Childhood headaches: Behavioral assessment and treatment

Abstract

Many children experience chronic headaches, particularly migraine and tension headaches. These can be quite debilitating for the child and produce much concern from caregivers and health professionals. Following a discussion of pathophysiology and epidemiological findings, we emphasize the need for nonpharmacological interventions for chronic headaches. This review explores advances in the behavioral assessment and treatment of childhood headaches. We outline behavioral assessment procedures, including the behavioral interview, headache questionnaires, self-monitoring, caregiver observations, and psychophysiological recording. Treatment typically encompasses relaxation training, biofeedback, assertion training, and cognitive therapy. Parental involvement is also one emphasized component in behavioral approaches to treatment. Our review suggests that behavioral treatment strategies are effective in the management of childhood headaches, although most of the research support appears limited to relaxation training and biofeedback. Nonetheless, behavioral assessment and treatment of childhood headaches appears to be a promising clinical and research direction.