Online Health Chat with Cheryl Cairns, RN, MSN, CPNP

February 18, 2011


Cleveland_Clinic_Host: Cyberbullying affects more than half of adolescents and teens on a daily basis. It is an anti-social behavior that involves hurting others using online tools such as social networking sites and cell phones. Cyberbullying is an increasing epidemic that can lead to anxiety, depression, and even suicide. 

Unlike physical bullying, the cyberbully uses technology to quickly spread offensive messages and images to a large network of peers. In the viral world that we live in, these messages can last forever, and can have a lasting impact on your child. 

Cheryl Cairns, RN, MSN, CPNP, has been a registered nurse for more than 23 years and a pediatric nurse practitioner for 11 years. She provides preventive and chronic care, as well as urgent ill visits for children at Cleveland Clinic Children’s Hospital Community Pediatrics, Willoughby Hills. She is preceptor for Advanced Practice Nurses for Case Western Reserve University, the University of Akron, Kent State University, The Ohio State University, and Ursuline College. She also has taught AD nursing students for Lakeland Community College.

Cheryl is a graduate of Lakeland Community College and received her BSN, MSN, and CPNP degrees from the University of Akron. She is a doctoral student at The Ohio State University, with a focus on adolescent mental health. She obtained additional education on the impact of technology in relation to interactions of childhood, including cyberbullying.

Cleveland Clinic Children’s Hospital has a staff of more than 50 pediatric primary care physicians who serve children from birth to young adulthood at convenient locations throughout northern Ohio. With access to leading-edge diagnostic and treatment resources, as well as a total commitment to family-centered care, our pediatric professionals are well-equipped to diagnose and treat common, everyday illnesses, as well as serious childhood diseases and conditions, such as cancer, diabetes, and congenital heart disease. Besides general pediatric care, members of our team have special interests in a number of childhood-related developmental issues, conditions, and diseases, including adolescent care, behavioral problems, and school difficulties.

To make an appointment with any of the other specialists in the Cleveland Clinic Children’s Hospital Pediatric Institute, please call 216.444. KIDS (5437) or call toll-free at 800.223.2273, ext. 5437  You can also visit us online at

Cleveland_Clinic_Host: Thank you for joining us for today's Online Health Chat, "How to Protect Your Child from Cyberbullying." Unfortunately, Dr. Lonzer is unable to join us today, but Cheryl Cairns, RN, MSN, CPNP, nurse practitioner at Cleveland Clinic Children's Hospital, is here to answer your questions. Cheryl, we are thrilled to have you here today for this chat. Thank you for being here. Let's begin with questions!

momB: What constitutes cyberbullying? How far does it have to go before it is considered serious?

Cheryl_Cairns_RN_MSN_CPNP: Cyberbullying is any type of harassment or bullying (teasing, telling lies, making fun of someone, making rude or mean comments, spreading rumors, or making threatening or aggressive comments) that occurs through email, chat rooms, instant messaging, videos, pictures posted on Web sites, or sent through cell phones. That is a pretty broad description. If this emotional distress or harm is repeated, then it should be taken serious.

howardt: What are some signs that I can watch out for to see if my daughter may be on the receiving end of cyberbullying? How about (God forbid!) that she is actually the aggressor and is the one doing the bullying?

Cheryl_Cairns_RN_MSN_CPNP: Children who stop using their cell phone or the Internet, may be victims of cyberbullying. Acting depressed or not want to participate in functions that she previously enjoyed may also be signs. If you notice these behaviors, talk with her in a non-judgmental way, and let her know you are there to support her.

If you child is the aggressor, she may not use the Internet when you are there. Click the computer off. Again, monitoring that what your child is doing is OK.

louder: How do you balance your trust of your children and their privacy, while at the same time monitor or protect them as a parent should?

Cheryl_Cairns_RN_MSN_CPNP: As a mother myself with three sons, I know this is challenging even without the input of technology. You have the responsibility to protect your child, even though your child may not see it that way. Treat technology the same way you would if your child wanted to go to someone's house you didn't know. Have the discussion that you want to give them freedom and trust, but your role is to also protect them.

vroom: If you find out your child is being harassed by someone and you want to bring this to the attention of the bully’s parents but you do not have their address or telephone number, how can you get this information? Is this an acceptable step in trying to help your child?

Cheryl_Cairns_RN_MSN_CPNP: This would depend on how the harassment is delivered. If the harassment is from a cell phone, you can get the telephone number from the cell phone. (Encourage your child not to respond to the harassment.) You can also report harassment to the Internet service provider. If the harassment is interfering with your child’s education -- for example, he or she doesn't want to go to school -- you can address it with school administration.

Prepare Your Child

soccermom2: My son is entering middle school in the fall. What advice can I give him if he finds himself on the receiving end of cyberbullying?

Cheryl_Cairns_RN_MSN_CPNP: Soccermom2, this is great that you're already thinking about what to do before he is even entering school. Parent and child discussions are key. Make sure he is comfortable in coming to you or a trusted adult, such as a teacher, if he is being bullied or feels threatened. Before he is permitted access to social media sites, such as twitter or Facebook, know how to block inappropriate messages and behavior. You should know how to access blocking capabilities and have access to controls on his cell phone. If he does receive a threatening message, be sure he does not respond.

geri_t: I know it's impossible to completely prevent bullying. How can I best prepare my kids to deal with bullies and the emotions that accompany bullying?

Cheryl_Cairns_RN_MSN_CPNP: Again it is great to start with an open discussion. You are right. We cannot prevent bullying (we never could), but talking about how it feels when someone makes you angry or sad is crucial. Here are some points to consider in your discussion:

  • Talk to them about the negative consequences of bullying.
  • Instruct your children to never give out their passwords (not even to friends).  
  • If you are going to use a network site, set it up with your child. This can start the discussion.
  • Ask them if they have ever been bullied and how it made them feel.
  • Teach your children how to block cyberbullies. Seventy percent of teens said this was the most effective way of prevention.

The Cyberbully

cleve_fan: My daughter has been involved with cyberbullying, only she has been the bully. I was shocked to hear the mean things she has said to classmates. This is not how I raised her to treat others. But when I address the issue with her, she tells me "they started it." How do I teach her that bullying and retaliation are not how you deal with difficult people and situations, and also monitor her to be sure she is not continuing this behavior?

Cheryl_Cairns_RN_MSN_CPNP: Don't despair. It is not uncommon to be the bully. More than 70% of children have stated people cyberbully because they think it is funny. Talk to her just like you would if you heard her talking negatively toward someone. That it is not acceptable behavior. Also, discuss the reaction that cyberbullying has on the victim. Retaliation, whether in person or using technology, does not solve problems. You can place restrictions on her use (Internet, cell phone) as consequences for her bullying behavior. You can also place blocks on her phone and social networking sites.

sara_f: I am a teacher who has seen many bullies and bullied throughout the years. I can console and counsel the bullied students, but it is the bullies themselves I worry about. They seem to have no empathy, and no concern for the consequences of their actions. What should teachers/administrators and parents do to help the bully?

Cheryl_Cairns_RN_MSN_CPNP: This is a topic that is currently being researched. Eighty percent of teens say that others cyberbully because they think it is funny. Many children don't realize the effect it has on others. That is one of the issues involved in cyberbullying, The abuser does not see the effect on the victim. As a teacher, I would recommend continuing to support the victims and also be a leader in support of education to all children on bullying. I realize this is another issue the schools have to address, but it is one of great importance.

In School

greg_88: What is the school’s responsibility in protecting against cyberbullying? So often, the bullying starts in school and continues on Facebook into the evening. Should schools be responsible for punishing the bully, or should it be restricted to parental discipline?

Cheryl_Cairns_RN_MSN_CPNP: This is a very relevant question, and one that is currently being debated on many fronts. The school does have a responsibility if the bullying interferes with academics. So if your child is missing school, or if there is a decrease in your child’s grades, then this is something the school should address. If your child is being bullied, both you and your child should go to the administration to discuss your concerns.

worried_mom: Do you think the recent rise in cyberbullying in schools is related to the recent finding about the decline in empathy among younger people? And is there someone or something to blame? The parents? Media?

Cheryl_Cairns_RN_MSN_CPNP: Bullying has always been around. With new technology come new challenges. The issue is multifaceted, and we as a society need to address it. I think these types of forums, and communication among parents, children, teachers, health care, and law enforcement will lead to a better understanding of the causes and how we can address them. Talking to children about: "If you can't say anything nice, don't say anything" is important.

Social Networks

K_H_: Should I inform the parents of my daughter’s now ex-friend that she is cyberbullying my daughter? I can’t imagine her parents monitor her Facebook or texts based on the messages that my daughter has shown me. I don’t think they would approve of her behavior, but I don’t want to make things worse between the girls.

Cheryl_Cairns_RN_MSN_CPNP: This depends on your relationship with the girl's parents. If you are comfortable discussing this with them, then it is appropriate. If not, then I would discuss with your daughter and block this girl from any networking sites that your daughter is in.

jilliank: My daughter has been receiving mean texts and Facebook messages from a few girls at school. How can I step in to protect her without causing more trouble? I don’t want to fight her fights, but I don’t want her to get hurt.

Cheryl_Cairns_RN_MSN_CPNP: You are your daughter’s advocate, so get involved. The definition of cyberbullying is the willful and repeated harm inflicted through the use of cell phones, computers, and other electronic devices. If she is receiving these messages, you should discuss with her how to block messages. On Facebook, you can go to the help page, and it has instructions on how to block. She should not respond to the messages. Children (even teens) need to know you support and believe in them.

playdoy: When messages or pictures have been posted on line, is there a way to have them removed from another person’s Facebook page, etc.?

Cheryl_Cairns_RN_MSN_CPNP: Unfortunately, as I am aware if this has already been posted, I am not aware of retraction. You can report the posting to Facebook. There is a report link near the content page. Here is a very important message to tell our children: what you post is now available to the whole world. Think before posting!!!!!

General Questions

klm09: At what point does cyberbullying cross the line and become a legal matter?

Cheryl_Cairns_RN_MSN_CPNP: Ohio does not currently have a specific cyberbullying law. One is currently pending. There is also a bullying law pending at the Federal level so this is an area that is being addressed. If you are concerned about your child's welfare regarding cyberbullying, you should report it. Law enforcement has a role and responsibility in prevention and responding to cyberbullying.

patent: Can you give names of some of the software or programs that are available to help keep track of what my children are doing on line so that I can monitor their activities?

Cheryl_Cairns_RN_MSN_CPNP: I'm sorry I am not familiar with all the software available. Each cell phone provider offers options of blocking and monitoring messages and calls. I have reviewed Verizon and ATT, and these both cost $4.99 per month. Emails, and social networks have information on monitoring and blocking under the help tab. Facebook had a very informative description related to cyberbullying. Communication is the key. I realize how hard that can be with teens, but starting the conversation on technology responsibility is the first step.


Cleveland_Clinic_Host: I'm sorry to say that our time with Cheryl is now over. Thank you again Cheryl for taking the time to answer our questions today about Cyberbullying.

Cheryl_Cairns_RN_MSN_CPNP: Cyberbullying is an important aspect in our children's lives. More than 80% of children use technology, and we need to be aware of the potential consequences that may arise.

Thank you for participating today. I appreciated all your questions and I hope my information was helpful.

Here are some credible web resources for reference:

More Information
  • To make an appointment with any of the other specialists in our Cleveland Clinic Children’s Hospital Pediatric Institute, please call 216.444. KIDS (5437) or call toll-free at 800.223.2273, ext. 5437  You can also visit us online at
  • A remote second opinion may also be requested from Cleveland Clinic through the secure eCleveland Clinic MyConsult Web site. To request a remote second opinion, visit