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child being bullied

Food allergy-related bullying assessment methods don’t fully capture hurdles

child being bullied

When asked a simple “yes” or “no” question about food allergy-related bullying, 17% of kids said they’d been bullied, teased or harassed about their food allergy. But when asked to reply to a multi-item list of victimization behaviors, that number jumped to 31%.

Living with a food allergy can greatly impact a child’s everyday life – from limiting participation in social activities to being treated differently by peers. While previous research indicates many kids experience food allergy-related bullying, a new study in the Journal of Pediatric Psychology found that offering kids with food allergies a multi-question assessment gives a more accurate picture of the size and scope of the problem.

When asked a simple “yes” or “no” question about food allergy-related bullying, 17% of kids said they’d been bullied, teased or harassed about their food allergy. But when asked to reply to a multi-item list of victimization behaviors, that number jumped to 31%. Furthermore, Children’s National Hospital researchers found that only 12% of parents reported being aware of it.

The reported bullying ranged from verbal teasing or criticism to more overt acts such as an allergen being waved in their face or intentionally put in their food. Researchers say identifying accurate assessment methods for this problem are critical so children can get the help they need.

“Food allergy-related bullying can have a negative impact on a child’s quality of life. By using a more comprehensive assessment, we found that children with food allergies were bullied more than originally reported and parents may be in the dark about it,” says Linda Herbert, Ph.D., director of the Psychosocial Clinical and Research Program in the Division of Allergy and Immunology at Children’s National and one of the study’s researcher.

“The results of this study demonstrate a need for greater food allergy education and awareness of food allergy-related bullying among communities and schools where food allergy-related bullying is most likely to occur,” Herbert adds.

The study looked at food allergy-related bullying among a diverse patient population and evaluated parent-child disagreement and bullying assessment methods. It included 121 children and 121 primary caregivers who completed questionnaires. The children ranged in age from 9 to 15-years-old and were diagnosed by an allergist with at least one of the top eight IgE-mediated food allergies – peanut, tree nut, cow’s milk, egg, wheat, soy, shellfish and fish.

Of the 41 youth who reported food allergy-related bullying:

  • 51% reported experiencing overt physical acts such as an allergen being waved in their face, thrown at them or intentionally put in their food.
  • 66% reported bullying experiences that are categorized as non-physical overt victimization acts including verbal teasing, remarks or criticisms about their allergy and verbal threats or intimidation.
  • Eight reported relational bullying, such as rumors being spread, people speaking behind their back and being intentionally ignored or excluded due to their food allergy.

The researchers also note that food allergy bullying perpetrators included, but were not limited to, classmates and other students, and bullying most commonly occurred at school.

The authors found that only 12% of parents reported that their child had been bullied because of their food allergy and of those, 93% said their child had reported the bullying to them. Some parents reported they had been made fun of or teased themselves because of concerns about their child’s food allergy.

“It’s important to find ways for children to open up about food allergy-related bullying,” Herbert says. “Asking additional specific questions about peer experiences during clinic appointments will hopefully get children and caregivers the help and support they need.”

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, under Award Number K23AI130184 and National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, under Award Number P20MD000198. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Epinephrine auto-injector for allergy

Assessing daily food allergy self-management among adolescents

Epinephrine auto-injector for allergy

Adolescents reported that epinephrine auto-injectors were frequently available, but least likely to be present outside of the home or school.

Severe food allergic reactions can be life-threatening or fatal and are experienced by up to 40% of children with food allergies, with adolescents at greatest risk. To assess early adolescents’ food allergy self-management, Linda Herbert, Ph.D., and her colleagues at Children’s National Hospital, had 101 adolescents ages 10-14 years complete the Food Allergy Management 24-Hour Recall as an interview.

Adolescents reported that epinephrine auto-injectors were frequently available, but least likely to be present outside of the home or school. Adolescents also relied on past experience with food to determine safety, which is not a recommended strategy. Appropriate assessment of food safety and problem-solving involving how to keep epinephrine auto-injectors with adolescents outside the home should be primary intervention targets.

Study authors from Children’s National include: Linda Herbert, Ph.D., Ashley Ramos, Ph.D., Frances Cooke, Kaushalendra Amatya, Ph.D., and Hemant Sharma, M.D., M.H.S.

Read the full study in the Annals of Allergy, Asthma, and Immunology.

piece of bread with question mark cut out

The Food Allergy Parent Mentoring Program: A pilot intervention

piece of bread with question mark cut out

Parents of young children with newly diagnosed food allergy are at risk for poor psychosocial outcomes due to food allergy’s life-threatening nature and demanding management routines. Presently, there are no interventions to support food allergy parents during this adjustment phase.

Ashley Ramos, Ph.D., and colleagues at Children’s National Hospital conducted a pilot study to explore the feasibility, acceptability and preliminary efficacy of a novel intervention using peer mentorship to improve psychosocial functioning in parents of young children with newly diagnosed food allergy. Parent mentors were trained in mentorship and matched with a mentee, a parent of a child under the age of 5 years with newly diagnosed food allergy, for a 6-month intervention period.

Their findings indicate the use of a peer mentorship program to support parents of children with newly diagnosed food allergy is feasible and helpful. It may be appropriate to develop and implement such programs in allergy clinics.

Study authors from Children’s National include: Ashley Ramos, Ph.D., Frances Cooke, Emily Miller and Linda Herbert, Ph.D.

Read the full study in the Journal of Pediatric Psychology.

common food allergens

Psychotherapeutic treatment for psychosocial concerns related to food allergy

common food allergens

Pediatric food allergy is a growing public health concern, with 8 percent of children in the United States affected. Although new treatments for food allergies are being developed, the vast majority of cases are currently managed by daily evaluation of food safety and vigilance for accidental allergen exposure and allergic reactions. This often impacts patients’ and caregivers’ quality of life and overall psychosocial functioning.

In a recent article published in the Journal of Allergy and Clinical Immunology: In Practice, Linda Herbert, Ph.D., and Audrey DunnGalvin, Ph.D., provide a review of mental health concerns related to food allergy. The authors present two cases in which patients received psychological services for food allergy-related anxiety. For both cases, treatment resulted in decreased anxiety and improved food allergy management/oral immunotherapy treatment engagement.

The authors also discuss unmet food allergy-related psychosocial needs, including the lack of food allergy-specific anxiety measures, psychosocial domains that warrant investigation, development of supportive interventions for patients engaging in allergen immunotherapy and the lack of adequate mental health providers with food allergy expertise.

Read the full article in the Journal of Allergy and Clinical Immunology: In Practice.

foods that cause allergies

Patients’ perspectives and needs on novel food allergy treatments

foods that cause allergies

Food allergy is a major public health concern in many countries around the world. In the United States, studies suggest that it affects up to 8% of children and 10% of adults and is responsible for an emergency room admission every three minutes. Historically, the only treatment for food allergy has been complete allergen avoidance combined with rescue medications when accidental exposures occur. Fortunately, advances in food allergy research over the past decade have yielded new treatments, but with these new treatments come new stressors.

In a recent study published in the journal Current Treatment Options in Allergy, Linda Herbert, Ph.D., and colleagues provide an overview of the current state of the literature regarding patients’ and caregivers’ food allergy experiences and needs within the United States. The authors also put forth a set of recommendations regarding how best to proceed with patient-centered development and evaluation of new food allergy treatments.

Read the full study in Current Treatment Options in Allergy.