Chronic headaches and migraines can interfere in children’s daily lives, including multiple absences from school and missing extracurricular activities. Missing school can lead to problems with academics and can unintentionally make headaches worse.

Below are some tips for things you can do, even during summer months, to help your child cope with headaches:

• Track them: Keep a headache diary to help identify triggers and potential solutions. For example, you may find that headaches occur in similar situations (e.g., during tests, around air fresheners). Then, a plan can be made to reduce the likelihood of a headache (e.g., asking to be seated away from strong scents).
• Get ahead of them: Make sure your family is practicing good headache hygiene. Have your child bring a water bottle and snacks to school and extracurricular activities.
• Practice relaxation: Many children notice an increase in headaches during the school year due to stress. Practicing ways to relax, even during the summer months, will help your child build skills to use when they feel stressed.

• Work with teachers and staff to create a plan: When children are sent home from school due to a headache, they can accidentally learn they cannot handle headaches. Instead, children benefit from having a plan for managing headaches at school without going home.

  • Talk to your school to see if your child would benefit from having a 504 plan or IEP. Helpful accommodations may include allowing your child to have a water bottle in class, letting your child briefly lay down in a dark room when they have a migraine, and having rescue medication in the nurse’s office.
• Praise your child for staying in school: Focus on the times your child copes well and stays in school, which will help build your child’s confidence in managing headaches.

Some children refuse to go to school or participate in activities and need more support. Below are some tips for managing school and activity refusal. If needed, a therapist can help families implement these strategies and address underlying anxiety or problems leading to school avoidance.

• Create a reward chart: Find rewards your child is excited about so they can earn those when they engage in activities and school.
• Talk to your child about their concerns: For older children, ask about their worries regarding going to school and help them problem-solve. Some children may have headaches linked to stress with peers or bullying you can help address.
• If needed, create a graduated approach: Some children have experienced avoidance for a long time and may need to gradually ease back into activities. This may look like having them attend activities part-time and gradually increasing the amount of time spent at school and activities.
• If children stay home, limit secondary gains: Sometimes children will miss activities or school. Make sure they are not receiving other rewards, like unlimited TV time or fun activities, for staying home. Set the expectation that schoolwork still needs to be completed on the days they miss school.

Headaches can lead to extra difficulty for families and interfere with school and activities. However, these strategies can help children to live a fuller life even with a headache diagnosis. The WVU Medicine Children’s Neurology Department and Behavioral Medicine and Psychiatry Program can help support your family in dealing with headaches and their consequences.

References

• Headache Relief Guide
• Kaczynski, K. (2019) Cognitive-behavioral therapy for chronic headache disorders in children and adolescents. In R.D. Friedberg & J.K. Paternostro (Eds.), Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions (pp. 261-278). Springer.