Bullying Risk in Children with Disabilities: A Review of the Literature
Bullying, also called peer victimization, is a ''disrespectful relationship problem'' that occurs when one or more children repeatedly use aggressive behaviour to manipulate, upset, or harm another child who is vulnerable because of his or her physical, mental, or social features1. Children can be bullied in several ways. For example, a child who is physically bullied may be kicked, hit, or pushed by a peer who is older or stronger while a child who is verbally bullied may be called mean names, insulted, or threatened.2,3 Many parents, educators, and health professionals are familiar with physical and verbal forms of bullying. However, it is also bullying when a child uses ostracism, rumour spreading, or gossip to sabotage another child's peer relationships and isolate him or her from the peer group.2 This type of bullying, called relational bullying, can be just as harmful to a child as being physically harassed or attacked.4
Children who are bullied face many social and emotional risks, including a greater chance of feeling depressed or anxious, being lonely, and having low self-esteem.5 Other impacts of bullying can include headaches or problems sleeping, poor attendance at school, low motivation and a drop in academic performance; in extreme cases, suicidal thoughts or actions may occur.2 In fact, bullying is such a serious problem that countries around the world, including Canada, have made it a priority in children's health to prevent and manage bullying in our schools and communities.6
Are children with disabilities at risk?
Although many children may be bullied at one time or another, children with disabilities appear to be especially vulnerable to being the targets of repeated aggression from their peers.7,8,9 In this Keeping Current, we have reviewed the research literature and summarized current evidence about the risk of being bullied for children who have three very common childhood disabilities present in Canadian classrooms:
- Developmental Coordination Disorder (DCD),
- Specific Language Impairment (SLI),
- Attention Deficit Hyperactivity Disorder (ADHD).
We considered it important to review what is known about the risk for bullying across these particular groups because their disabilities may not be immediately apparent to others. Parents, teachers, and service providers may not even be aware that children with DCD, SLI, or ADHD may be among those children with disabilities who are at higher risk of being bullied. Evidence suggests that children who have these types of "hidden" disabilities are less likely to be offered protection by their peer group than are children whose disabilities are more visible (e.g., children with physical disabilities such as spina bifida).10
Bullying Risk among Children with DCD
DCD is a movement disorder that affects 5 to 6 % of school-aged children.11 Children who have DCD struggle to learn and perform age-appropriate motor skills despite having normal intelligence and no other neurological disorders.11 A child with DCD may demonstrate significant difficulty with self-care tasks (e.g., dressing, using utensils, tying shoes); academic tasks (e.g., printing, handwriting, copying, completing activities in gym class); and/or extracurricular activities (e.g., taking part in sports and playground activities). In addition to their motor difficulties, many children with DCD also have trouble fully participating in social and recreational activities so that they become increasingly isolated from their peers.12
Children with DCD have several physical traits that might increase their vulnerability to being bullied. For example, they may look clumsy and awkward when they move and struggle with simple motor-based self-care and academic tasks that other kids their age can do.13,14 They also may not be as physically fit as their peers and may be overweight.15 Our research with parents of children with DCD suggests that families often describe concerns about bullying by the time their children reach 9 or 10 years of age.12 Similar concerns also have been raised in other studies involving parents whose children have DCD.16,17
To date, very few studies have examined the risk for being bullied directly by asking the children with DCD themselves about their experiences. In one of the few published studies on this topic, Piek and her colleagues18 compared 43 seven to eleven year-old Australian children who scored as being "at risk" for DCD on a screening measure to a control group of 43 children of the same age. In that study, children at risk for DCD did not report being bullied more often than their peers, but bullying did have a greater impact on their self-esteem. This was found to be especially true for girls at risk of having DCD.
Recently, our research team found that 159 ten year-old Canadian children at risk for DCD reported experiencing more verbal and relational bullying than a comparison group of 159 same-age peers. We also found that being at risk for DCD, and being bullied, predicted children's reports of being depressed.19 Unlike the Australian study, we did not find that the impact of being bullied was different for boys and girls. Of course, both our study and the Australian study are preliminary so further research is needed. In either case, the findings of both studies suggest that being bullied negatively impacts the emotional well-being of children who are at risk for, or have, DCD.
Bullying Risk among Children with SLI
Children who have specific language impairment (SLI) have significant difficulty learning spoken language even though they have average intelligence and no known sensory (e.g., hearing loss) or neurological problems that might explain their delays.20 Affecting about 7% of primary school children,21 young children with SLI may have trouble learning new words, putting words together to make complete sentences, understanding and following directions, and understanding or telling stories.22 When they enter school, many children with SLI will have difficulty learning to read and write.23 Some school-age children with SLI also have trouble understanding and using non-literal language (e.g., jokes, riddles, and sarcasm), which can impact negatively on their peer relationships.24
Children with SLI are less skilled at many social activities that are important to developing peer relationships, including knowing how to join peer groups,25,26 negotiating with peers and resolving conflicts,27,28,29 and taking part in group learning activities.30,31 Recent studies also suggest that children with SLI are at increased risk of being bullied.32,33,34 For example, researchers in the United Kingdom found that the risk of peer victimization among 11-year-old children with SLI was 36% — fully three times larger than the level reported by children of the same age with no language difficulties.32,33 In addition, adolescents with SLI reported a lifetime risk of being bullied that was nearly twice that of their age mates (49% vs. 27%), and five times as many reported being victimized throughout childhood (13% among children with SLI vs. 2% among typically developing peers).34
Bullying Risk among Children with ADHD
ADHD affects approximately 3-7% of all school-age children.11 Children who have ADHD have difficulty staying focused and appropriately regulating their emotions and behaviour,34 which can put them at risk for academic and social problems.36,37 Due to their difficulties, children with ADHD often behave in ways that are viewed by their peers as disruptive and aggressive.38 In some cases, their behavioural difficulties may trigger peer victimization and social exclusion.9
Children with ADHD may be up to four times more likely to be bullied than their peers.9 They also report more verbal, physical and relational victimization than do children without ADHD.39,40 In fact, the risk of being frequently bullied may be as much as 10 times greater among children with ADHD.41 In a qualitative study of peer victimization among four boys with ADHD, Shea and Weiner39 describe how chronic bullying can lead to feelings of powerlessness and severe psychological distress. The boys, along with their parents, talked about feeling "beaten down" and reported being unable to stop the vicious cycle of verbal bullying and social exclusion that thwarted the boys' attempts to make new friends. Even at a young age, if bullying is present, children with ADHD may experience depression and anxiety.42
What does this research evidence mean?
A lot more is known about the risk for repeated peer victimization among children with ADHD or SLI than among children with DCD. For children with SLI or ADHD, studies show an increased risk for being bullied compared to other children of the same age without any disability. Research about the risk of being bullied for children with DCD is still emerging; however, the available literature suggests that some of these children may be vulnerable.
In addition, this research provides only the overall or group risk of a child being bullied. This means that some children with DCD, SLI, or ADHD are not bullied. Understanding the factors that might influence whether or not an individual child with DCD, SLI, or ADHD is at risk for being bullied is an area in need of more research. Nevertheless, it is important for adults to be aware that these children may be at heightened risk of being bullied, even though their disabilities are not always obvious or visible to others. The need for adults to be aware of the risks faced by children with "hidden" disabilities extends to other vulnerable groups too (e.g., children with learning disabilities). Therefore, parents and teachers should be familiar with the signs that a child is being bullied and know what they can do to help.
What can I do to learn more about bullying and how to stop it?
The Promoting Relationships and Eliminating Violence Network (PREVNet) is a national network of researchers, community organizations, and governments that aims to prevent and stop bullying in Canada. Much like CanChild, a main goal of PREVNet is to help translate research evidence for everyday use by consumers, such as parents, teachers, and children. PREVNet has produced a series of research-based toolkits and resources about bullying that can be downloaded at no charge from their website. The following are brochures that may be of interest to elementary school children and their parents and teachers:
- Making a Difference in Bullying: What Parents of Elementary Children Need to Know (© PREVNet 2007)
- Making a Difference in Bullying: What Teachers of Elementary Children Need to Know (© PREVNet 2007)
- Tip Sheet for Elementary Children: What You Can Do if You are Bullied (© PREVNet 2007)
Wenonah Campbell is supported by a Post-Doctoral Fellowship Award from the McMaster Child Health Research Institute.
Who do I contact if I want more information?
CanChild Centre for Childhood Disability Research
Institute for Applied Health Sciences, Room 408
1400 Main St. W., Hamilton, ON L8S 1C7
Tel: 905-525-9140 x 27850