Like scraped knees or training wheels, bullying has sometimes been considered a normal part of childhood.

“Our cultural perspective has been that it’s just something that happens, a rite of passage,” says Rockford psychiatrist Martha Crotts. “In fact, it’s really damaging to children and adults. It’s a major toxic problem.”

Crotts and her partner, Richard Jaconette, are psychiatrists who specialize in child and adolescent issues. They treat clients who have been bullied and those who are bullies.

“The data we have on children suggests that most bullies are both victims and perpetrators,” Crotts says. “It’s almost more urgent to seek professional help if your child is the bully.”

Perpetrators are at great risk for psychological and emotional problems, she says, including suicidal thoughts, homicidal ideation and criminal activity. They may be more at risk for mental health problems than the children they pick on.

Being bullied can bring serious problems, too, including low self-esteem, poor school performance, absenteeism, anxiety, depression, eating disorders and, sometimes, suicide. Warning signs that a child is being bullied may include physical ailments such as headaches and stomachaches.

Today’s technology, including cell phones and the Internet, has made it easier for bullies to remain anonymous. While research is still scarce, Crotts says, a recent study showed 14 percent of kids in sixth through 10th grade said they experienced some form of cyberbullying. Of those, 70 percent were bullied by someone they knew; half of those were classmates.

Whatever form the bullying takes, parents should address the problem with their children as soon as they suspect it, she advises.

“Ask them about it, and not just once,” she says. “Promote the idea that you’re willing to listen anytime.”

While parents sometimes discover their children are victims of cyberbullying, Crotts doesn’t advise them to cyberstalk their own kids. It’s better to voice concerns and then suggest looking at e-mail or Facebook together, she says. It’s the same advice she gives parents who want to read their kids’ diaries or search their rooms. Parents need to find a middle ground between turning a blind eye and becoming a voyeur.

“You should be concerned about privacy issues, but you have to be vigilant,” she explains. “The script is, ‘I want to be honest about my concerns. Can you show me some of that?’”

If a child is being bullied, parents may turn to pediatricians, family doctors, child psychologists, psychiatrists or social workers for help. If the bullying is occurring in school, teachers, guidance counselors or administrators need to be alerted.

Sometimes, if the abuse is severe and long-standing, it may be best for the child to be removed from that school. But confronting and solving the problem may be more empowering for the child, she says.

While school is the most common site for bullying, Crotts says, it doesn’t necessarily occur in the classroom. It can happen in the lunchroom, on the playground, in the hallways, at the bus stop, in the gym. Outside school, it occurs at summer programs, camps, sporting events and neighborhood hangouts — anyplace kids are surrounded by peers.

Victims of bullying often fit a certain profile, she says. They may have a passive personality, lack a large group of friends and may be easily intimidated. While both girls and boys are victims of bullying, sometimes boys have a harder time admitting it.

“There’s a belief that they should be able to handle it,” Crotts says. “They don’t want to seem weak.”

Bullying can even hurt those who are not directly involved.

“It rarely involves just one child,” she says. “Other children who are bystanders can be adversely affected.”

Schoolwide anti-bullying efforts can be very effective, Crotts says, especially if they promote respect for diversity and sensitivity to the feelings of others. Teaching problem solving, anger management and conflict resolution can help combat bullying.

She cites a program implemented in Denver after the Columbine High School shootings. While children were being taught not to bully, test scores there markedly improved. Students perform better when they feel safe.

“We ask our schools to do a great deal with limited resources,” Crotts says, “but this is a problem that can be discussed, considered carefully and addressed. We can, as a society, eradicate this. We could have big gains in the health and welfare of our children.”

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