Headache Tied to School Problems, Poor Attendance in US Youth

By Lisa Rapaport

February 04, 2021

(Reuters Health) - School-age children and adolescents who have frequent or severe headaches may be more likely to experience school-related problems and absenteeism, a new study suggests.

Researchers examined data on 34,403 U.S. youth who were part of the National Survey of Children's Health in 2017 and 2018. This included 1,514 children (3.7%) whose parents reported that they currently suffered from frequent or severe headaches and said that a health care provider had discussed this condition with them.

Compared to children and teens without headache, those whose parents reported the condition were more likely to have poor attendance, missing at least 11 days of school in the previous 12 months (adjusted odds ratio 2.7). Youth with headaches were also more likely to have school-reported problems, meaning parents were called by school officials to discuss issues with their child (aOR 1.6).

"While some children may experience difficulty coping with pain, many of these youth have migraine, a neurological disorder that not only causes headache attacks, but increases sensitivity to light and noise, can produce nausea or vomiting, and may distort their ability to see, speak, move, or think normally," said lead study author Scott Turner, an assistant professor of pediatrics at the University of Alabama at Birmingham School of Medicine.

"It is often these other symptoms that prevent them from fully participating in school and other activities," Turner said by email. "Clinicians should specifically ask youth about the impact of headache on school attendance and performance and help them develop an effective treatment plan."

The effect of headache on schooling was more pronounced for adolescents than for elementary students. Compared to kids aged 6-11 years, teens 15-17 were more likely to have poor attendance (aOR 1.6) and to repeat a grade (aOR 2.1).

Several health conditions in addition to headache were also associated with school problems and absenteeism, the researchers report in JAMA Pediatrics.

Youth with allergies, for example, were more likely to have poor attendance (aOR 2.1) and school-reported problems (aOR 1.4). And those with asthma were more likely than those without it to have poor attendance (aOR 2.8).

Mental health also impacted school. Poor attendance was more common among children and teens with anxiety (aOR 2.8) and depression (aOR 2.4). School-reported problems were also more common with anxiety (aOR 2.1) and depression (aOR 2.4).

One limitation of the study was that the prevalence of headache was lower than expected, researchers note. They also lacked data to distinguish between different types of headaches.

It's also likely that frequent headaches that are not severe, a type that wasn't assessed in the study, may still negatively impact school attendance and performance, said Bonnie Leadbeater, professor emeritus in the department of psychology at the University of Victoria, in Canada.

Severe frequent headaches can result in poor attention and missed days at school impairing cognitive performance including attention and concentration, Leadbeater, who wasn't involved in the study, said by email. Chronic illness also may make going to school less appealing and interfere with play and peer relationships.

"Children experiencing repeated headaches need to be assessed by a physician, nurse, or counsellor particularly if they are associated with functional problems like attending school, sleep, concentration or mental health concerns," Leadbeater said. "These need to be taken seriously and treated before school problems are compounded by health problems."

SOURCE: https://bit.ly/3oL4wBV JAMA Pediatrics, online February 1, 2021.