title: Behavioral management of conversion disorder in children.
abstract: OBJECTIVE
  To describe the behavioral management of conversion disorder in children and to preliminarily assess its effectiveness.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Inpatient pediatric rehabilitation unit.
  
  
  METHODS
  The first eight patients with conversion disorder treated on our pediatric rehabilitation unit, between 9 and 18 years of age. Six were girls. Three cases are described in detail.
  
  
  METHODS
  All patients were treated as inpatients, using a behavioral approach. Inadvertent reinforcement of illness behavior was identified, and a reward system was established for good attainment. Some patients had a "level" system instituted, with increasing privileges for goal achievement. All patients and their families had psychological assessment and instruction in pain and stress management strategies.
  
  
  METHODS
  Restoration of normal gait and function, independence in activities of daily living (ADL), and symptom recurrence after discharge.
  
  
  RESULTS
  All patients attained normal gait and ADL function before discharge.
  
  
  CONCLUSIONS
  (1) Behavioral management of conversion disorder in children appears to be as effective as in adults, although at times a behavioral reward or "level" system may be necessary for adequate reinforcement. (2) Instruction of the patient and family in appropriate stress and pain management appears key to maintaining treatment effect over time.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Primary Children's Medical Center, Salt Lake City, UT, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Gooch
authors.forename: R
authors.initials: R
authors.lastname: Wolcott
authors.forename: J
authors.initials: J
authors.lastname: Speed
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D003291:Conversion Disorder / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000523:psychology* / Q000628:therapy; D011602:Psychophysiologic Disorders / Q000523:psychology* / Q000628:therapy; D012189:Retrospective Studies; D012803:Sick Role