Bullying: What Speech-Language Pathologists Should Know Stephanie Hughesa

Purpose: The purpose of this tutorial is to introduce speech-language pathologists (SLPs) to the broad issues surrounding the problem of school bullying in childhood and adolescence. Specifically, types of bullying and their causes are considered, as are the roles students take when bullying occurs and the effects of bullying on students with communication disorders. Strategies and suggestions to help SLPs more effectively prevent and manage bullying of students with communication disorders are discussed. Method: A review of the scholarly literature in education, psychology, child and adolescent development, and speechlanguage pathology was conducted. Recommendations for how SLPs can prevent and intervene in bullying incidences were extrapolated from the reviewed literature.


amie” is a bright sixth grader who has moderate to severe stuttering. Jamie reports that he does okay in school and has good friends. His parents say that Jamie has begun to receive Cs and Ds in school, does not get invited to birthday parties or to classmates’ homes, and often gets off the bus after school in tears. Jamie’s parents worry that he does not seem to fit in with other children and is deliberately excluded from peers’ social activities. Jamie often complains of an upset stomach and has missed several days of school this year. A conversation with Jamie’s teacher, Mrs. Ference, revealed that Jamie tends to stutter quite severely when called on to answer questions in his social studies class. Earlier in the year, a classmate imitated Jamie’s stuttering when giving his own answer, and a few of the other boys have done this, too. Mrs. Ference privately talked with these boys, and they stopped. But now whenever Jamie stutters, Mrs. Ference notices a lot of snickering and whispering from classmates. Each time this happens, Mrs. Ference admonishes the class that Jamie cannot help his stuttering, but this strategy has not

Results: Students with communication disorders are at particularly high risk for being bullied by peers. Some students with communication disorders are “provocative victims” in that they demonstrate impairments in social skills that draw the attention of bullies. Both provocative victims and typical students may react aggressively when bullied and bully others in retaliation. Conclusion: SLPs can and should help to create an inclusive environment for all students while addressing bullying of students with communication disorders via therapeutic activities. Key Words: school bullying, relational bullying, peer relationships, social skills, intervention

seemed to improve the situation. Jamie shrugs or says “I don’t know” more and more often when called on in class. School is clearly very unpleasant for Jamie. The school environment seems detrimental to Jamie’s academic success, as he avoids school and his grades are suffering. The purpose of this tutorial is to give speech-language pathologists (SLPs) the knowledge and tools to identify and respond appropriately to bullying situations like that of Jamie. The tutorial includes a broad overview of bullying and its causes and consequences. Strategies and suggestions to help SLPs more effectively prevent and manage bullying of students with communication disorders are discussed.

What Is Bullying?

Correspondence to Stephanie Hughes: [email protected] Editor: C. Melanie Schuele Associate Editor: Ellen Kelly

Bullying is defined as “unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time” (U.S. Department of Health and Human Services, n.d.-a, para. 1). Children and adolescents (and, indeed, adults) do not always act kindly or with respect toward each other. Thus, it is important to differentiate between unkind, disrespectful, or otherwise inappropriate behaviors and the phenomenon of bullying. Three necessary elements of bullying are that the behavior (a) involves the intent to cause fear or harm, (b) is repetitious, and (c) is

Received February 1, 2013 Revision received May 15, 2013 Accepted December 20, 2013 DOI: 10.1044/2013_LSHSS-13-0013

Disclosure: The author has declared that no competing interests existed at the time of publication.


University of Toledo, OH

Language, Speech, and Hearing Services in Schools • Vol. 45 • 3–13 • January 2014 • A American Speech-Language-Hearing Association


perpetuated by a person who holds some form of power over the person at whom the behavior is directed. Careful judgment must be taken in applying this definition of bullying. For example, a student may post a humiliating video of another student on a website like YouTube, where it is seen by hundreds or even thousands of fellow classmates as well as the general public. Even though the student who posted the video did so only one time, the component of repetition could have been assumed a priori based on the sheer number of times the video has the potential to be viewed. Likewise, the student in the video has little power to stop other people from viewing the video, as what is on the Internet tends to stay on the Internet (Kowalski, Limber, & Agatston, 2012). Further, a power differential can be created based on any difference that tends to tip the balance of favor toward one student or a group of students. For example, popular students are less likely than unpopular students to be bullied (Mynard & Joseph, 1997), whereas students who have disabilities (Whitney, Smith, & Thompson, 1994), weight problems (Janssen, Craig, Boyce, & Pickett, 2004), or sexual or gender orientation differences (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010) are at a significantly greater risk for being bullied than peers without these conditions or characteristics. Children can bully each other in a variety of ways. Bullying can occur in overt or direct ways, such as hitting, kicking, or shoving (physical bullying) or name-calling or threatening (verbal bullying; Olweus, 2001). Many children report experiencing a combination of physical and verbal bullying (Orpinas, Horne, & Staniszewski, 2003). Another way of bullying, called cyberbullying, takes place in online and digital environments. Cyberbullying has increased as social media and other technologies such as smart phones have become more prevalent (Raskauskas & Stoltz, 2007). Cyberbullying is a relatively easy way for children to bully each other outside of school, though school is where cyberbullies identify their targets (Raskauskas & Stoltz, 2007). A fourth way of bullying is relational bullying, also known as social bullying (Olweus, 1991). Relational bullying occurs when students spread rumors or gossip about other students, deliberately exclude peers from group activities, or otherwise shun fellow students. Relational bullying is particularly devastating to students. Yet there is evidence that SLPs take relational bullying less seriously than other forms of bullying and that SLPs do not think they should intervene when relational bullying occurs (Blood, Boyle, Blood, & Nalesnik, 2010; Blood, Robins, Blood, Boyle, & Finke, 2011).

Who Bullies, and Why? Boys tend to bully more than girls (Cook, Williams, Guerra, Kim, & Sadek, 2010), though girls seem more likely than boys to engage in relational bullying (see Dake, Price, and Telljohann [2003] for a review of this debate). Bullying occurs most often in middle school (Nansel et al., 2001) and when students are transitioning from one school environment to another, for example, from elementary to middle

school or from middle school to high school (Pellegrini & Long, 2002). Well-intentioned adults may assume that bullying is the result of peer conflict. As such, an adult may bring together the child who is bullied and the child who is engaging in bullying behaviors to mediate the conflict. Unfortunately, this form of intervention is upsetting for the child who is bullied and may reinforce feelings of power for the child who bullies. Children who experience bullying should not be expected to engage in dialogue with the children who bully them or to resolve bullying on their own. The terms peer victimization and peer abuse often are used synonymously with bullying to emphasize that, much like spousal abuse or child abuse, bullying is not the result of conflict and is not the fault of the person who is bullied (Olweus, 1993). Furthermore, although the terms bully and victim are used here and in the bullying literature, telling a child that he or she is a victim can reinforce feelings of powerlessness for students who are bullied (e.g., Evans, 2011). So if bullying is not a result of arguments or conflicts between peers, why does it occur? One theory is that bullying is a result of competition for social dominance, particularly when bullying occurs among male students (Pellegrini & Long, 2002). In The Bully Society, Klein (2012) suggested that social dominance can be influenced by several factors, including adherence to gender norms, socioeconomic status, and race– ethnicity. Klein argued that pressure to conform to gender norms, especially rigid ideas about masculinity, may have the greatest impact on school bullying. Male students who are physically weaker than peers are at risk for being bullied, as are students who are not (or do not appear to be) heterosexual. In some school cultures, athletic performance is prized above scholastic achievement, creating an environment where administrators and educators may be permissive of bullying by popular male athletes. Girls are also under pressure to prove their heterosexuality, yet must respond in a physically or verbally aggressive manner if threatened by other girls (Klein, 2012). Other theories about why children bully explore the role of parents. Evans (2011) argued that some young children bully their peers because they become overwhelmed by emotional, physical, or social challenges in their environment. Ideally, parents would help children deal constructively with these challenges by teaching positive replacement behaviors, such as talking through problems and agreeing on solutions. Instead, some parents model and reinforce verbal bullying when they use phrases such as “Look at me when I’m talking to you!” and “I’ll give you something to cry about!” (Evans, 2011, p. 4), and this leads to the child bullying his or her peers. Likewise, harsh verbal or physical punishments for bullying are not effective as they do not teach children who bully to seek constructive solutions to environmental challenges (Evans, 2011). Similarly, parents who are inconsistent or overly permissive may also put their children at risk to become bullies, as these parents do not teach their children skills to problem solve disagreements or interact more positively with peers (Nation, Vieno, Perkins, & Santinello, 2008).

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Prevalence of Bullying and Students’ Roles in Bullying Olweus (1993) suggested that schools may have “hot spots” for bullying. This term refers to places that provide opportunities for bullying because of the lack of adult supervision. Craig, Pepler, and Atlas (2000) video- and audio-recorded elementary students during recess and in the classroom and observed physical or verbal bullying 4.5 times per hour on the playground and 2.4 times per hour in the classroom. Thus, playgrounds may be “hot spots” for bullying. Instances of bullying were brief, lasting less than 35 s on average, indicating that it is difficult for adults to notice and intervene when bullying occurs. Craig et al. (2000) observed that adults intervened in only 15% of bullying episodes on the playground and only 18% in the classroom. Thus, the presence of an adult in the immediate vicinity (such as a classroom) tends to reduce the prevalence of bullying, but adults respond to very few bullying incidents in general, regardless of where the bullying takes place. Furthermore, adults and students tend to have different perceptions of how often adults intervene in bullying situations, and teachers’ perceptions of the frequency with which they intervene in bullying situations may not be accurate. Charach, Pepler, and Ziegler (1995) surveyed teachers and students and found that teachers reported intervening in 75% of bullying episodes. It is interesting to note, then, that students reported teachers intervening in only 25% of episodes. Although Charach et al. (1995) did not observe or record bullying incidents in this study, data from Craig et al. (2000) seem to substantiate the finding that teachers respond to far fewer bullying incidences than they perceive. Wang, Iannotti, and Nansel (2009) examined the frequency with which American 6th- through 10th-grade students reported that they had, at least once in the past 2 months, been involved in bullying, whether as a bully, victim, or both bully and victim. Physical bullying was reported by 21% of students, verbal bullying by 54% of students, relational bullying by 51% of students, and cyberbullying by 14% of students. Approximately one third of students reported themselves as a bully as well as a victim for each category of bullying. Similarly, Juvonen, Graham, and Schuster (2003) found that 22% of sixth graders were involved in bullying: 7% as bullies, 9% as victims, and 6% as both bully and victim. Students seem especially prone to being bully and victim in the case of cyberbullying. In their review of school bullying studies, Wade and Beran (2011) found that 11%–17% of students have engaged in cyberbullying and 19%–29% of students have been cyberbullied. One interesting finding was that students who bully others at school tend to be victims of cyberbullying outside of school (Raskauskas & Stoltz, 2007). It may be the case that victims of traditional bullying at school take advantage of the anonymous nature of the Internet to retaliate against their bullies. At any rate, these statistics reveal that cyberbullying is as problematic as traditional, school-based bullying; further, the bully and victim categories may not be mutually exclusive. Some students are considered “provocative” victims of bullying because they engage in behaviors that can escalate

bullying by peers (Olweus, 1993). Behaviors that can escalate bullying include inappropriate responses to social cues, such as turn taking and personal space, or limited ability to understand humor, including sarcasm (Snyder, 2012). Provocative victims may respond with aggression to bullying and engage in retaliatory bullying (Van Cleave & Davis, 2006). Students with disabilities including autism and cognitive disabilities (Sheard, Clegg, Standen, & Cromby, 2001; van Roekel & Scholte, 2010), language disorders (Conti-Ramsden & Botting, 2004), and learning disabilities (Nabuzoka & Smith, 1993) appear to be at risk for being provocative victims and bullying others. Students may observe bullying as bystanders. The majority of bullying incidents are observed by several peers (Craig & Pepler, 1997; O’Connell, Pepler, & Craig, 1999). Students who witness bullying have choices in how they respond, and their actions (or inactions) influence the duration of bullying episodes and whether the bully feels empowered to continue bullying other students (Craig & Pepler, 1997; Salmivalli, Voeten, & Poskiparta, 2011). Salmivalli et al. (2011) suggested that children that observe bullying and decide not to intervene or help the victim might take on one of three roles: “assistants,” who join in the bullying; “reinforcers,” who encourage bullying by providing an audience or giving positive feedback to bullies in the form of cheering or laughing; or “outsiders,” who remove themselves altogether from the situation. Most students passively observe bullying, taking on a reinforcer role rather than actively engaging in bullying (O’Connell et al., 1999). It is a rare student who will defend someone who is being bullied, even though most students feel empathy for victims (Rigby & Slee, 1992) and report that seeing bullying makes them feel unpleasant (Charach et al., 1995). Students who decide to intervene and defend the victim when they see bullying are sometimes called “upstanders.” (The term upstander was first coined by Samantha Power in her 2002 commencement address to Swarthmore College; though she used the term in the context of people who defended victims of genocide, many antibullying programs for children have adopted this terminology.) These students may also be called “defenders” (Olweus, 2001; Salmivalli et al., 2011). However they are labeled, students who stand up for other students play an important role in reducing the frequency of bullying. When these students express disapproval of bullying behaviors, they give negative feedback to bullies and disrupt the cycle of positive reinforcement bullies receive when they believe that they are achieving social dominance and peer approval through bullying (Salmivalli et al., 2011). That more students do not intervene when they see a classmate being bullied is unfortunate, as appropriate peer intervention is considered an important component of reducing bullying in schools (Pepler, Craig, & O’Connell, 2010).

Consequences of Bullying Bullying has gained increased public awareness in recent years as a result of frequent media reports of bullying.

Hughes: What SLPs Should Know About Bullying


Lee Hirsch’s (2011) documentary Bully, for example, followed five children who were bullied and showed the isolation, emotional distress, and sometimes physical abuse the children experienced on a daily basis. It is common for students who are bullied to experience depression, psychosomatic illness, anxiety, and sleep disorders (Forero, McLellan, Rissel, & Bauman, 1999; Salmon, James, & Smith, 1998). In a survey of high school students, a third of students who were bullied experienced symptoms that sound much like posttraumatic stress disorder: feelings of panic, repeatedly thinking about past bullying episodes, and inability to concentrate at school (Sharp, 1995). Unfortunately, these feelings of anxiety and distress tend to linger after graduation into adulthood. Carlisle and Rofes (2007) found that adults who were bullied once a week or more in school for several years reported high levels of shame and anxiety and also experienced difficulties in their relationships with others. Likewise, Nansel et al. (2001) found that adults who had been bullied in school continued to experience low self-esteem and high levels of depression. It is important to note that whereas bullied students and students who bully are more likely to think about suicide than peers, suicide is not a normal or typical response to bullying (Kim & Leventhal, 2008). The academic effects of bullying should not be underestimated. Students who are bullied are at an increased risk for poor academic performance over the course of their school careers (Glew, Fan, Katon, Rivara, & Kernic, 2005). They view school as an unsafe environment, and their anxiety about being bullied has an adverse impact on academic performance (Card & Hodges, 2008). The National Association of School Psychologists estimates that 160,000 students in the United States are absent from school each day because they fear bullying (Swearer, 2011). But what about the effects of bullying on students who bully? Bullies have poorer psychosocial adjustment than their peers, including alcohol use, smoking, and lower academic achievement (Nansel et al., 2001). Longitudinal studies indicate that students who bully are at increased risk for aggressive conduct disorder as teens and preteens (Emond, Ormel, Veenstra, & Oldehinkel, 2007) and will continue to demonstrate antisocial and other violent behaviors as adults (Rigby, 2003). Olweus (1992) noted that 60% of children who were bullies in school had at least one criminal conviction by the age of 24. Students who witness bullying may experience similar types of emotional distress as students who are bullied. Students who have been bullied may “relive” their bullying experiences when they watch peers being bullied (Russell, Franz, & Driscoll, 2001). Students who have never been bullied may experience anxiety as they wonder if their turn to be bullied is next (Glover, Gough, Johnson, & Cartwright, 2000). Students who witness bullying may turn to drugs and alcohol as a means of coping with or avoiding their emotional distress, as witnessing bullying is correlated with substance abuse (Rivers, Poteat, Noret, & Ashurst, 2009).

Bullying of Children With Communication Disorders Bullying may start at an early age for children with communication disorders. Children appear to recognize communication disorders and respond negatively to them while still in preschool. For example, Ezrati-Vinacour, Platzky, and Yairi (2001) examined children’s awareness of stuttering by using a video of two seal puppets. One puppet spoke fluently, and the other stuttered. After watching the video, children were asked questions about the puppets. By the age of 4, children agreed that stuttered speech was “not good” and preferred to have a friend who did not stutter. Langevin, Packman, and Onslow (2009) observed preschoolers who stutter and their typically developing peers on the playground. They found that although the majority of peer responses to stuttering were neutral or positive, negative responses included mocking, walking away from, and ignoring children who stutter. Preschoolers who stuttered were less likely to be leaders on the playground and had more difficulty resolving conflicts with peers. Langevin, Packman, and Onslow (2010) found that teasing was one of the most reported reactions of preschoolers to peers who stutter. Consequently, preschoolers who were teased or had negative peer responses to their stuttering expressed frustration, reduced talking, withdrawal, and avoidance. Given these findings, it is not surprising that preschoolers with communication disorders tend to have fewer positive social interactions with their typically developing peers (Gertner, Rice, & Hadley, 1994; Guralnick, Connor, Hammond, Gottman, & Kinnish, 1996; Rice, Sell, & Hadley, 1991). Children with communication disorders continue to have difficulties with peer relationships as they mature. Expressive language disorders and specific language impairment (SLI) increase children’s risk for being bullied (Lindsay, Dockrell, & Mackie, 2008; Savage, 2005). Knox and Conti-Ramsden (2003) found that children with SLI were three times more likely than typically developing peers to report being at risk for bullying. Students with autism spectrum disorder (ASD) report greater incidences of bullying than peers (Little, 2001; van Roekel & Scholte, 2010). A growing body of research indicates that children who stutter are at increased risk for being bullied (Blood & Blood, 2004, 2007; Hugh-Jones & Smith, 1999; Langevin, Bortnick, Hammer, & Wiebe, 1998). Peers also believe that children who stutter are less popular and more likely to be bullied than classmates (Davis, Howell, & Cooke, 2002). As a whole, these studies indicate that children with communication disorders are viewed negatively by peers and are at greater risk for bullying.

Protecting Students With Communication Disorders From Bullying Bullying has emotional, social, and academic consequences, but there are also legal consequences for bullying. Many students are protected from discrimination and/or

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harassment by U.S. law. For example, Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, or national origin, and Title X of the Education Amendments Act of 1972 prohibits discrimination based on sex as well as gender-based harassment. Students with communication disorders are similarly protected by Section 504 of the Rehabilitation Act of 1973 and by Title II of the Americans With Disabilities Act of 1990, which prohibit discrimination based on disability. According to the Office for Civil Rights (2010), school districts may violate students’ civil rights “when peer harassment based on I disability is sufficiently serious that it creates a hostile environment and such harassment is encouraged, tolerated, not adequately addressed, or ignored by school employees” (p. 2). Thus, students with communication disorders are afforded special legal protections from being bullied at school. Speech-language pathologists in schools have the unique ability to help other educators and school personnel recognize the importance of a safe environment for children with communication disorders. Unfortunately, adults who work in school settings may contribute to or engage in bullying. McEvoy (2005) found that it is common to have at least one teacher who bullies students in a school and that both students and fellow teachers are able to identify teachers who bully. Students with communication disorders and other disabilities are at high risk for teacher bullying. A focus group found that special education students, including students with communication disorders, experienced negative reactions from peers and educators that ranged from staring and sneering to physical violence (Holzbauer & Conrad, 2010). Juvonen et al. (2003) found that teachers as well as peers hold negative opinions of provocative students who are bullied and bully others. Thus, most students with communication disorders probably do not receive the support from school personnel that they should. Speechlanguage pathologists can educate coworkers about the need for supportive, inclusive environments for students with communication disorders.

Effective Bullying Interventions Bullying is a problem that is best remediated through collaboration among administrators, teachers, school personnel, parents, and students (Espelage & Swearer, 2003). It is important to take a whole-school approach to bullying so that students, parents, and school personnel receive similar training and information. Some schools have bullying conferences to help students recognize bullying behaviors, avoid bullying others, and respond appropriately to bullying. Other strategies include firm consequences for bullying, increased playground supervision, and meetings with parents to discuss bullying. Ttofi and Farrington (2011) found that short-term implementation of a single antibullying strategy is less effective than long-term implementation of multiple strategies. Some of the most effective strategies that children can use to cope with bullying include pretending that bullying is not bothersome, developing problem-solving strategies with adults, and seeking social support from peers (Langevin,

Kully, & Ross-Harold, 2012). It is important to note, however, that strategies to reduce bullying should be tailored to meet the needs of individual children. According to Kochenderfer-Ladd and Skinner (2002), some children may have inadequate coping resources or interpret the actions of their peers in maladaptive ways. In their survey of fourth graders, Kochenderfer-Ladd and Skinner found that gender and the ways in which chronically victimized children cope with bullying can mitigate or exacerbate negative outcomes. For example, girls who experience bullying may cope by seeking social support from teachers and peers, but boys are expected to solve their own problems. When boys ask for social support, they may be viewed negatively by peers and adults. Furthermore, Camodeca and Goossens (2005) reported that bullies and victims often conceptualize appropriate responses to bullying in different ways. Bullies tend to believe that witnesses and victims can stop bullying by retaliating against the bully. Other children, including victims and girls in general, tend to believe that assertiveness and pretending that bullying does not bother them are the more helpful strategies. Victims, however, are more likely to recommend that witnesses retaliate against bullies on behalf of victims. These studies suggest that students’ individual beliefs about bullying should be considered carefully when developing coping strategies for bullying. Students can give adults insight into how they would like bullying to be addressed in schools. Davis and Nixon (2010) surveyed a diverse body of more than 10,000 students who reported being bullied at least twice a month. These students reported that the most helpful things that adults can do for students who are bullied are to listen, give advice, and check back with students to see if the bullying has stopped. The least helpful things that adults can do are to tell bullied students to stop tattling or to ignore the bullying altogether. Students do not want to be told by adults that they should solve their own bullying problems. It also is unhelpful when adults say things that make students feel that they are to blame for being bullied, such as “if you wouldn’t cry, the other kids would leave you alone.” Extrapolating from these findings, SLPs may be able to best support students with communication disorders by assuring these students that it is okay to talk about bullying and that school personnel want to help and support them. If a child reports that he or she is being bullied, thank the child for reporting the bullying. Alert the appropriate person at school, and follow up with the child. Clinicians will recognize that some students, especially those with pragmatic language disorders or ASD, may be viewed as chronic “tattlers” in that they repeatedly inform teachers and school staff of rule breaking by peers. These students may find it difficult to understand the difference between minor infractions of rules versus bullying or dangerous behaviors that should be reported. Avoiding words such as “tattling” and “snitching” makes it easier for all students to confide in school personnel when bullying occurs. Table 1 provides a list of things that SLPs and other adults in schools can do when they observe instances of bullying, compiled from suggestions at www. (U.S. Department of Health and

Hughes: What SLPs Should Know About Bullying


Table 1. How to respond to bullying. Step



Stop bullying on the spot.


Find out what happened.


Support the children involved.

Action • • • • • • • • • • • • • •


Help students to be more than a bystander.

• • • •

Do not ignore the bullying. Act right away. Enlist the help of another adult if needed. Separate the children who are involved. Make sure everyone is safe: Contact the police and/or medical personnel if necessary. Model calm, respectful language to all parties. Continue to keep all parties separate, including parents. Gather facts from witnesses, peers, parents, teachers, etc. Review the definition of bullying and your school’s policies and consequences for bullying. Note that teen dating violence, gang violence, and peer conflicts without a power imbalance do not qualify as bullying, even if they have serious repercussions, and should be handled accordingly. Assure the child who is bullied that it is not his or her fault. Refer to the school counselor or mental health specialist if necessary. Role-play how to deal with the bullying situation in a constructive way. Establish open communication with the student, his or her parents, teachers, administrators, etc., to develop a plan for helping the student to be safe. Make sure that the child who bullies understands what she or he did wrong. Avoid “zero-tolerance” punishments like expulsion in favor of consequences that teach (such as doing a book report on bullying, giving a presentation to the class on why bullying is bad, etc.). Follow up with both victim and bully to make sure everything has been resolved. Make sure bystanders are okay and feel safe in the school environment. Make sure all students know how to respond to prevent and manage bullying. Create a school environment where students are encouraged to help students who are bullied.

Note. Compiled from

Human Services, n.d.-b). Readers may refer to this website for additional information and to review the evidence base for the suggestions listed in the table.

Addressing Bullying Directly in Speech and Language Therapy Students on SLPs’ caseloads have diverse communication deficits and psychosocial profiles that need to be considered in therapy. Social skills development is especially important for children with ASD and other pragmatic difficulties, as students who improve their social skills are less likely to be bullied (Kaiser & Rasminsky, 2003; Rigby, 2002). SLPs have proven to be very sensitive to the potential for bullying of children with ASD and tend to intervene by reporting bullying, educating students, and supporting victims to a greater extent than for students with other communication disorders (Blood, Blood, Coniglio, Finke, & Boyle, 2013; Blood et al., 2010, 2011). Although for students with ASD working on social skills is a typical therapy target that addresses core deficits, improved pragmatics also may help these students to be more resilient to bullying. Programs such as Winner’s (2005) “social thinking” program can provide SLPs with resources and treatment goals to help children with ASD develop better peer relationships by teaching the “why” behind social behaviors like eye contact, perspective taking, and turn taking rather than focusing on rote learning of these skills. (See Crooke, Hendrix, & Rachman [2008] for a brief report on the effectiveness of the social thinking program.) Incorporating carefully selected, typically developing peers

into therapeutic activities and social groups can give students with ASD socially appropriate role models and increase positive relationships with peers (e.g., Rowden-Racette, 2011). In general, SLPs should make efforts to encourage friendships between kind, mature students and children with communication disorders who have few friends. Research has shown that having just one good friend can alleviate the negative effects of bullying (Hodges, Boivin, Vitaro, & Bukowski, 1999; Laursen, Bukowski, Aunola, & Nurmi, 2007). Some children who do not have distinct cognitive or pragmatic disorders may also experience bullying and struggle to make friends with others. Murphy, Yaruss, and Quesal (2007) examined some strategies that worked to reduce bullying of a 9-year-old boy who stuttered; they suggested that SLPs can help children who stutter learn about the nature of bullying. Some students may be overly sensitive to inquisitive comments about their disorder and interpret such comments as bullying. In addition, students may not understand much about bullying in general and can be helped to understand why students bully others and that bullying is not the fault of the person who is bullied. Clinicians can also provide students with constructive ways to respond to bullying and help students to visualize how they can respond to bullying. Role-playing can help students develop the skills and confidence to react appropriately to bullying. Students can be guided to brainstorm assertive, alternative behaviors to typically nonhelpful responses to bullying, such as threatening, hitting, or crying. Educating classmates about the communication disorder also may be helpful. Murphy et al. suggested that a classroom

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presentation, carefully planned and conducted by both the student and SLP with input from the classroom teacher, can help reduce bullying for children who stutter. More strategies for helping children who stutter, their parents, and teachers can be found in Minimizing Bullying for Children Who Stutter: A Practical Guide for SLPs (Murphy, Quesal, Reardon-Reeves, & Yaruss, 2013) and the accompanying workbooks for students who stutter, for parents, and for teachers. Langevin et al. (2012) also described activities to help children who stutter cope with bullying in their Comprehensive Stuttering Program for School-Age Children. Like Murphy et al. (2007, 2013), Langevin and colleagues (2012) provided suggestions that could be useful for children with a variety of communication disorders. The program incorporates a bullying seminar for parents, group discussions about bullying, and problem solving with children. Topics discussed with children include explaining bullying and associated behaviors, learning why people bully, and exploring ways in which people are different and may be vulnerable to bullying even beyond their communication disorder. Differences between tattling and telling are discussed, and the importance of telling adults when bullying occurs is emphasized. Children also learn strategies like telling the bully to stop and saying why they do not like the bullying behavior, as well as problem solving that includes guidelines to help children “(1) identify the problem; (2) attack the problem not the person; (3) treat a person’s feelings with respect; and (4) take responsibility for your actions” (Langevin et al., 2012, p. 147). Turn taking, use of humor, compromising, seeking help, and role-playing are also discussed as strategies to reduce bullying.

Advocating for Change: What SLPs Can Do to Help Reduce Bullying in Schools Many SLPs may wish to help change the climate at their school in order to make school a more pleasant and effective learning environment for all children, including students with communication disorders. The following suggestions are provided for SLPs who wish to delve more deeply into antibullying advocacy work. Readers who wish to gain a better understanding of how these suggestions might work in practice are directed to a study by Langevin and Prasad (2012), which detailed the authors’ use of an antibullying program for stuttering called Teasing and Bullying: Unacceptable Behavior (Langevin, 2000).

Suggestion 1: Investigate the Prevalence of Bullying One of the first steps in addressing bullying in schools is to assess school climate and prevalence of bullying. Administering a survey about bullying is a crucial first step as school administrators consider the extent to which students are bullied and what should be done about it (Cornell & Bandyopadhyay, 2010). A number of surveys are available for purchase, including the Bully Survey (Swearer, 2013) and the Olweus Bullying Questionnaire (Olweus, 2007). Educators and SLPs can also make their own less formal survey to

determine the impact of bullying on students. For most students, a simple written questionnaire conducted anonymously will provide honest information about students’ experiences with bullying. Young children and students with cognitive difficulties may relay useful information during conversations about bullying that are conducted in an empathetic and nonjudgmental manner. Many children in general are hesitant to report bullying. So a gentle and indirect approach may be better than a direct one. Conversations with parents may also provide insights into the school experiences of students. Does the child talk about having friends at school? Do these friendships seem healthy? Students will sometimes consider bullies to be their friends, as they believe it is better to have mean friends than no friends at all (Snyder, 2012).

Suggestion 2: Learn About and Help Develop School Bullying Policies Children will experience many interactions with peers and adults throughout their school day, from the school bus driver and hall monitors to teachers and perhaps the SLP. All school personnel and students should be aware of the school or school district’s antibullying policies—if such policies exist. Students should hear consistent messages about bullying from all school personnel. SLPs can play an important role in bullying prevention, but they must use the same language and vocabulary that everyone else in the school uses when discussing bullying. The itinerant nature of some school-based positions means that SLPs may be less aware of school antibullying policies than other educators. SLPs can address this potential awareness gap by asking supervisors and administrators to discuss existing antibullying policies. It may be helpful to clarify what these policies may mean in practice, especially for children with communication disorders who are bullied and/or bully others. SLPs can help to create antibullying policies by serving on bullying prevention committees in schools, school districts, and communities. If such committees and initiatives do not exist, SLPs can talk to school administrators and community members about forming them. Encourage the development of consistent messages against bullying that are easily understood by students and can be implemented by school personnel. Note that in some school districts, any incidence of bullying or suspected bullying is handled via suspension or expulsion, no matter if the student was engaging in retaliatory bullying, was a first-time offender, or did not intend to harm or frighten another student. These socalled zero-tolerance policies have not proven to be effective (Skiba, 2000). SLPs should advocate against their use, especially when extenuating circumstances may apply to students who bully others because they are bullied.

Suggestion 3: Contribute to a School Environment That Is Inclusive of All Students Most children feel uncomfortable when they witness bullying. When the school culture is exclusive of children on

Hughes: What SLPs Should Know About Bullying


the basis of overt or implied differences, all children are at risk for being bullied and having less successful academic outcomes (Meyer-Adams & Conner, 2008). SLPs can address issues of inclusion by responding to slurs they hear when conducting therapy or walking in the hallways. For example, students should be told consistently that it is not acceptable to use labels like “special ed” or “retarded” to describe people or things. Ignoring the use of words as hurtful labels (e.g., “You’re so gay”) is harmful to all students. Racial or ethnic slurs and negative comments about socioeconomic status also contribute to exclusive school environments. SLPs, school personnel, and administrators may need to evaluate the culture of their schools in an effort to create an environment that is inclusive of all students. Displaying antibullying rules or posters that encourage diversity may help to promote an inclusive school environment.

Conclusion Bullying should not be considered a normal part of children’s school experiences, as its consequences are often traumatic and long-lasting. The burgeoning literature in this area suggests that children with communication disorders are at risk for bullying and that SLPs need more education about bullying prevention and intervention strategies. SLPs have legal and ethical obligations to ensure that children with communication disorders have safe school environments that are free from peer and educator abuse. Learning more about bullying, addressing bullying in speech and language therapy, and advocating for antibullying programs are important aspects of reducing bullying in schools. Documenting the impact of antibullying efforts is an important part of bullying prevention and management for students with communication disorders. Relatively few researchers to date have attempted to do so (e.g., Langevin et al., 2012; Langevin & Prasad, 2012; Murphy et al., 2007). SLPs who address bullying in therapy or whose schools have implemented antibullying programs are uniquely positioned to make significant contributions to the bullying literature. Careful observation and reporting of the effects of antibullying efforts are necessary to improve bullying at school for students with communication disorders. Finally, what about Jamie, the sixth grader introduced at the beginning of this tutorial who was struggling with bullying? Jamie’s SLP took a multifaceted approach to dealing with Jamie’s bullying. She realized that Jamie’s negative peer interactions probably stemmed as much from his poor social skills as from his stuttered speech. He often interrupted people and did not seem to know how to join a conversation appropriately. Eye contact was poor even when Jamie was not speaking; his gaze tended to roam around the room rather than focus on his conversational partner. As Jamie and his SLP worked together in therapy to identify what he did when he stuttered, they realized that Jamie often interrupted people whenever a thought came to him. “If I think about what I’m going to say for too long,” Jamie explained, “I stutter more. So I just talk fast whenever

I know what I want to say.” In addition to his fluency goals, Jamie and his SLP worked on waiting for the appropriate time to speak. Jamie practiced joining other students in conversation via group therapy with peers who had similar communication goals. He also practiced his conversational skills with peers who were typically developing. Jamie took on the roles of “movie director” and “actor” as he engaged with peers in conversational role-plays that were recorded on the SLP’s iPad. Jamie then critiqued his turn taking and eye contact with the support of his SLP. The SLP also introduced Jamie to the website of Friends, the National Association of Young People who Stutter ( Jamie enjoyed reading about other children’s experiences with stuttering and even attended a regional Friends conference with his family. There he made a new friend who lived a few hours away. Jamie frequently talked to his new friend online. Jamie’s parents were pleased, but they were concerned that Jamie still seemed isolated at school. With the help of the school counselor and one of Jamie’s teachers, the SLP identified a classmate named Aaron who could serve the role of Jamie’s “buddy,” sitting with him at lunch and talking to him between classes. Aaron had a sister with Down syndrome and was understanding of Jamie’s stuttering. Jamie found that Aaron did not like it when Jamie interrupted him and often told him “quit it.” This was helpful, Jamie said, because it helped him remember to do what he worked on in speech therapy. Jamie invited Aaron to his house for pizza and video games, and the boys planned to join an extramural soccer team together. Though things were getting better at school, students still mocked Jamie when he talked in class. The SLP recommended that Jamie give a presentation on stuttering to his class with her help. Jamie worked on a poster about stuttering that included famous people who stutter, myths about stuttering, and why people stutter, though he declined to present it to classmates, feeling that he “wasn’t ready yet.” Jamie did have a talk with Mrs. Ference, his social studies teacher. Jamie asked her to not say things about his stuttering to the whole class—even if they laughed at him— because he found this embarrassing. Instead, Jamie commented that he noticed that students in the class were often unruly while others were speaking, not just himself. He asked Mrs. Ference if she could make a rule that everyone needed to be quiet when others are speaking and that the whole class (including Jamie) would have some of the class points they accumulated for a weekly movie revoked if someone talked or made noise out of turn. Mrs. Ference agreed, and the laughing and verbal bullying of Jamie in class significantly decreased. In conclusion, the evidence that bullying has long-lasting academic, physical, emotional, and social consequences is too great to be ignored. Children with communication disorders need help to develop social skills that will allow them to prevent and/or manage bullying successfully. SLPs can and should inquire whether students on their caseload experience bullying or difficulties with peer relationships. Further, therapeutic activities that emphasize social skills, empowerment, and education are well within the purview of SLPs and are necessary to help children with communication disorders thrive in

10 Language, Speech, and Hearing Services in Schools • Vol. 45 • 3–13 • January 2014

the school environment. Recent evidence suggests that the efforts of some SLPs to reduce bullying have been successful. These efforts should be documented and continue on a larger scale to effect positive changes in the lives of children with communication disorders.

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Hughes: What SLPs Should Know About Bullying


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Bullying: what speech-language pathologists should know.

The purpose of this tutorial is to introduce speech-language pathologists (SLPs) to the broad issues surrounding the problem of school bullying in chi...
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