children’s phone,” Greer said. “I do believe this could hurt the trust between a parent and a child, and isn’t the best way to go about typical monitoring, and I only recommend phone mirroring for dire situations.”

Before leaving any session, Greer reminds everyone she speaks with about the importance of a trusted adult.

“I tell parents and all adults it is important that children have a trusted adult they know they can come to at all times. Parents have to be okay with the fact that the adult may be someone other than them, it is all about a child feeling safe and opening up,” she said. “I also remind every child that I come in contact with that having an adult you trust is one of the most important things you can do to protect yourself and even help a friend.”

Both Greer and Dr. Pyrc see the issue and know there is a lot of work to be done to ensure we are helping our children with their new reality. Both professionals share their tips to help parents and families better support their children.

1. Take your child’s phone before they go to sleep at night. Disrupted sleep has a negative impact on adolescents.
2. Have an open dialogue with your child without judgment and give them the ability to freely express themselves to you. Given the amount of time kids are online, these conversations should happen every day.
3. Ask about their social media. Talk to your child about what they’re seeing, how it impacts them/makes them feel, and know who they’re communicating with.
4. Ensure your child can identify a trusted adult and make sure they understand that an adult can be their go-to person at all times.
5. Talk to your child about good social media etiquette. Remind them if they see something, say something and describe how that can help save someone’s life.
6. If you believe your child is in danger, there are apps available that can monitor their phone so you can see everything they see and get them the help they need immediately.
7. Reach out for help. Do not wait until your child is in a dire situation to reach out for help and get them the resources that could save their life.

Monitor your child’s social media, and make sure you have their usernames/passwords in case of an emergency situation.

Important to note:

Instagram has an anonymous reporting tool that allows users to report when they believe something could be wrong with a friend. The site sends the person resources depending on what was reported on their behalf. These resources could be vital in saving someone’s life by simply reporting.

One day in 7^th grade, Emma came home especially upset about the cruel words hurled against her. The talented pre-teen picked up her ukulele and wrote a song.

I don't know what I'll do to brush off the dust.
You've really messed me up.
I don't know what I'll do to brush off the dust.
Don't you know, it’s mean to be mean.

Through music, Emma found the relief she desperately needed. Little did she know that song would one day be recorded in a professional studio and have its own music video.

Healing Through Music

Music is a passion for Emma. She plays five instruments and sings, but songwriting may be what she enjoys most.

“Writing music for me has been a big outlet. It helps me deal with a lot of issues,” said Emma in a recent interview with Cook Children’s via Zoom. “Sometimes it's hard to talk about things, but it's so much easier to write to get my feelings across.”

Emma is a long-time Cook Children’s patient. During one of her visits to the medical center several years ago, she stopped by the hospital’s Child Life Zone, which features a fully functional, industry standard recording studio. It was here she met recording studio producer Raymond Turner.

“Emma was one of those patients who could probably write a song every day,” Raymond said. “She had a great voice and played ukulele. So we started talking about the CD project, what it was going to be entitled, and why we wanted it to be called that.”

Each year, Raymond produces an album of songs written and/or performed by Cook Children’s patients. In 2018, the CD was called ‘We Rise’ and aimed to give patients a space to express their feelings about resiliency and overcoming hurdles. Raymond and Emma worked together to take her song, ‘Don’t You Know,’ from a simple tune she’d play from time to time, to a fully-produced track to be featured on the upcoming album.

“It took her a while to actually record it because we talked about every line,” Raymond explained. “I go, ‘Okay, what does that mean? Where did that come from?’ And I know her intent was really to shed light on what she had gone through and the pain of that, but also to let whoever that person was know that at this point, it's not going to affect her.”

Raymond and Emma’s shared goal was to make ‘Don’t You Know’ an empowering anthem to bring awareness to the issue of bullying. When ‘We Rise’ was released, Emma’s song was one of nine on the album. But the work wasn’t over yet. Soon, a new project began that would turn ‘Don’t You Know’ into a music video that would air on CLZ-TV, Cook Children’s 24/7 in-house TV network.

Bringing a song to life

Stella, 16, has been drawing ever since she can remember. She loves art, but wasn’t too keen on painting until she was stuck in a hospital bed at Cook Children’s.

During her stay, a resident artist with the Creative Artist in Residency Programme (CARPE) delivered a canvas and painting supplies to Stella’s room. The program, which focuses on therapeutic art, is designed to provide an artistic outlet to patients who may be feeling fear, anxiety or frustration due to their medical condition. Stella’s painting of her IV bags impressed the artist resident so much, she was invited to appear on CLZ-TV’s art show.

“I was sitting at my desk and I happened to look up and see this patient’s artwork on TV,” Raymond said. “I was like ‘That’s it, that’s the art.’ I knew I had to talk to her about this project.”

Stella eagerly agreed to help illustrate the music video for ‘Don’t You Know.’ She put Emma’s song on repeat and with the words and melody in her mind, got to work illustrating the featured character – a girl with brown hair and big blue eyes. It was a laborious process to draw the many different emotions portrayed in the song. After nearly a year of tedious work, Stella delivered the final artwork that would bring Emma’s song to life.

“I've never personally been bullied before, but whenever I listened to the song, it made sense. It definitely gave me a perspective and understanding of how bullying negatively affects people,” said Stella.

She hopes her art can help amplify the message that bullying is harmful and can leave lasting scars.

“If I could take her song, which I can tell how meaningful it is to (Emma), and do anything to enhance it, to give it a microphone or to make it shine, that would be enough for me,” said Stella. “It’s really satisfying to know that we’re leaving a mark on the world, even if I was a small part of it. It’s really comforting in a sense.”

Their combined efforts made for a first-of-its-kind music video for Cook Children’s. Though the gifted team in the Child Life Zone broadcast studio have made countless videos for CLZ-TV, never have two patients created both the music and the visuals. And even more intriguing, Emma and Stella never met until the project was complete and they were interviewed together via Zoom for this article.

“It’s been neat to see how patients who have never met can come together to work on the same project,” said Raymond. “You would have thought that Stella and Emma sat in a room together. There’s a seamlessness that you feel when you watch and listen.”

Despite their different experiences with bullying, both girls say they hope kids and parents alike can walk away from the video hearing the message loud and clear.

“I hope that people will be able to see the impact of bullying, because for me, it made me feel like I was nothing,” said Emma. “It made me feel like I was worthless and useless. Sometimes people forget that the person they're saying those things to have feelings, and what you say can be life changing.”

At a minimum, COVID-19 has clearly upended our normal day-to-day functioning. However, for many this pandemic has had a devastating impact.

It’s reported that one-third of the entire global population has been in lockdown mode with school closures impacting an estimated 1.5 billion children worldwide. There are many things to worry about right now when it comes to keeping our families safe and healthy.

Now, we must also worry about the very serious risks associated with your child’s increased online activity.

One of those risks is cyberbullying, and unfortunately 87% of our children and teens have seen cyberbullying online, either as a victim or observer.

With that high rate of occurrence during normal times, there’s legitimate concern for increased risk of children experiencing cyberbullying. After all, most kids have increased time on devices, free time, and frustration.

To further complicate this issue, children and teens may end up suffering silently because they do not have the normal outlets accessible to them to seek help, specifically school counselors, teachers, coaches and peers.

Furthermore, the visual cues that are evident with some types of bullying are not observed, thus bullying incidents go unnoticed and not investigated.

It is critical for parents to be armed with information to help increase their awareness, know what behaviors to look for, how to talk to their child and/or teen and how to help.

Where Cyberbullying Occurs

According to Ditch the Label students identified the social media platforms they experienced cyberbullying on the most:

1. Instagram (42%)
2. Facebook (37%)
3. Snapchat (31%)
4. WhatsApp (12%)
5. YouTube (10%)
6. Twitter (9%)

The Impact of Cyberbullying

Cyberbullying has shown to have a significant negative impact on children and teens including a negative impact on learning, an increase in somatic complaints (i.e., headaches, stomach aches, sleep disturbance), an increase in depression and social anxiety, lowered self-esteem, negative impact on relationships and possible behavior problems.

Thus, it is critical that parents be aware of potential bullying/cyberbullying in order to help their child/teen cope effectively and empower them.

Certain populations are targeted more than others:

• Girls (35%) are more likely to be a victim than boys (26%), according to the Pew Research Center.
• More than half of all children and teens who identify as LGBTQ experienced cyberbullying, according to StopBullying.

What to look for: The signs a child/teen may be a victim of cyberbullying

• Avoiding the use of computers/devices, especially those that have internet access – this is the biggest flag.
• Exhibit anxiety when receiving a text, some type of message or an email.
• Withdrawing from family and friends.
• Isolation.
• Increased agitation, irritability and moodiness.
• Increased anxiety and feelings of being stressed out.
• Exhibits signs of depression, fear or low self-esteem.
• Increased somatic complaints such as headaches and stomach aches or they stop eating.
• Changes in sleep patterns, possibly an increase in nightmares.
• Declining grades.
• Resist attending school and social events, possibly a change in friend group.
• Skipping school and/or getting into trouble at school.
• Increased behavior problems or getting in trouble at school.
• In serious case attempting self-harm and/or suicidal thoughts.

Behaviors to look for that might suggest your child/teen is the cyberbully:

• Stop using their computer/device when someone comes near them.
• Secretive about what they are doing online.
• Spend an excessive amount of time on their computer/device.
• Look nervous or jumpy when they are online.
• Become aggressive and angry when their online activity is limited or removed.

What can parents do to help?

Parents beginning from a young age need to have and encourage open and frequent dialogue in general about bullying and cyberbullying, especially as they gain more access to computers and technology. The reality is bullying is not limited to children and teens, unfortunately it is common among adults as well, so it is important to teach and model healthy social and emotional functioning from an early age. Be sure to talk about what bully/cyberbullying is and how to know when it is happening.

Directly ask your child/teen if they have been or are being bullied/cyberbullied, be willing to share either personal experiences or those of close friends and family so they realize they are not alone. Many children/teens won’t tell their parents that they are being cyberbullied because they are afraid they will lose their computer/device and Internet privileges so it is imperative that you communicate they will not lose their privileges if they are being cyberbullied. Encourage them to unplug from technology or certain apps but do not threaten to take away access.

Teach your child/teen tips on how to stay safe with technology including never sharing their Internet passwords with anyone except parents, never send messages when they are upset or angry, always be polite online – never say something to someone else that would hurt them personally, never put anything online that they would not want their parents to know, never post their own or others’ personal information, refuse to pass along any cyberbully messages and teach them how to be a good bystander – stand up for others and tell others to stop engaging in cyberbully behavior.

Parents need to keep themselves current on technology, apps and acronyms. They should also use parental control apps on your child/teen’s computer and devices. In addition, parents should limit data access and turn off access during certain hours, make it mandatory that you know your child/teen’s passwords and know who your child/teen communicates with online.

If your child/teen does report to you they are being cyberbullied these are guidelines to help you and your child/teen:

• NEVER respond to any message, text or post, regardless of how untrue or hurtful it is
• NEVER seek revenge
• SAVE all the evidence
• Report any issue to the Internet Service Provider (ISP), or social media websites such as Facebook, YouTube
• Report any threats of harm or sexual messages to police
• Report all information to school authorities
• Block all communication with the cyberbully

Resources (with links):

• STOMP Out Bullying
• Cyberbullying.org
• Nobully.org
• Safekids.com
• connectsafely.org
• Staysafeonline.org
• Education.com website
• National Crime Prevention Council
• Stopcyberbullying.org
• Stopbullying.gov
• Center for Safe and Responsible Internet Use
• Cyberbullying Research Center
• DoSomething.org
• WiredSafety.com
• Texas Attorney General’s Office
• National Center for Missing and Exploited Children

And, I’m pretty sure my freshly minted 10 year old will soon be asking about his own Twitter, Instagram or YouTube account soon. I realize this is a tricky situation. Especially since I’m the medical advisor for Digital Health at Cook Children’s and I’m active on social media.

Trust me I see the irony … or maybe the hypocrisy.

But Right now I’m planning to hold off AS.LONG.AS.I.CAN.

Why?

Because I’m a parent. I worry about my kids like everyone else and I want them to be safe and protected

I’m also a pediatrician and I talk to too many kids in my office who are dealing with the negative fall-out of social media. I also see way too many studies addressing how social media has caused harm.

Social media can lead to:

• A fear of missing out. I wasn’t cool in high school (this may shock you and if it doesn’t just stay quiet) but I really didn’t know what I was missing out on. Everyone partied on the weekend but didn’t say much to me about it on Monday. If there had been pictures and posts from the weekends, I would’ve understood how left out I probably was.
• Inappropriate expectations of appearance. We don’t look like the celebrities we follow on social media and we probably never will. Sometimes though it’s important to remember the celebrities don’t look like the celebrities when they are on social media either. They are photoshopped and edited many times. But still, our kids are left to compare themselves to people who taking professional photos or using editing software to make everything look perfect. It’s their job after all. Unfortunately, that doesn’t keep many of us from feeling jealous or feeling like we’ve fallen short when we don’t.
• Bullying. Anonymous or even semi-anonymous (or “behind the screen”) empowered bullying can cause isolation and fear. And it doesn’t stop when you go home from school like it did when I was a kid/teen.
• A lack of ability to process our feelings. The constant ding of dopamine we get from the amount of likes on our posts enables us to continue posting to get our fix rather than process and dive into our sadness.
• Oversharing and shame. Teenagers and preteens don’t understand the significance of oversharing and what can happen later when those details (or pictures) get shared to a wider audience.

So what should we do as parents?

Here’s what I recommend:

• Keep your child off social media as long as possible. I know. I hear it too with my three kids. But the longer you can keep them away from it, the more time you have to talk to your kids about this issue and let them mature to handle what will inevitably come their way.
• When they get on, you get copies of their passwords and connect with their accounts. You can have privacy when you are out from under my roof. Oh man, I’m starting to sound more and more like my dad. But until then, sorry kids, I’m doing everything in my power to protect you.
• You reserve the right to delete the account and take their phone at any time. I paid for it and I can take it away.

I hope this helps. Just know I’m dealing with it too and would love to hear your thoughts. Again for irony … on social media.

On Wednesday, Oct. 17, experts from Cook Children’s gathered at the Regional Child Health Summit to look at 2018 data and trends from more than 8,000 parents who participated in a survey. People from Tarrant, Denton, Parker, Johnson, Hood and Wise Counties participated in the latest Community-wide Children’s Health & Assessment Planning Survey (CCHAPS).

The purpose of the summit was to look at key children’s health priorities in the region and discuss potential area for community action to improve children’s health with the experts in the room.

During the course of the day, several important topics were discussed. Here are some of the highlights.

1. Play time with other children

• 82 percent of the children in our region play with other children every other day or every day, but there is a decrease in daily play from 2015 (from 71 percent to 63 percent.

2. School safety

• 92 percent across the region report children are safe at school. This is lower than the national rate (98%) and the state rate (97%).

3. Children and health care.

• Children in our region are more likely to have a primary physician than children statewide or nationally – even our homeless children. Between 85 – 98 percent of children in this region have a primary care doctor; compared to 65 percent statewide and 73 percent nationwide.
• 10 percent of children in our region, were without health care at some time in the last 12 months. That’s lower that the state average (15%), but slightly higher than nationwide (8%)

4. School Days Missed

• Children in our region are more likely to miss school than the state and national rates reflect and they are more likely to miss more days annually than statewide and national rates reflect.
• 65 percent of our children miss between 1 and 6 days of school per year due to illness or health problems.

5. Mental Health Disorders

• The most common mental health disorder among children in the area is sleep problems, followed by self-esteem, overeating or undereating, traumatic events, wetting the bed and negative or obsessive thoughts.

6. Bullying

• The number of children in our region bullied or teased at school decreased in 2018 from 17percent to 13 percent. Still the number of kids impacted is large with an estimated 93,655 children.

7. Abuse and Neglect

• Except for Denton, the rate all of the CCHAPS region counties is higher than the statewide rate for all three years. The Denton County rate of confirmed child abuse and neglect victims is half of the statewide rate (4.3 percent vs. 8.5). The Hood County rate is more than two and a half times the statewide rate (23.2 vs. 8.5) [Source: Texas Department of Family and Protective Services Data Book. (2016).]

To learn more about the CCHAPS survey and findings, click here.

If not, take a moment to introduce them to the Florida State receiver so they can learn from his wonderful example.

Rudolph was visiting students at Montford Middle School in Tallahassee with other Florida State football players. He saw a boy sitting by himself at the lunch room table and decided to join him for pizza. The boy was named Bo Paske and he has autism.

“I'm not sure what exactly made this incredibly kind man share a lunch table with my son, but I'm happy to say that it will not soon be forgotten,” Leah Paske, Bo’s mom, wrote on her Facebook page. “This is one day I didn't have to worry if my sweet boy ate lunch alone, because he sat across from someone who is a hero in many eyes.”

All it took was a moment of acceptance and kindness to change the day of one child’s life and bring tears of joy to a mom.

And that’s why all of our kids need to know about Travis Rudolph.

Too many times kids who are thought of as different are shunned, picked on or bullied at school.

Many times when we think of bullying, it’s the big kid pushing the little kids around on the playground. In the movies, we love to see the bullied kid “fight back,” but in reality, this is not the best way to take care of bullying.

As a parent, you may be at a loss when your kids come home crying after they had to sit alone at a lunch table, or if we hear that our child was the one making fun of another child with their friends. The best way to help our kids, who may be bullied, the bully or a bystander, is to know the signs of bullying and address them immediately.

Bullying comes in many forms. It can be physical, verbal or relational, and can occur at school, in the community or on electronic technology. The actual definition of bullying is any unwanted, aggressive behavior, involving a real or perceived power imbalance, which is repeated, or has the potential to be repeated, over time.

This can be excluding someone from a group on purpose, making fun of their appearance or pushing them in the hallway after lunch every day. These things can occur in person, on social media sites or via text messages. Cyberbullying is rapidly growing, in part because the bullies don’t have to actually face the person they are bullying to see the reaction it causes. This form of communication also allows rumors to spread very rapidly to many more people than would otherwise be involved.

How do you pick up on bullying?

• Have family conversations about school, friends and activities.
• If your kids have social media, monitor it and have talks about what is posted every week. Most victims of cyberbullying don’t think to tell an adult. They suffer in silence.
• If your child starts to dislike school, riding the bus or an activity they have normally enjoyed in the past, investigate the reasons. These could be signs of bullying, among other things.

So, as a parent, what are the right things to do if you find out your child was somehow involved in bullying?

• Address the behavior immediately. If you learn that your child has been bullied, make sure you let them know it was not their fault, and it is not OK for others to treat them that way. If they were aggressive with another kid, make sure they know this is not appropriate behavior.
• Make sure teachers or group leaders are aware. Most of the time bullying is not happening when you are present, so other adults need to be involved to stop the behaviors while they are occurring or right after. They also can mediate between the groups of kids and their parents.
• Step in and speak up. If you see bullying in action, separate the kids and let everyone involved (including witnesses) know this behavior is wrong. Make sure everyone is safe. Question each child separately, in private.
• Talk to your kids. Involve them in coming up with a plan that will make them feel safe. Also, try to keep their normal routine in place, if possible.

It is also important to not only address bullying from the side of the victimized child, but also from the side of the bully. When you are talking to your kids, make sure they are not feeling bullied, but also make sure they are not intentionally or unintentionally bullying others. It’s easier said than done. But talk to them about the example of the Florida State receiver and ask if they would have done the same thing. It might be a great way to have a conversation about this subject.

Sometimes kids bully to “fit in” or because they are dealing with some other major stress in their life. Try to find out the reasons behind the behavior while making sure they know bullying will not be tolerated. Come up with consequences that will encourage them to instead learn to be a good friend and treat other people with respect. You can also find them an appropriate outlet for “fitting in,” such as a joining a sports team, club, etc.

If it seems like your child is deeply impacted by bullying or other traumatic events, then don’t be afraid to involve the school counselor, their pediatrician or other mental health professional to find other ways for your child to cope with any emotional consequences of bullying.

Let’s all work together to help our kids feel safe, and learn to be respectful to one another! If we all took time to find a Bo Paske today, we could make a difference in someone’s life.

Eriel Hayes, M.D.

Photo Credit: Leah Paske

Related Topics:

• Teaching your daughter to stand up to ‘Mean Girls’
• Bullying is a ‘serious public health problem’
• Is your teen's smart phone making them depressed?
• Sibling bullying
• Are popular kids bullied?

Meet Dr. Hayes:

A report released this week by the National Academies of Sciences, Engineering and Medicine calls bullying a “serious public health problem” and says the zero-tolerance policies schools use to automatically suspend students for bullying are ineffective.

Lisa Elliott, Ph.D., a licensed psychologist and clinic manager of Cook Children’s Behavioral Health Clinic in Denton, agrees.

“There are so many reasons why zero-tolerance policies don’t work. It’s primarily lip service to look good, but without back bone or laws to support the effort,” Elliott said. “The policy is clearly not working. We aren’t looking at the issues and not addressing the problems. We aren’t teaching children effective tools to handle bullying or conflict.”

Elliott is simply fed up. She’s seen too many kids come into her office depressed, frightened or even suicidal because they can’t get away from their bully or bullies.

“I think that bullying is worse than ever before because of cyberbullying,” Elliott said. “Kids can’t get a break.”

May parents in Cook Children’s six-county service region agree. According to the 2015 Community-wide Children’s Health Assessment & Planning Survey (CCHAPS), 16 percent of parents said their child has been bullied, compared to 10 percent in 2012.

Elliott says there are four types of bullying: physical, verbal relationship (or social) and cyberbullying. Each form of bullying is harmful alone, however combined they are even more harmful and powerful.

Elliott points to the death of David Molak, a 16-year old San Antonio boy, as an example of the harm that his family believes comes from the constant harassment a child receives in the world of cyber bullying.

“In today’s age, bullies don’t push you into lockers, they don’t tell their victims to meet them behind the school’s dumpster after class, they cower behind user names and fake profiles from miles away constantly berating and abusing good, innocent people,” Cliff Molak, the boy’s brother, said in a Facebook post that went viral.

Since the death of David, the Molak family has been working to get “David’s Law” passed in Texas, which would address the issue of cyberbullying in Texas and hold those charged with harassment on social media to pay at least a $500 fee or spend up to a year in prison. State legislation will vote on the law in 2017.

“We need consequences for the people responsible for this kind of bullying and harassment,” Elliott said. “Right now cyberbullying isn’t defined in the Texas harassment statute. A law like David’s law is about someone getting picked on around the clock. This is about constant bullying, where the kids feel like there’s no escape.”

No child is bully-proof. Elliott offers parents the following talking points when speaking to their child about bullying:

• Even people who say they're your friends can bully you.
• You should confront your friends when they're being hurtful to you or others.
• Retaliating may feel good temporarily, but refusing to stoop to the bully's level will win you more popularity in the long run.
• When you hear a false rumor, just ignore it and be yourself.
• You're most likeable when you respect yourself and others.
• Bullies usually have their own insecurities. Returning meanness with kindness is the best way to break down their defense.

And in the end to let kids know that they may be the best resources to end bullying where they live.

Researchers from Princeton, Rutgers University and Yale University found that kids could greatly reduce the amount of bullying and student conflict just by spreading the message against bullying. The engaged group of influential students in 56 New Jersey middle schools spread the message about the dangers of bullying using messaging platforms such as Instagram, print posters and colorful wristbands. They discussed how to handle conflict in their own way with the peers. The team saw a 30 percent drop in student conflict reports.

“Kids have to be involved and they have to stand up to the bullies,” Elliott said. “The kids are the teachers in the moment. We need to empower our children to be the game changers.”

They could all learn a lesson from a young woman named Marissa Heintschel.

I learned about Marissa during one of my recent searches for news about my field, pediatric endocrine. The news story featured students in the Frisco high school independent study and mentorship program.

One of the students in this program was Marissa, who had chosen pediatric endocrinology as her focus of study. I reached out to her via Twitter to learn more about her experience in the program and was very impressed by her story.

Like many in my field, she had a personal connection to pediatric endocrinology, having been diagnosed with Type 1 diabetes at 7 years old. She shared with me her passion for medicine and her experience she’s gained and the research that she did during her year in the program.

I asked how her experience had changed her view of children living with a chronic condition such as Type 1 diabetes. Her answer gave me a fresh, personal perspective on challenges of life with this chronic condition:

“I have always made it very public that I had Type 1 diabetes,” she said. “I went through the whole phase of trying to hide it away from people. I wish I would’ve realized sooner the importance of taking care of myself because when I was 14 or so I was stupid and thought that if I ignored my diabetes it will go away and that I could run away from my problems.

I wear an insulin pump. I’ve been called things like a robot and people in random places will just stare at me.

There was once this kid in my class sophomore year that I started to become really good friends with. One day I asked where he went and someone said that he went to go take his shot because he was diabetic. It was so surprising to me because no one really knew he was diabetic.

So then I started talking to the kid more and more about his diabetes and he just opened up to me and was able to talk about his problems that only people like us could understand. After he opened up to me, he told me how thankful he was that we had grown closer because he now felt he had the confidence to tell people about his diabetes.”

Marissa’s story got me to thinking about the importance of sharing about having Type 1 diabetes and how difficult it can be. I, and others on the Cook Children’s diabetes team, speak to children and their families about sharing about their diabetes when we meet with them at Cook Children’s during the difficult period of initial diagnosis.

• Support
• Safety

These are the two important reasons for S haring with others about having diabetes.

Sharing opens the opportunity to understand better the routine (checking blood sugars, taking shots, meal planning, etc.) that someone with Type 1 diabetes must do daily. Sharing opens up opportunity for support and encouragement. In Marissa’s case, it may be the opportunity to encourage and support someone else with Type 1 diabetes.

Marissa’s story also shows that sharing does open up vulnerability and risk. I asked Cook Children’s endocrine clinical therapist, Kim Cox, how she talks to children and families about sharing about diabetes.

“I usually talk to them about how ‘secrets’ tend to make other kids think it’s a bigger deal.

Why don’t they want others knowing? Are they

…. embarrassed?

... afraid of bullying?

... etc.

Being honest (but brief) about answering peers questions seems to work best. For example, I have diabetes, I have to take medicine when I eat now. We then discuss those issues.”

I use the example of a kid who gets glasses in school. In the beginning, you notice every time you see them, peers will comment and possibly even say mean things, but as time goes on, their glasses just become part of them and you only notice if they don’t have them on. Other kids move on to something else.

Safety is important because even in the best of cases diabetes care is unpredictable. High or low blood sugars affect mood and behavior. In particular, a low blood sugar can cause erratic behavior and eventually unconsciousness. Knowing about the diabetes allows others to have the advantage of understanding and help someone with Type 1 diabetes.

Marissa has a future of opportunity ahead of her and will be starting college at my alma mater, Texas A&M, where she will major in biomedical engineering and pre-med. She told me that she chose biomedical engineering because the potential that technologies such as stem cell research and tissue engineering for a cure for diseases such as diabetes. Being a doctor is her dream, and I think that she has learned a lot from her experience that will help her in the long journey to a field in medicine.

We all know about Facebook, Twitter and Instagram. All three are great resources to stay updated with people and news. But even those old favorites come with concerns if your child posts something inappropriate that can be damaging to their reputation and may have forever consequences.

But what about the latest apps?

Jody Hawkins, Information Security Officer at Cook Children’s, gives his thoughts on the benefits and dangers of today’s social media, depending on the way it’s used. Below is a list of social media platforms and apps with brief explanations of what to look out for as a parent. We begin with looking at the latest app that could pose danger to your kids – Periscope.

Periscope – Hawkins calls this “possibly the next worst app for Kids.” Periscope is a new iPhone app that allows users to share real time videos on Twitter. Currently it is only available on iPhone; but Hawkins expects that to change soon. The problems are quickly rising for parents and kids.

Twitter has pushed Periscope into production to get ahead of the competition in hot pursuit. A lot of work has been done in regards to privacy, safety and keeping offensive language off the comments. By default, Periscope uses your GPS location and allows any users on Twitter to know your location while shooting video.

“Think about that, parents. Your child posts a video and every creeper in the world can suddenly see where he or she lives,” Hawkins said. “When Periscope first launched, the locator would allow others to ‘zoom in’ on the location and see an actual intersection. That feature has since been disabled; however, the location given is still in the neighborhood of where the user is located.”

Pros: Twitter is a fun and interesting app when used appropriately. The live-streaming app makes it easy for users to track broadcasts from friends, as well as streams of people from around the world. Users can watch live and recorded broadcasts and make a friend’s list and look at a global tab. You can block spam and it’s easier now to block any annoying comments.

Cons: Currently, Periscope allows anybody to say anything which could include cyber-bullying and inappropriate comments. Online, anonymity encourages juvenile behavior and brings out the worst in some people. Even if a child turns off the GPS location device, a predator familiar with the area where the child is walking will know how to locate him or her.

Hawkins says: “Through trial and error, I am sure Periscope will improve in regards to monitoring posts and better protecting user’s privacy. However, even with improvement, this app is not for kids. For now, it is what it is – another concern for parents.”

Social media apps are geared toward young adults and adults. The app creators and companies like Google, Twitter, Facebook, etc. are catering to the broadest audience possible. Too many limitations on apps like Periscope and they lose their adult users. That means it’s up to parents to monitor their children’s usage of such apps. The permanence of things posted to the Internet can be a danger for anyone; however, it is especially dangerous when in the hands of a child who hasn’t developed a more mature sense of reasoning.

As if you didn’t have enough to worry about as a parent these days, here are eight apps to be aware of that your kids may be using:

1. Hot or Not – This app allows you to upload pictures of yourself while other people in your area vote on whether you are “hot” or not. You can vote on others in your area as well.

Pros: There are no benefits for children to use this app.

Cons: If someone scores badly, this can damage a teenager’s self-esteem. Chat is available and connections can be made with strangers.

Hawkins says: He describes this app as a “game of sorts” for kids, but it can be a risky one. In an attempt to receive a higher score, users often resort to posting risqué pictures.

2. Badoo – This social/dating app promotes the idea of meeting new people, sharing interests and even dating. It’s a way to make connections with people who share similar characteristics and you can search for people nearby. Users have to pay monthly.

Pros: If you are an adult, it’s an outlet to socialize with others who share the same interests as you.

Cons: It allows you to find people nearby to chat with and leads to meeting strangers. Badoo uses GPS technology, making it easy for predators to find your child.

Hawkins says: He would not recommend this app for the under 18 aged crowd due to the risks.

3. Palringo & 4. Tango – Both of these social messaging apps allow users to meet people from all over the globe. Palringo is a group chat app that lets you create social groups based on mutual interests and allows you to send messages to the entire group or chat one-on-one. Discussions can range from topics about sports to adult content. Tango lets you talk, text, call and video chat with friends or strangers all over the world for free.

Pros: People can find like-minded friends from all over the world. Think an international, accessible pen pal.

• Palringo can lead to discussing about inappropriate topics and predators may use these apps to meet children

Hawkins says: Both apps are good for meeting people you would never otherwise meet and finding people who can talk about your interest. Younger children shouldn’t be involved and even teens who participate should only do so in groups appropriate for their age group and with careful adult supervision.

5. Tinder – This dating app allows users to connect with new and interesting people around you. This app lets people see images of other users— you swipe right to like the picture or swipe left to pass. If someone likes you back, then it’s a match. After the match is created, you have the option to chat with the individual by phone.

Pros: There are no benefits for children to use this app.

Cons: This promotes meeting other like-minded adults and bases a “match” from physical looks.

Hawkins says: “I see this as more of a dating app for people aged 18 and older and I would not recommend it for younger teens.”

6. Grindr – This social media app is aimed toward gay, bisexual and bi-curious men. This app uses your mobile’s location-based services to show you Grindr guys close in your area.

Pros: Provides an outlet for an adult male to be comfortable with his sexuality and connect with others. But the key word in the previous sentence is “adult.”

• Can lead to kids meeting with adults and all the dangers involved. This is not Ok for kids. In fact, it’s very dangerous.

Hawkins says: “If your son has this app, I suppose the closet door is open” and parents may take this opportunity to talk sexuality and risks with their children. As with all dating apps, Hawkins would not suggest this for people under 18 years old due to the likelihood of meeting up with adults.

7. Chat Roulette – This is an online chat website that pairs random people together to video chat. Every time you begin a new chat, you never know who you are going to come face-to-face with.

Pros: There are no benefits for children to use this app.

Cons: The user can encounter people eliciting inappropriate acts. You never know what will pop up on the screen.

Hawkins says: The first thing listed on the app’s download page says it all – “Warning! For adults only!” Hawkins encourages parents to be aware of what their children are viewing online and really take part in their lives, including what they are doing online. This social outlet is not recommended for the under 18 year old age group.

8. Fake-a-Text -This app allows the user to set who the text is to look like it’s from, what the text will say, and when it will be sent.

Pros: Children can impress their friends and look cool by looking like a celebrity texts them.

Cons: This can hurt reputations and upset friends by tricking them. This app also encourages lying.

Hawkins says: “This is a teen’s dream if they want to fool their friends,” Hawkins says. This “evil little app of deception” can hurt the reputation of a real person. For example: a teenage boy can convince his friends that a real girl sent a sexual text, even though she didn’t, and this can harm her reputation.

Social media has its benefits, but those benefits can come with drawbacks. Tell your child to be cautious about the information he/she is putting out there in the online world. You also might want to have the “stranger danger” talk again with a reminder to be careful about the people he/she is chatting with online. Finding the right balance with what you share online and what you keep private is key in the social media domain. Give them a certain time frame to log-in and make sure it’s on a computer that you can view.

- Article written by Amanda Burmeister

About the source

Jody S. Hawkins, Information Systems Security Officer, has been in technology for medical facilities since early 2000 and has been practicing for more than 20 years with his start in the United States Air Force. He is a part of Cook Children's Experts on Call Speakers Bureau. Hawkins specializes in privacy and technology safety and is a regular speaker at the National HIT/HIPAA Conference. He has been quoted and published in several national publications, including Health Information Management Magazine.

Hawkins' can speak on a variety of security topics facing our children & parents today, including:

• Social media
• Cyber bullying
• Sexting
• Safety online (Parents & Child)
• General home networking security
• Virtual Child (Parents)
• Internet Safety (Parents & Child)

Surprised? Lisa Elliott, Ph.D., clinic manager of Cook Children's Behavioral Health in Denton, Texas, isn't. Elliott, a licensed psychologist, says parents and teachers often have an outdated view of what a victim looks like.

"The general public has always perceived that children who are vulnerable to bullying have some sort of social deficit, physical handicap or learning disability," Elliott said. "While this is true, socially adept kids are equally vulnerable to bullying, especially when they attempt to climb the social ladder."

Last year, the American Sociological Review published the "Casualties of Social Combat" study, which examined more than 4,200 middle- and high-school students and found that the more popular students became, the more vulnerable they were to bullying.

Snakes and (Social) Ladders

For several years, Elliott has given presentations on bullying to the local community. She says parents are surprised when they hear a popular student can be both a bully and a victim at the same time. According to Elliott, the danger comes when a child tries to gain more status in a social clique that is emotionally aggressive or manipulative. Signs of this nonphysical bullying can be subtle and easily mislabeled as "drama."

Jockeying for position

According to the study, bullying is more likely to occur within a social group, between two "friends" who are on the same level in social heirarchy. On the outside, this may simply look like typical relationship drama. What's actually happening may be subtle but serious bullying.

How to Stop the Cycle 

No child is bully-proof. According to Elliott, the key is to to make sure your child can spot an unhealthy friendship before it goes too far.

"We should communicate to our children what true friendship is, and what it isn't," Elliott said. "This will help them discern which peers they can trust and which ones are trying to manipulate them."

Elliott offers parents the following talking points when speaking to their child about bullying:

• Even people who say they're your friends, can bully you.
• You should confront your friends when they're being hurtful to you or others.
• Retaliating may feel good temporarily, but refusing to stoop to the bully's level will win you more popularity in the long run.
• When you hear a false rumor, just ignore it and be yourself.
• You're most likeable when you respect yourself and others.
• Bullies usually have their own insecurities. Returning meanness with kindess is the best way to break down their defense.

Warning signs

If you worry your child is being bullied, look for the following signs:

• Sudden change in friendships.
• Unexpected drop in grades.
• Irritability or moodiness.
• Reluctance to go to school.
• Avoidance of social situations.
• Faked illnesses or complaints of feeling sick.

Listening to this conversation got me thinking about some of the other parenting research I have done as a pediatrician and to help with our kids as they have been growing up. We all want what is best for our children, but sometimes figuring that out is difficult. But, as a pediatrician who is interested in learning and development, that’s what I’m here for. 

I decided to share some things with you that you might not have thought about before. Some of the studies are common sense and others have some pretty surprising results. Either way, I plan to offer lots of practical advice about how you can use the study to help your child learn and develop well.

Here are some of the questions I will answer over the next few weeks:

Is calling your child smart really a bright idea?

Why should everyone homeschool (don’t jump to conclusions here…wait for the post)?

Why do you want your kid to point (even if it’s not “polite”)?

And many more!

What questions do you have about how you can help your child learn and develop? Leave a comment below. If I don’t have a post that answers it, I’ll write it.

It's no question that social media has changed the way that we interact with the world. We went to a museum exhibit recently and I kept getting dirty looks, chasing after my boys because I kept walking in front of people trying get the perfect picture on their phone ... there's no doubt that I "photo-bombed" lots of Facebook posts, tweets and Instagram accounts that day.

We are more connected now with more people than ever before. The problem is the types of connections that these mediums tend to foster. Adults have a difficult time with many aspects of social media: deciphering true friendship, using caution when posting personal information and being careful not to say and do things because of the security and anonymity of being behind the computer. These three issues are even more difficult for teenagers to wrap their heads around.

So, when is the right age to let your child use social media? It depends.

It depends on so many things and there's not a simple answer but here are some questions you need to ask yourself.

1) What does your tween/teenager want to use it for?

I'm not sure what the answer you're looking for here is. My guess is that the most honest answer you would get from your child is," Everyone else has one." There are really different uses for some of the different platforms so you should probably weight each answer in the context of your child and the platform.

Facebook - You may not get many requests for using Facebook ... believe it or not, some reports say it is declining in use by our teenagers. Yogi Berra once said, "Nobody goes there anymore. It's too crowded." Facebook may be too crowded with adults to attract teenagers anymore. Nobody wants their parents to be able to see the pictures of them at a party. Many teenagers even say they have grown tired of Facebook because they are tired of the unneccessary drama that users are trying to stir. 

Twitter - Many tweens migrated to Twitter in 2012 and 2013. One of the most common reasons is that parents aren't there yet so it keeps them ahead of their parents' online presence. I think it also provides them a level of connection to celebrities that some of the other platforms don't provide. I got a picture of my boys retweeted by Vince Carter (@mrvincecarter15) last year and I have to admit I got a little bit of a rush from it. You can imagine what any amount of social recognition by one of your teen's heroes would provide. 

Instagram - Instagram seems to be a pretty quickly expanding social network. Teens seem to like the visual components to it and the rapidity with which they can post. It used to be popular because parents and adults weren't on the site, but we can get involved and ruin that pretty quickly (and it's started to happen already).

Snapchat - Snapchat is a way to share photos and share them with friends in a way that (in theory) cannot be stored on the phone. However, as with anything digital, there is always a loophoole and recipients can take a screen shot of the Snap and save it to their phone. When I ask my patients who have Snapchat about this, they say they only use it to take crazy or silly pictures of themselves and share them. Of course, no one I know is using them for sexting or anything less honorable (sarcasm intended).

2) Will you have access to the accounts any time you want?

Just like snooping on a cell phone, snooping around on your children's accounts without their knowledge doesn't work. What happens if you find something that concerns you? Do you address them directly, indirectly or just fret and worry about what you've found but not bring it up? You have to set a ground rule up front about what your level of supervision will be so that there are no surprises down the road.

3) How will you protect them from inappropriae content/behavior?

Social media has dangers and if we allow our children to be on them, we have to protect them from harm.

1) Predators - Unfortunately, this happens more commonly than it should. Your teenagers should not accept friend requests from people they don't know and should use caution about posting personal information.

2) Bullying - Your teeangers could be bullied online, but they could also be bullying others online. Teenagers often lose their inhibition when they are sitting at a keyboard and don't stop because they don't receive the feedback of a person getting upset like they would be if they were bullying in person.

3) Social acceptance - Teenagers commonly post things online in order to get acceptance from others. There is a growing trend of teenagers (especially girls) posting videos of themselves asking, "Am I Pretty or Ugly?" Of course, they get a mix of responses but many are aggressively negative and teenagers have a hard time moving past the negative responses or realizing that someone is simply responding to hurt them.

4) Social pressure - Teenagers have always had an intense anxiety to be cool. They have a desire to be wearing the "right" clothes, have the "right" friends and find themselves at the "right" parties. So, what has changed because of social media? All the same pressures are there but they are present in front of your teenagers 24 hours a day. They not only have to sort through all these issues, they have to post about them and read their friends posts about them, all the while struggling to keep up. It's exhausting just to think about it.

In summary, every teenager will eventually ask you for some form of social network access. Even if you don't have teenagers, it's important to start to think through some of these issues early so that you're prepared when the time comes. Discussing these issues with your teenagers before you give them access can prepare them to use social media in a healthy way.