Bullying and atopic dermatitis

What is bullying ?

Children with atopic dermatitis are often victims of bullying. Bullying is defined as any kind of physical, psychological, sexual or financial abuse and cyberbullying which is carried out by the child’s peers and which makes the child feel in danger. It’s always a case of power abuse against weaker children for the purpose of attaining a goal. Bullying involves aggressive, manipulative and exclusionary behaviour which is performed consciously and repeatedly.

What are the signs your child Is being bullied?

We have to always pay attention to sudden changes in our child’s behaviour, especially the following:

1. Changes in interpersonal relationships (with parents, teachers and peers):

  • The child suddenly changes his or her behaviour (e.g. a previously sociable child becomes withdrawn, doesn’t communicate, hides his or her atopic skin with long sleeves on hot days etc.).
  • The child has low self-esteem; he or she believes she is ugly and unworthy of love and feels rejected by others.
  • The child becomes isolated from others at school or kindergarten (he or she feels lonely, rejected by his or her peers, is picked last in group games and often prefers the company of adults).
  • The child is irritated, rude and aggressive and behaves disruptively in class.
  • The child declines to talk and resorts to lies to be left alone.
  • The child doesn’t mention friends in his or her talk, doesn’t attend birthday parties and doesn’t invite friends to his or her home.
  • The child has trouble eating and sleeping. He or she has nightmares, cries in his or her sleep and goes to the bathroom often.
  • The child may steal money and other valuable things.

2. Changes in school grades, child’s attitude towards school and social inclusion of the child:

  • The child resists going to school by crying, pretending to be ill, expressing fear and anxiety.
  • The child feels afraid or uncomfortable when having to attend school trips, excursions or going to school with the school bus.
  • The child asks to be driven to school because he or she is afraid to walk to and from school alone.
  • If parents refuse to drive the child to school, he or she changes the path he or she normally takes and may start leaving for school earlier or later than usual.
  • The child’s grades drop or he or she skips classes.

3. Changes in the child’s physical state:

  • The child has unexplained injuries (bruises, scratches etc.).
  • His or her chronic illness, e.g. atopic dermatitis, worsens.
  • The child stops eating or overeats.
  • He or she gets sick more often or often complains about pain in the stomach, head and so on.
  • The child indicates directly or indirectly that he or she no longer wants to live.

4. Damaged personal possession:

  • The child’s personal possessions are often damaged or stolen.

Who to turn to and how to act?

What happens after we discover that our child has been a victim of bullying plays an important role in the consequence the abuse will have for our child. It’s of vital importance that parents are able to identify that their child has been abused and respond appropriately.

The special dynamics that develops between the victim and the abuser prevents the victim from stopping abuse on his or her own. Without adult intervention bullying can never end.

Respond immediately

As adults we must respond to bullying immediately and within the limits of our competencies, roles and authority – this goes for both parents and kindergarten or school employees.

Important procedures
  • First, the child’s safety needs to be taken care of. Physical protection and emotional support should be provided for the abused child.
  • It’s good to set in motion any procedures that the kindergarten or school your child attends has in place in case of peer abuse. Usually, this involves alerting the class teacher, the principal and/or the school counsellor and psychologist to the problem.
  • Be prepared that a larger number of people may be involved in resolving the problem of your child’s bullying. Apart from the class teacher(s) and the principle, the counsellor may decide to include witnesses, the bully’s parents and the parents of the child’s classmates to clarify the situation and work towards a solution. Bulling is a complex phenomenon and one that is impossible to tackle alone – bringing together as many people as necessary to put an end to it is a plus.
  • The counsellor will also speak to your child and your child’s bully about the abuse. This should always happen separately – the bully and his or her victim should never be made to confront each other.
  • If the bully has committed a criminal offence with his or her abuse, a police officer and a social worker may be brought in to work on the case together with the class teachers, the principle and the school counsellors. Depending on the case, the school or kindergarten may also reach out to non-governmental organisations, e.g. atopic dermatitis patients advocate groups, in order to formulate a plan to tackle peer abuse.

What about prevention?

When dealing with bullying, we mustn’t forget about prevention. Victims of bullying are often children who differ from their peers in one way or the other (because of their grades, nationality, looks – e.g. rashes and scars in atopic dermatitis), which is why it’s essential to educate parents and children on how to accept those who are different from them.

 

The signs and symptoms of atopic dermatitis leave a strong mark on the child’s appearance and behaviour. The illness is also grossly misunderstood and it’s crucial that we educate parents and children about it. A lot of parents and children still wrongly believe that atopic dermatitis is contagious and their behaviour mirrors their own fears and misunderstanding. Facing various unpleasant remarks and social isolation, many children with atopic dermatitis withdraw from others and aren’t able to explain what they’re going through. This is where we as parents must step in and offer our help.

What can doctors and healthcare workers do in cases of abuse?

Healthcare workers need to look out for signs of bullying in children and teenagers with atopic dermatitis and offer them support.

It’s very important that healthcare workers are aware of the problem of  bullying as children won’t report abuse themselves. Here are a few questions that can help healthcare workers detect instances of peer abuse:

  • Do you enjoy your classes/kindergarten?
  • Do you feel safe at school/kindergarten?
  • Do you like going to school/kindergarten?
  • How are your grades?
  • Do you have any friends at school/kindergarten?
  • Do you like your teachers? Do they understand you?

A multifaceted cooperation between doctors, the patient, family members, psychologists, school workers and non-governmental organisations can help create a safety net for children and teenagers facing this difficult illness. In this way we can achieve important social changes that will greatly enhance the lives of the little patients.

 

Confidential telephones and contacts

Different countries have different support programs and phone numbers that you can contact in distress.

We also advise you to contact a local NGO that represents patients with atopic dermatitis in your country.

Kids and their parents may turn to various helplines when experiencing abuse. They may also contact different organisations, who will get in touch with the kindergarten/school. The organisations may offer to host educational events for children and employees to help empower the patients who suffer from atopic dermatitis.

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    Novaković, T.  Navodila s priročnikom za obravnavo medvrstniškega nasilja v vzgojnoizobraževalnih zavodih. Ljubljana. Zavod RS za šolstvo; 2018.
  2. Sullivan K. The Anti- bullying Handbook. London: Oxford University Press; 2011. 
  3. Štirn, M in Minič M. Pihosocialna podpora žrtvam nasilja v družini in nasilja zaradi spola. Ljubljana: ISA Inštitut; 2017. 
  4. Leszczynska, MA., Jaquez SA, Diaz LZ. 2020. More to Skin Than Meets the Eye: Bullying and Childhood Skin Conditions. The dermatologist, 28, 9.