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Objective Parents of youth with chronic pain report psychosocial difficulties, yet treatment often focuses on improving their child's functioning and pain. This study evaluated changes in parents' social and emotional functioning and explored predictors of change, as they completed a parent-focused intervention while their child was enrolled in an intensive interdisciplinary pain treatment (IIPT) program. Methods Parents (n  = 69) completed questionnaires at baseline and weekly (average duration of 4 weeks) during their child's participation in IIPT. Parents engaged in 3 groups per week providing education, therapeutic art, and psychotherapy (3 hr/week total). Results At baseline, 38% of parents reported scores in the clinically elevated range for at least 1 psychosocial variable. Linear mixed modeling for the full sample indicated reduced parent anxiety (t  =  − 2.72, p  <.01) and depression (t  =  − 3.59, p  <.001), but not increased emotional support (t  =   1.86, p  >. 05) or reduced social isolation (t  =  − 1.20, p  >.05). For parents with at least moderately elevated psychosocial concerns, statistically significant improvements were observed for all 4 outcomes (all p 's<.01). Psychological flexibility, cognitive reappraisal, and emotional suppression were found to be related to changes in parent outcomes (anxiety, depression, isolation, and support). Conclusions Findings support the benefit of parent-focused interventions in addition to child-focused interventions. Many parents of youth participating in IIPT had elevated scores for at least 1 psychosocial concern at baseline. Brief, parent-focused intervention including psychoeducation, therapeutic art, and psychotherapy targeting mindfulness, acceptance, and values had a significant impact on these parents, particularly those with greater struggles at baseline. [ABSTRACT FROM AUTHOR]

The current study sought to provide practical information for the clinical use of child and parent reports of child anxiety symptoms by investigating agreement between parent, child, and clinician as well as the predictive value of this information. Examining 88 anxious children and their parents, the study compared agreement by correlating parent and child responses on the Spence Children's Anxiety Scale (SCAS); comparing parent and child responses to clinician data operationalized through continuous and dichotomous variables from the Anxiety Disorder Interview Schedule for Children; and examining the relative clinical utility of parent and child reports on the SCAS in terms of positive and negative predictive value. Results indicated that parent and child agreement on the SCAS was moderate to high for most anxiety disorder symptoms and that both were generally consistent with clinician impressions. Moreover, both child and parent provided unique information to the diagnostic process. (Contains 5 tables.)

The authors examined the benefits of video modeling to teach a unique vocational skill set to an adolescent and two young adults with Autism Spectrum Disorders. Video modeling was used to teach skills necessary to entertain customers and promote products in a retail setting while wearing a WalkAround[R] costume. The three participants were observed before and after watching a video model perform the skills in the costume in scripted and naturalistic scenes. Data can be interpreted to conclude that all participants learned to use the skills in combination or sequence after watching the video model. The skills generalized to an actual job opportunity. The participants reported they enjoyed the work, and comments from supervisors were positive. Implications are discussed. (Contains 2 tables and 1 figure.)

Research in pediatric hospitals has shown that active music engagement, preferred music listening, and music-assisted relaxation can decrease anxiety and increase relaxation responses. However, there is little research on the use of music therapy with pediatric chronic pain conditions such as amplified pain syndromes. The purpose of the current study was to examine the effects of 3 specific music therapy interventions (active music engagement, live patient-selected music, and music-assisted relaxation) on anxiety and relaxation levels in youth (ages 10-18) participating in a 40 hr per week hospital-based intensive interdisciplinary pain treatment program. A sample of 48 patients participated in this study which utilized a 3-period, 3-treatment cross-over design with 3 interventions delivered in a quasi-randomized order determined by when the patients started the treatment program. State anxiety was measured via the state form of the State-Trait Inventory for Cognitive and Somatic Anxiety for Children and relaxation scores were assessed with a Visual Analog Scale. Statistically significant changes were found in anxiety and relaxation outcomes across all interventions provided. Results suggest that music therapy services (using active music engagement, live patient-selected music, and music-assisted relaxation) may be an effective modality to decrease anxiety and increase relaxation levels in pediatric patients with amplified pain syndromes. [ABSTRACT FROM AUTHOR]

Objective: Chronic pain is associated with school difficulties; however, there is limited published evidence on the cognitive or neuropsychological functioning of youth with chronic pain.Method: When beginning intensive interdisciplinary pain treatment, 94 youth (age = 10-18) with chronic pain completed neuropsychological assessment (e.g., intelligence, academic skills, learning and recall, and attention) and clinical questionnaires (e.g., pain and physical and psychological functioning). We compared neuropsychological scores with test norms and with clinical questionnaires.Results: Youth with chronic pain had higher verbal comprehension and full scale IQ scores than expected, below-average nondominant hand dexterity, and difficulty with visual recall. Self-reported difficulties with executive functioning were associated with small-to-moderate difficulties with objectively measured attention. Performance on neuropsychological measures was generally not associated with pain, impairment, anxiety, or depression, though catastrophizing was negatively correlated with perceptual reasoning. An expected number of these youth had learning disorders (14%); however, more than expected had an autism spectrum disorder (9%) or attention deficit hyperactivity disorder (18%), and nearly a quarter demonstrated characteristics of nonverbal learning disability (22%).Conclusions: Some of these cognitive findings may be a consequence of chronic pain, and others may reflect subtle neurodevelopmental differences that may predate or be comorbid with pain. Regardless of etiology, with more than half the current sample experiencing some type of learning challenge, often undiagnosed, pediatric psychologists evaluating youth with chronic pain may wish to screen for comorbid learning difficulties. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the effectiveness of video eyewear in reducing disruptive behavior in a typical pediatric dental population during restorative treatment appointments. Methods: One hundred twenty-eight 4- to 15-year-olds were recruited from a continuous sample of patients seen in an urban dental clinic. Direct observations of distress, self-reported measures of pain, and patient satisfaction were obtained in a randomized clinical trial comparing 2 different types of glasses: (1) wraparound video eyewear; and (2) sunglasses (typical treatment in this dental clinic). Results: Analyses of covariance, using treatment condition (control vs experimental) as the primary independent variable and controlling for the effects of age, found that children wearing video eyewear glasses demonstrated significantly less disruptive behavior then those in the control group and that they liked their eyewear significantly better than those wearing the regular sunglasses. Conclusions: Wraparound video eyewear can be an effective approach to managing distress in children undergoing restorative dental treatment. [ABSTRACT FROM AUTHOR]

Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth. This study examined changes in brain activation associated with experiencing physical pain, and the observation of physical and emotional pain in others, by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youth (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain. Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus). These changes support interpretation that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.

Purpose: The purpose of this study was to evaluate the effectiveness of VibraJect, a vibrating attachment for a traditional syringe, in reducing pain related disruptive behavior and self-reported pain in children receiving local anesthesia., Methods: The procedure involved a randomized, controlled, single-blinded study of 90 children receiving local anesthesia for routine restorative procedures. Participants were randomly assigned to either a control (injection as usual) or experimental (injection using the VibraJect) group. Participants were recruited from a large, urban pediatric dental clinic within a university medical center., Results: Using 2-way analysis of variance and 2-tailed, between-subject t tests, there were no significant differences between injection with and without the VibraJect on any measures of pain, including self-reported intensity, independent direct observations of pain related disruptive behavior, and subjective dentist ratings., Conclusions: VibraJect did not provide any benefits over a conventional approach to anesthesia injection for children in this study.