On top of all the other hardships they face daily, adolescent students living with disabilities or chronic illness are more likely to be victims of bullying from their peers at school, a new French and Irish study finds.

"We were not overly surprised to learn that children with disability are more vulnerable to bullying, because of a lower self-esteem, sometimes differences in appearance or because they have special needs," said lead author Mariane Sentenac, of the University Paul Sabatier in Toulouse, France.

Sentenac and her colleagues used data from the Irish and French 2006 Health Behavior in School-aged Children World Health Organization collaborative study. In all, 12,048 students ages 11, 13 and 15 participated. The findings appear online in the Journal of Adolescent Health.

Students responded to items on how frequently they had been bullied at school in the past couple of months. They also answered questions on whether they had a disability or chronic illness such as cerebral palsy, diabetes, arthritis or allergy. Twenty percent of the students in Ireland and 16.6 percent in France reported having one of these conditions.

The study showed that students who reported having a disability or chronic illness - no matter where they lived - were more likely to be bullied by peers than those who did not. For instance, in France, 41 percent of boys with a disability or chronic illness reported being bullied compared with 32 percent of boys without. Gender, however, was not a factor in being bullied - both boys and girls were equally victimized.

Also, when students with a disability or chronic illness were restricted from participating in school activities, they had a 30-percent additional risk of being bullied.

Mark Schuster, MD, professor of pediatrics at Children's Hospital Boston and Harvard Medical School, said that bullying of children with disabilities is a definite problem in the United States as well.

"Unfortunately, children who stand out in any way, because of their health, their race, their orientation, or anything else that distinguishes them from most kids in a school, can find themselves a target of bullying," Schuster said.

The study suggested better family communication and anti-bullying prevention programs could help reverse this trend.

"In my view, good relations with teachers and parents could play an important role in preventing and detecting bully-
ing behaviors between students because they are in a position to observe two different aspects of the adolescent's life," Sentenac said.