title: Bullying and ostracism experiences in children with special health care needs.
abstract: OBJECTIVE
  Bullying experiences are becoming increasingly common in children and can have devastating consequences. Ostracism threatens a child's need for self-esteem, sense of belonging, sense of control, and meaningful existence. Recent literature suggests that children with special health care needs may be at risk for these negative events and consequences. This study compares bullying and ostracism experiences in children with and without various special health care needs.
  
  
  METHODS
  Participants aged 8 to 17 years completed questionnaires during a routine primary care or subspecialty clinic visit. Children with learning disabilities (N = 34), attention deficit or hyperactivity disorder (N = 100), autism spectrum disorders (N = 32), behavioral or mental health disorders (N = 33), and cystic fibrosis (CF, N = 22) were compared with 73 control children with no diagnosis on Reynolds' Bully-Victimization Scale scores and a 15-item pilot ostracism scale.
  
  
  RESULTS
  Compared with the control group, children in the learning disabilities, autism spectrum disorders, and attention deficit or hyperactivity disorder groups exhibited significant victimization scores on the Bully-Victimization Scale, whereas the behavioral or mental health disorders group had increased mean victimization scores. The learning disabilities group also reported clinically significant bullying. The CF group did not report involvement as bullies or victims. All children with special health care needs groups had increased mean frequency of threats to basic needs related to ostracism, and children with attention deficit or hyperactivity disorder and autism spectrum disorders were at higher risk for ostracism experiences.
  
  
  CONCLUSIONS
  Children with special health care needs may be at higher risk for bullying, victimization, and ostracism. Further research is needed to explore this relationship, especially as it relates to child adjustment. Children with special health care needs should be asked about bullying and ostracism experiences and potential effects as part of mental health screening.
authors.affiliation: Division of Developmental Pediatrics and Genetics, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA. twymank@slu.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Twyman
authors.forename: Conway F
authors.initials: CF
authors.lastname: Saylor
authors.forename: Danielle
authors.initials: D
authors.lastname: Saia
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Macias
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Taylor
authors.forename: Eve
authors.initials: E
authors.lastname: Spratt
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity; D019958:Attention Deficit and Disruptive Behavior Disorders; D002648:Child; D005260:Female; D006801:Humans; D007859:Learning Disabilities; D008297:Male; D001523:Mental Disorders; D011581:Psychological Tests; D012919:Social Behavior; D011795:Surveys and Questionnaires