The environmental conditions related to headache in 38 children are reviewed from the Illinois Institute of Technology and the Franciscan Children’s Hospital and Rehabilitation Center, Boston, MA. Parents filled out the Children’s Headache Assessment Scale (CHAS) at an evaluation for behavioral medicine treatment and the parent rating questionnaire was completed again after therapy. The frequency of specific CHAS categories (stress antecedents, physical antecedents, attention consequences, escape consequences, coping responses, and medication use) varied widely and were changed by behavioral medicine treatment. There was less interference of headache with school attendance and improved coping responses after treatment. 
COMMENT. The Children’s Headache Assessment Scale focuses on situations and events surrounding the headaches rather than questioning parents about the symptoms. This study shows that the parent rating questionnaire is of value in behavioral assessment of pediatric headache and in following responses to behavioral treatment.