Pediatric physicians can play a key role in addressing and preventing bullying and cyberbullying today. Despite the plethora of new research and findings, the current state of knowledge does permit us to make certain generalizations. Here is a handful of useful tips.

Today’s Bullying: Social Cruelty. Many adults conceptualize bullying as physical, sometimes violent behavior, but that is not what is dominating the bullying landscape today. In 2010-2011, researchers at the Massachusetts Aggression Reduction Center found that repetitive, seemingly minor "gateway behaviors" were by far the most frequent in victim reports. These rude, insolent acts (like eye rolling, pointedly whispering in front of others, or snickering) usually do not break any specific rules, so adults often ignore them. But "gateway behaviors" may normalize disrespect or even reward it, and research reveals how toxic they can be. Gateway behaviors can happen online, too, and kids need to hear that it’s not okay to join in on bashing and forwarding comments and personal information.

Don’t Berate – Instead, Educate. Although young people are comfortable with technology, they are not necessarily knowledgeable about it, according to Nancy Willard, director of the Center for Safe and Responsible Internet Use. Avoiding cyberproblems is not just about technical knowledge; it is also about maturity and common sense. Bottom line? Adults need to ask children about their social lives online, according to the Pew Research Center’s 2007 Internet & American Life Project. Even if an adult is not proficient in cyberspace communications, he or she can be loud and clear about the absolute necessity to watch what one says, whatever the format, and to remain civil to others at all times.

Take Parental Reports Seriously. At times, both children and parents tend to overuse the term "bullying" to refer to a host of interpersonal problems, perhaps because the target is completely innocent in bullying situations. It’s important to be aware of these tendencies and to gently ask patients to walk you through bullying or cyberbullying incidents that they have reported. Be aware that they may, in fact, be describing more commonly occurring social problems, such as fights or one-time cruel remarks. If a situation is clearly not bullying, then you’ll have an opportunity for education. (See examples of key questions below). Regardless, the appropriate action is to focus on resolving the social problem, not to debate the appropriate label.

Some Situations Require Talking. When upset or in distress, children and teens may be more likely to text others to garner social support. But by repeatedly exposing the texter to his or her emotional cue words, texting can result in a simple conflict’s quick escalation, or can even change it into a complex bullying situation. Explain that it is not a good idea to use texting, e-mail, or instant messaging to try to resolve a disagreement or settle an argument. Children are unlikely to realize these facts independently, and they need to be coached to think about situations in which actual talking – either on the phone or face to face – might be the best way to relate to others.