1. Amy Hawkins BACCH Annual Scientific Meeting 9 th October 2012

2. Content Introduction Aim Methods Results Discussion, including study limitations and implications of our findings

3. Introduction Studies from the US have suggested that transition from primary to secondary education is an ‘at risk’ time for bullying, particularly amongst minority racial groups 1,2 The degree of inter-racial mixing declines as children progress through school 3,4 Little published evidence from the UK Pre-existing data from the ALSPAC cohort not yet examined 1 Bradshaw et al, 2009; 2 Nansel et al, 2001; 3 Virdee et al, 2000; 4 Pitts et al. 2001

4. The Avon Area Transatlantic slave trade African-Caribbean and Somali communities in St Pauls, Montpellier and Easton Predominantly white population

5. Aim To examine the differences between white, mixed race and ethnic minority children at the transition to secondary school in terms of: Bullying Racial attitudes and friendships Behavioural difficulties Mood Self-esteem

6. Methods 1 The Avon Longitudinal Study of Parents and Children (ALSPAC): Children living in Avon with estimated dates of delivery between April 1991 and December 1992 15,247 women enrolled during pregnancy 5 15,211 children surviving to 1 year 5 5 Boyd et al, 2012

7. Methods 2 Study subgroup completed racial attitudes questions from ‘all around me’ at 12 years (n=7017) Self-defined racial categorisation at 12 years based on skin colour 3 categories for meaningful statistical analysis: ‘white’, ‘mixed colour’, ‘racial minority’

8. Methods 3 Primary outcome: Bullying at 12.5 years (compared with 8 years) Secondary outcomes: Discrimination, racial attitudes and friendships at 12 years, mood at 10.5 and 14 years, self-esteem at 14 years Behavioural difficulties at 11.5 years Statistical methodology STATA: chi-squared or Fisher’s exact tests Logistic regression controlling for gender, maternal education and early puberty

9. Results 1: Demographics Self-defined racial group at 12 years (n=7017): Child’s perception of his/her skin colourFrequencyPercentage White660794.16 Mixed Colour2553.63 Asian480.68 Black420.60 Other650.93 Total7017100

10. Results 2: Bullying No significant difference in risk of bullying at 8 years Overt bullying at 12.5 years (n=1236): Baseline bullying prevalence amongst white children 40.34% Relational bullying: no significant difference * Adjusted for gender, maternal education and early puberty Bullying prevalenceLogistic regression* Mixed Colour 42.9%OR 1.00 (95% CI 0.52 to 1.93) Ethnic minority 65.7%OR 3.49 (95% CI 1.42 to 8.59)

11. Results 3: Racial discrimination Verbal and physical racial discrimination at 12 years (n=4991):* Verbal racial discrimination Physical racial discrimination Mixed Colour Prevalence 9.80% OR 6.63 (95% CI 3.76 to 11.69) Prevalence 31.37% OR 2.34 (95%CI 1.47 to 3.70) Ethnic minority Prevalence 12.90% OR 8.29 (95% CI 3.95 to 17.42) Prevalence 32.90% OR 1.29 (95% CI 0.74 to 2.24) * Adjusted for gender, maternal education and early puberty

12. Results 4: Friendships No significant differences in racial attitudes at 145 months (12.08 years) Mixed race children were more likely to retain friends of a different skin colour at the transition to secondary school (n=4991) There was no significant difference for ethnic minority children OR 2.34, 95% CI 1.47 to 3.70* * Adjusted for gender, maternal education and early puberty

13. Results 5: Mood, behaviour and self-esteem No statistically significant association between racial group and... 1. Depression score at 10.5 or 14 years 2. Behavioural difficulties at 11.5 years 3. Racial attitudes at 12 years 4. Self-esteem at 14 years

14. Discussion 1: Summary No difference between racial groups in risk of bullying at 8 years Ethnic minority but not mixed race children have an increased risk of being bullied at 12.5 years A decline in inter-racial friendships at the transition to secondary school, except for mixed race children No differences between racial groups in terms of mood, behaviour, racial attitudes or self-esteem

15. Discussion 2: Limitations Relatively small proportion of non-white children; ‘racial minority’ groups had to be grouped together Children were asked about ‘skin colour’ rather than race or ethnicity Fewer ethnic minority inhabitants than some UK cities Missing data (social and educational bias)

16. Discussion 3: Results in Context Increased risk of bullying amongst ethnic minority children 6,7 New social hierarchy 8 Puberty 9 Inter-racial mixing declines at the transition to secondary school 3,4, although not for mixed race children Complex relationship between racial discrimination, mood and behavioural disorders 10,11,12,13 6 (Espelage and Swearer 2003) 7 (Smith, Madsen and Moody 1999) 8 (Pellegrini and Long 2002) 9 (Collins 2003) 3 (Virdee et al. 2000) 4 (Pitts et al. 2001) 10 (Coker et al. 2009) 11 (Brody et al. 2006) 12 (Paradies 2006) 13 (Huynh and Fuligni 2010)

17. Discussion 4: Implications Wide-reaching implications for health professionals and educationalists For paediatricians, the key challenge is to focus on periods of transition to re-assess and support vulnerable children Schools need to take positive action to protect ethnic minority and mixed race children

18. Any questions?

19. References 1 1. Bradshaw C, Sawyer A & O'Brennan L. A social disorganization perspective on bullying-related attitudes and behaviors: the influence of school context. American Journal of Community Psychology (2009); 43:204-20. 2. Nansel T R, Overpeck M, Pilla R S et al. Bullying behaviors among US youth. JAMA: the journal of the American Medical Association (2001); 285: 2094. 3. Virdee S, Modood T, Newburn T. Understanding racial harassment in school. Economic and Social Research Council (2000). 4. Pitts J, Marlow A, Porteous D et al. Inter-Group and Inter-Racial Violence and the Victimisation of School Students in a London Neighbourhood. ERSC (2001). 5. Boyd A, Golding J, Macleod J, Lawlor DA, Fraser A, Henderson J, Molloy L, Ness A, Ring S, Davey Smith G. Cohort profile: The ‘Children of the Nineties’- the index offspring of the Avon Longitudinal Study of Parents and Children. Int J Epidemiol. 2012. Apr 16 [epub ahead of print] doi: 10.1093/ije/dys064 6. Espelage D L, Swearer A M. Research on school bullying and victimization: What have we learned and where do we go from here? School Psychology Review (2003); 32: 365-383.

20. References 2 7. Smith P K, Madsen K C, Moody J C. What causes the age decline in reports of being bullied at school? Towards a developmental analysis of risks of being bullied. Educational Research (1999); 41: 267-285. 8. Pellegrini A D, Long J D. A longitudinal study of bullying, dominance, and victimization during the transition from primary school through secondary school. British Journal of Developmental Psychology (2002); 20: 259-280. 9. Collins, W A. More than myth: The developmental significance of romantic relationships during adolescence. Journal of research on adolescence (2003); 13: 1-24. 10. Coker T, Elliott M, Kanouse D et al. Perceived racial/ethnic discrimination among fifth-grade students and its association with mental health. American Journal of Public Health (2009); 99: 878-84. 11. Brody G H, Chen Y F, Murry V M B et al. Perceived Discrimination and the Adjustment of African American Youths: A Five Year Longitudinal Analysis With Contextual Moderation Effects. Child Development (2006); 77: 1170-1189. 12. Paradies Y. A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology (2006); 35: 888. 13. Huynh V, Fuligni A. Discrimination Hurts: The Academic, Psychological, and Physical Well-Being of Adolescents. Journal of Research on Adolescence (2010); 20: 916-941.