title: School impairment in adolescents with chronic pain.
abstract: The purpose of this study was to assess and describe school functioning among adolescents presenting for evaluation in a tertiary care pediatric chronic pain clinic. Adolescents (n = 220, aged 12-17) and their parents participated in the study, providing self-reported data on school attendance, school performance, and perceived academic competence. Participants' schools provided official attendance records, descriptions of accommodations implemented to address the student's pain problems in the school setting, and teacher ratings of academic competence. Results show that many adolescents with chronic pain miss a significant amount of school, experience a decline in grades, and perceive pain to interfere with their school success. Various indicators of school impairment are highly intercorrelated, suggesting that impairment or success in 1 domain is typically associated with similar patterns in other domains of school functioning. However, as a group, adolescents with pain are viewed by themselves and their teachers as academically competent. Strong correlations emerged between different reporters of school functioning indicators such as attendance, suggesting that reliance on parent or adolescent reporting may be sufficient when assessing these domains. Findings underscore the importance of broadly assessing school functioning in adolescents with chronic pain.
  
  
  CONCLUSIONS
  This study extends our understanding of school functioning among adolescents with chronic pain. It highlights the need to assess both school attendance and performance in this population as well as how schools respond to pain problems. Devising summary indicators of school impairment can be useful in both clinical and research contexts.
authors.affiliation: Children's Hospital Boston, Boston, Massachusetts 02115, USA. deirdre.logan@childrens.harvard.edu
authors.forename: Deirdre E
authors.initials: DE
authors.lastname: Logan
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Stein
authors.forename: Laura
authors.initials: L
authors.lastname: Chastain
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002908:Chronic Disease / Q000523:psychology; D015331:Cohort Studies; D004185:Disability Evaluation; D005178:Faculty / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010148:Intractable Pain / Q000523:psychology*; D012574:Schools / Q000706:statistics & numerical data*