Parent and child report measures of the frequency and quality of parent responses to children’s recurrent headache were evaluated for 153 pediatric patients at the University of Maryland School of Medicine, Baltimore, using a 16-item scale modeled after part II of the West Haven-Yale Multidimensional Pain Inventory, which assesses patients’ perceptions of others’ responses to pain, and a Child Behavior Checklist, to assess parent perceptions of the child’s behavioral responses. Parent-perceived negative responses (eg. ignore, leave room, frustration) were correlated with increased levels of behavior problems in adolescents. Parent affiliative or distracting responses (eg. talk or read to child, express sympathy) were associated with lower levels of functional disability in younger children. [1]

COMMENT. As might be expected, parental negative response to pediatric headache is an important factor in causation of functional disability and behavioral problems associated with recurrent pain. To prevent the development of behavioral problems, parents of children 11 years of age and younger should reinforce symptom-free periods and use distractions and supportive comments in response to pain-related behavior. Parents of adolescents should be over solicitous and should avoid negative or punitive responses.