Virtual Issue Summary: Kids (with headache disorders) are not just little adults (with headache disorders)

Headache® has begun to resume the quarterly online release of its virtual issues. Virtual issues can be found at headachejournal.org and represent a carefully curated list of recent publications from the journal, unified around a specific content theme and woven together with an accompanying editorial. Virtual issues are intended to provide the reader with an easily accessible digest of recently published content from the journal to act as a primer on current understanding and ongoing research on the subject matter.

The editorial to this virtual issue, “Kids (with headache disorders) are not just little adults (with headache disorders),” highlights two important points:

1. Kids with headache disorders are not just little adults with headache disorders.  Therefore, we cannot simply continue to apply the approaches used to treat adults and expect the same outcomes.
2. Recently, significant scientific progress has been made because investigators and clinicians continue to collaborate and focus on studies designed specifically for youth.

Results:

A biopsychosocial model is guiding new research and recent findings, including: 

• Parental factors and early life stress are related to the incidence of headache disorders and the trajectories of the pain experience.
• Societal policies can impact headache disorders in youth; a clear example being school start times and their impact on sleep.
• More rigorous study of interventions targeting youth with headache disorders is occurring, with some trials showing promise and a number demonstrating that interventions used in adults have not shown efficacy in samples of children and adolescents.
• mHealth is showing potential to increase access to effective behavioral and non-pharmacological treatments.
• Treatment guidelines using evidence specifically from studies focused on youth are being developed.
• Devices that can become part of an adolescent’s acute treatment plan for migraine are showing promise.
• Mechanistic research is emerging that seeks to better understand how and why youth with migraine get better when they learn coping skills via cognitive behavioral therapy; novel neuroscience techniques of brain imaging and pain sensory testing are proving to be a means to discover underlying mechanisms of improvement.

Implications for Primary Care Clinicians:

Recent empirical research focused on youth with headache disorders (most often migraine) highlights the need to take a developmental and pediatric-specific approach to help them (and their families) get better. Simply taking findings and experiences with adult patients and downsizing your treatment plans is not an approach that is evidence-based or consistent with the current literature. This virtual issue provides excellent insight into ways to think about a pediatric-specific approach to the care you provide in your practice. 

In sum, the articles in this virtual issue clearly demonstrate the bright future ahead for children and adolescents with headache disorders, as well as those who care for them and work with them.

For more studies related to pediatric headache care, visit the Pediatric Headache Table of Contents. 

This summary is part of the First Contact – Headache in Primary Care initiative, an American Headache Society program that provides educational resources to empower healthcare professionals and improve headache and migraine care. We encourage providers in all stages of their careers tovisit our homepage to access educational tools to improve patient care.