Methodological Considerations in Research With Special Populations: Children and Adolescents

Andrasik, Frank; Powers, Scott W.; McGrath, Patrick J.

doi:10.1111/j.1526-4610.2005.05104.x

Cited by 30 publications

(47 citation statements)

References 26 publications

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“…An additional challenge for the clinical diagnosis of influenza arises from young children's inability to describe their subjective symptoms. Because the reliability of such symptoms is questionable in young children [24], we did not analyze any subjective symptoms in children <3 years of age.…”

Section: Discussionmentioning

confidence: 99%

Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Heinonen

Peltola

Silvennoinen

et al. 2011

Eur J Clin Microbiol Infect Dis

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We aimed to determine whether there are signs or symptoms that could help clinicians to distinguish between influenza and other respiratory infections. The clinical data for this matched case-control analysis were derived from a 2-year prospective cohort study of respiratory infections among children aged≤13 years. At any signs of respiratory infection, the children were examined and nasal swabs were obtained for virologic analyses. Cases were 353 children with laboratory-confirmed influenza and controls were 353 children with respiratory symptoms who tested negative for influenza. Cases and controls were matched for gender, age, and timing of the visit. In the multivariate conditional logistic regression analyses, fever was the only sign that independently predicted influenza virus infection, with odds ratios ranging from 13.55 (95% confidence interval [CI], 6.90-26.63) to 50.10 (95% CI, 16.25-154.45), depending on the degree of fever. In all analyses, the predictive capability of fever increased with incremental elevations in the child's temperature. The likelihood ratio of fever≥40.0°C in predicting influenza was 6.00 (95% CI, 2.80-12.96). Among unselected children seen as outpatients during influenza outbreaks, fever is the only reliable predictor of influenza virus infection. The optimal use of influenza-specific antiviral drugs in children may require virologic confirmation.

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Section: Discussionmentioning

confidence: 99%

Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Heinonen

Peltola

Silvennoinen

et al. 2011

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

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“…The lack of a continued parental support is a limiting factor. Other methods need to be developed as highlighted by Andrasik et al (2005).…”

Section: Discussionmentioning

confidence: 99%

“…Through therapy it became obvious that children in this age group needed the dialog in order to learn and reflect on self awareness in every-daylife with the purpose of using a technique of pain control. Andrasik et al (2005) addressed the need for age-related methodologies especially with concern to the younger child's cognitive development. The dialog in this study revealed that the young child has a clearer self-knowledge if guided through the reflection process.…”

Section: Discussionmentioning

confidence: 99%

“…Research of child-centered treatment modalities for the young child with specific descriptions of treatment elements and strategies is needed. The biopsychosocial complexity underlying TTH in children is described by several researchers (Andrasik et al 2005;Gassmann et al 2009;McGrath 2001). This underscores the relevance in researching treatment interventions offering the young child both the knowledge of body reactions and the ability to regulate these with stress and pain coping strategies.…”

Section: Introductionmentioning

confidence: 96%

“…Andrasik et al (2005) addressed methodological age-related issues related to children younger than twelve, and the challenges in research concerning their limited ability for using cognitive and self-coping strategies. Research of child-centered treatment modalities for the young child with specific descriptions of treatment elements and strategies is needed.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Computer Animated Relaxation Therapy in Children Between 7 and 13 Years with Tension-Type Headache: A Pilot Study

Tornøe

Skov

2011

Appl Psychophysiol Biofeedback

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This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy assisted by computer animated surface EMG provided from the trapezius muscles and with the physiotherapist as a participant observer. Outcome measures were (a) headache frequency and intensity, (b) pericranial tenderness, (c) tension patterns, and (d) evaluations assessed at baseline and at 3 months follow up. Nine children, mean age 10.9 (SD 1.7) years, diagnosed with frequent episodic or chronic tension-type headache completed the course. The results showed a mean improvement of 45% for headache frequency at 3 months follow up versus baseline and a significant reduction in headache frequency for all participants and in Total Tenderness Score for children with frequent episodic tension-type headache. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. Computer animated SEMG seems an applicable learning strategy for young headache sufferers. This study suggests that children below the age of 13 need both the dialog and guidance from a participant observer in order to achieve body awareness.

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Cognitive Behavioral Therapy Plus Amitriptyline for Chronic Migraine in Children and Adolescents

Powers

Kashikar‐Zuck

Allen

et al. 2013

JAMA

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243

271

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IMPORTANCE Early, safe, effective, and durable evidence-based interventions for children and adolescents with chronic migraine do not exist.OBJECTIVE To determine the benefits of cognitive behavioral therapy (CBT) when combined with amitriptyline vs headache education plus amitriptyline. DESIGN, SETTING, AND PARTICIPANTSA randomized clinical trial of 135 youth (79% female) aged 10 to 17 years diagnosed with chronic migraine (Ն15 days with headache/month) and a Pediatric Migraine Disability Assessment Score (PedMIDAS) greater than 20 points were assigned to the CBT plus amitriptyline group (n = 64) or the headache education plus amitriptyline group (n = 71). The study was conducted in the Headache Center at Cincinnati Children's Hospital between October 2006 and September 2012; 129 completed 20-week follow-up and 124 completed 12-month follow-up.INTERVENTIONS Ten CBT vs 10 headache education sessions involving equivalent time and therapist attention. Each group received 1 mg/kg/d of amitriptyline and a 20-week end point visit. In addition, follow-up visits were conducted at 3, 6, 9, and 12 months. MAIN OUTCOMES AND MEASURESThe primary end point was days with headache and the secondary end point was PedMIDAS (disability score range: 0-240 points; 0-10 for little to none, 11-30 for mild, 31-50 for moderate, >50 for severe); both end points were determined at 20 weeks. Durability was examined over the 12-month follow-up period. Clinical significance was measured by a 50% or greater reduction in days with headache and a disability score in the mild to none range (<20 points).RESULTS At baseline, there were a mean (SD) of 21 (5) days with headache per 28 days and the mean (SD) PedMIDAS was 68 (32) points. At the 20-week end point, days with headache were reduced by 11.5 for the CBT plus amitriptyline group vs 6.8 for the headache education plus amitriptyline group (difference, 4.7 [95% CI, 1.7-7.7] days; P = .002). The PedMIDAS decreased by 52.7 points for the CBT group vs 38.6 points for the headache education group (difference, 14.1 [95% CI, 3.3-24.9] points; P = .01). In the CBT group, 66% had a 50% or greater reduction in headache days vs 36% in the headache education group (odds ratio, 3.5 [95% CI, 1.7-7.2]; P < .001). At 12-month follow-up, 86% of the CBT group had a 50% or greater reduction in headache days vs 69% of the headache education group; 88% of the CBT group had a PedMIDAS of less than 20 points vs 76% of the headache education group. Measured treatment credibility and integrity was high for both groups.CONCLUSIONS AND RELEVANCE Among young persons with chronic migraine, the use of CBT plus amitriptyline resulted in greater reductions in days with headache and migraine-related disability compared with use of headache education plus amitriptyline. These findings support the efficacy of CBT in the treatment of chronic migraine in children and adolescents.

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Methodological Considerations in Research With Special Populations: Children and Adolescents

Cited by 30 publications

References 26 publications

Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Computer Animated Relaxation Therapy in Children Between 7 and 13 Years with Tension-Type Headache: A Pilot Study

Cognitive Behavioral Therapy Plus Amitriptyline for Chronic Migraine in Children and Adolescents

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