title: Covert video monitoring in the assessment of medically unexplained symptoms in children.
abstract: OBJECTIVE
  Diagnosis of medically unexplained symptoms (MUS) occurs after thorough evaluations have failed to identify a physiological cause for symptoms. However, families and providers may wonder if something has been missed, leading to reduced confidence in behavioral treatment. Confidence may be improved through the use of technology such as covert video monitoring to better assess functioning across settings.
  
  
  METHODS
  A 12-year-old male presented with progressive neurological decline, precipitated by chronic pain. After thorough evaluation and the failure of standard treatments (medical, rehabilitative, and psychological) covert video monitoring revealed that the patient demonstrated greater abilities when alone in his room. Negative reinforcement was used to initiate recovery, accompanied by positive reinforcement and a rehabilitative approach. Covert video monitoring assisted in three subsequent cases over the following 3 years.
  
  
  CONCLUSIONS
  In certain complex cases, video monitoring can inform the assessment and treatment of MUS. Discussion includes ethical and practical considerations.
authors.affiliation: Integrative Pain Management, Children's Mercy Hospital, Kansas City, MO 64108, USA. dpwallace@cmh.edu
authors.forename: Dustin P
authors.initials: DP
authors.lastname: Wallace
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Sim
authors.forename: Tracy E
authors.initials: TE
authors.lastname: Harrison
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Bruce
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harbeck-Weber
mesh_terms: D001521:Behavior Therapy; D002648:Child; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000523:psychology; D059408:Pain Management; D012054:Reinforcement, Psychology; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D014741:Video Recording