April 17, 2008 -- Late last spring, 14-year-old Sarah VanEssendelft of Mastic, N.Y., experienced bullying worthy of a teen movie.
"There was a group of five girls ... and they decided they didn't want me sitting at their lunch table anymore," said VanEssendelft. To get her to leave, they all brought in peanut butter and jelly sandwiches.
For VanEssendelft, it might as well have been arsenic.
Two weeks later, a boy in the back of her class opened up a peanut butter cup. The smell was enough to trigger VanEssendelft's peanut allergy and send her to the emergency room with breathing problems.
"My throat felt tight and my lips were getting really swollen, really fast," said VanEssendelft. "I looked like Angelina Jolie."
On the one hand, mean tricks or sneaking candy looks like mild behavioral problems to school administrators. On the other hand, given VanEssendelft's serious peanut allergy, those sandwiches might very well have been weapons.
Allergy As Target
Severe bullying and food allergies have emerged as troublesome issues for educators in recent years.
The number of reported food allergies doubled among young children in the last five years, according to researchers at the University of Chicago.
In response, legislators in New York and five other states have passed laws to protect food-allergic kids. Educators in some East Coast cities have outright banned peanuts in elementary schools.
But even with restrictions in place, schools have to find new ways to control the ever-growing problem of bullies.
Despite recent high profile school shootings, the National School Safety Center reports school violence has actually decreased since 1993.
But bullying is on the rise. Between 1999 and 2003, the NSSC reported an increase of the student population who were bullied across grades 6-12.
As VanEssendelft knows, when bullies target food allergies, kids and schools face a serious problem. After the peanut butter cup reaction, some of VanEssendelft's classmates didn't believe that her peanut allergy was triggered by smell.
"They said, 'oh, you just want attention, there's no way you can be allergic to the smell, this isn't true,'" said VanEssendelft. The five girls then held a meeting in the bathroom.
Luckily, VanEssendelft got wind of the secret conference when one girl pulled her out of class to warn her.
"She said, 'You can't come to lunch tomorrow ... because they're going to have a peanut party with everything peanut they can find, to watch your face blow up,'" VanEssendelft recounted.
Her family reported the plot to administrators who, according to the VanEssendelfts, said, since the girls had never been in trouble before, the school wouldn't punish them or search their lockers.
The principal of VanEssendelft's school did not respond to repeated phone calls and messages requesting an interview.
In Children's Minds
VanEssendelft reports that she grew up with these girls, attended birthday parties and play dates, and had always kept a careful eye out for peanuts. Yet, still, the girls tried to test her allergy.
"It's a bizarre concept in general: how can a food hurt you? Everyone eats food," said Dr. Scott Sicherer, associate professor of pediatrics at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine.
Sicherer, who has conducted workshops for teens with food allergies, found most teenagers have been bullied because of their allergy in the past.
VanEssendelft's 13-year-old brother, David, also has a peanut allergy and is also frequently bullied.
"Recently, I had a kid in the locker room say, 'I'm going to put peanut butter on the ball and I'm going to serve it to you so you have to set it,'" said David, who added this kid frequently makes peanut butter jokes and wants to see David inject himself with an epinephrine pen to stop a reaction.
"I think a lot of times kids get wrapped up in the experience and they don't think," said Susan Swearer, associate professor of school psychology at the University of Nebraska-Lincoln. "Actually, it's true they don't think — they've done studies, the whole myelination in the brain is not complete."
The best way to tackle the thinking problem in adolescents, Swearer explained, is to repeat conversations. "Say it 500 times: someone can die of a peanut allergy."
Policy, Disability or Both?
Despite an initial reluctance to punish bullying, the VanEssendelfts report that the school began an intensive peanut watch after Sarah had a reaction that landed her in the hospital for four days.
Sarah's mother, Lisa, also applied for a 504 plan — a consideration under the Americans with Disabilities Act — to have the school treat her food-allergic children the same way it treats children with other disabilities.
Now, all of Sarah's classrooms have no-eating policies, she gets a chaperone in charge of her medical issues on field trips, and if she rides a school bus, it must be swept out and cleaned for peanut residue.
"So, now, if kids give Sarah a hard time, it's considered a discrimination against a disability," said Lisa.
However, whether or not adults and teachers recognize a "hard time" may be hard to tell.
The NSSC reports 75 percent of children claim to have been bullied at one time or another during school, yet 49 percent of parents did not recognize bullying as a problem.
Teachers may also have a problem recognizing bullying, especially if the bullying is verbal and not physical.
"Schools do a much worse job of consequating verbal bullying," said Swearer. "Adults will tell us, 'We're not sure if the kids are joking around or not.'"
Yet, verbal abuse, including verbal threats, may be more serious than physical bullying.
"The psychological consequences are the most severe," said Pamela Cantor, a psychology professor in the department of psychiatry at Harvard Medical School.
Cantor noted that verbal taunts with a peanut allergy are essentially physical threats, as well. "That's a physical attack, these kids could die."
"The Mall Isn't Peanut-Free"
Allergists say there are no studies to quantify the mortality risk of a person with a severe food allergy. However, "there is a theme for people who have died: [they've been] teenagers and young adults who have asthma, people who know they are allergic," said Sicherer.
To stop an anaphylaxis reaction (hives, swelling, vomiting and breathing problems) someone must inject an epinephrine pen at the first sign and then go to the emergency room.
"What happens is not predictable," said Dr. Kathy Sheerin, of the Atlanta Allergy and Asthma Clinic. "You can have a near-death experience, and the next time, it may not be as bad — but, if you're standing there thinking of using it [epinephrine pen], you probably should have used it already."
It might be tempting for schools to do away with peanuts altogether, but Sheerin, who is also a mother of a child with a tree nut allergy, has different ideas.
"I think it's great that day cares and up to kindergarten are peanut-free," said Sheerin. "But the mall isn't peanut-free, the movies aren't peanut-free, your next door neighbor's house isn't peanut-free. The kids are going to have to learn to deal with it."
Most kids, in fact, want other kids to learn to deal with it, as well.
Sicherer recently gave a survey to about 70 teens, asking what they wished for most in school. The vast majority of teens wanted their peers — not adults — to be educated about food allergies.
"Whenever we talk about kids with food allergies in schools, their friends are a huge influence and can keep them safe," said Anne Munoz-Furlong, founder and CEO of the Food Allergy and Anaphylactic Network.
"We have very often had teenagers tell us that their friends are their body guards, their friends are their eyes and ears."