2. Non-pharmacologic measures in the management of pediatric and adolescent
migraine promote general well-being and good health. They can improve the
overall quality of life. These measures are basically three:
• Therapies – physical therapy, yoga, stress management, relaxation
techniques, breathing exercises, visualization, biofeedback and cognitive
3. People who use acute pain medicine for headaches more than two or
three times a week or more than 10 days out of the month may develop
‘medication overuse headaches’ (MOH). This important phenomenon should
be part of management discussion.
4. The classroom environment can be challenging for children with ADHD. The
treating pediatrician, parent, and child, in collaboration with school personnel
(teacher and educational psychologists), should specify appropriate target
outcomes to guide management. Primary care physicians / pediatricians
cannot work alone in the treatment of school-aged children with ADHD.
Ongoing communication with parents, teachers, and other school-based
professionals is necessary to monitor the progress and effectiveness
of specific interventions. This will go a long way in making a significant
difference in their academic and overall school experience.
5. Children with ADHD should best be treated with a multimodal approach,
using a combination of strategies. This will include:
• Psychoeducation (both children and parents)
• School accommodations (should be made in consultation with teachers
and school psychologists)
• Family therapy, support, respite for parents
• Parenting strategies
• Healthy lifestyle (sleep hygiene, age appropriate physical activity, healthy
eating, emphasis on screen time and mindfulness)
• Alternative therapies.
6. Sleep and screen time are important lifestyle determinant. There should be
more emphasis on these two important measures, especially in children with
ADHD. Resources in this regard: