Children with a disability or chronic illness experience higher rates of bullying than children who don’t report any medical challenges, according to recent findings from European researchers.

The results, based on survey data involving thousands of students in France and Ireland, found that bullying rates were higher in France overall. But those children who reported a medical condition such as juvenile arthritis were more vulnerable in either country, according to the data, published online late last year (2010) in the Journal of Adolescent Health.

“It was never shown in either country before that the rates of bullying were higher among kids who state that they have a chronic condition,” says Emmanuelle Godeau, MD, PhD, the principal investigator of the French portion of the study, who also worked closely with a French colleague, Mariane Sentenac.

In France, 41 percent of both boys and girls with a medical condition reported they had been bullied compared with lower rates – 31.8 percent for boys and 33.9 percent for girls – in those without. Among Irish school children, the split also was evident. The rates for boys and girls with a condition were 29.4 percent and 32.1 percent respectively compared with 26.1 percent and 23.6 percent for those without.

Also in both countries, the risk of being bullied ran 30 percent higher in those children with a disability or chronic disease, who said that their condition played a role in limiting school participation. It’s unclear precisely why that is, Dr. Godeau says, but she raises a few potential theories.

“It could be that those who come less to school and participate less in school activities – they have more severe disabilities,” she says. As a result, they may appear weaker or more vulnerable to those children looking for a bullying target. Another possibility: The missed days may prevent them from building the type of friendships that could help provide insulation against mean classmates.

The study really highlights the importance of building social networks for children with chronic illness, as it’s their friends that help them to navigate through childhood difficulties, says Harry Gewanter, MD, a pediatric rheumatologist based in Richmond, Va. In some senses, arthritis can be harder for other kids to understand, because the symptoms are variable and not always visible, he says. “You might be limping in the morning and fine by the afternoon.”

The study results were based on survey data from a total of 12,048 children in the two countries, ranging in age from 11 to 15 years old. One limitation was that the medical conditions, including arthritis, were reported by the children involved and not independently verified, Dr. Godeau says.

But education can help break bullying cycles, Dr. Godeau says. She points out that anti-bullying initiatives are more recent and less prevalent in France than in Ireland, which may at least partially explain the variation between the two countries.

Neither do educational efforts have to be targeted at a particular condition like arthritis, she says.

“That is, if parents and teachers talk to the other students about disability in general, this will raise the awareness of the kids toward kids with differences,” she says.