Recurrent pain and school failures are common problems in children visiting the school nurses office. The overall aim of the current study was to investigate the relationship between recurrent pain and academic achievement in school-aged children. Literature was searched in seven electronic databases and in relevant bibliographies. Study selection, data extraction, and study and evidence quality assessments were performed systematically with standardized tools. Twenty-one studies met the inclusion criteria and 13 verified an association between recurrent pain (headache, stomachache, and musculoskeletal pain) and negative academic achievement. Two longitudinal studies indicated a likely causal effect of pain on academic achievement. All studies had substantial methodological drawbacks and the overall quality of the evidence for the identified associations was low. Thus, children’s lack of success in school may be partly attributed to recurrent pain problems. However, more high-quality studies are needed, including on the direction of the association and its moderators and mediators.
ArrudaM. A.BigalM. E. (2012). Migraine and migraine subtypes in preadolescent children: Association with school performance. Neurology, 79, 1881–1888. doi:10.1212/WNL.0b013e318271f812
2.
Backe-HansenE.OgdenT. (1998). 10-åringer i Norden: kompetanse, risiko og oppvekstmiljø [10 year-olds in the Nordic region: competence, risk and upbringing environment]. Nordic Council of Ministers.
3.
BakoulaC.KapiA.VeltsistaA.KavadiasG.KolaitisG. (2006). Prevalence of recurrent complaints of pain among Greek schoolchildren and associated factors: A population-based study. Acta Paediatrica, 95, 947–951.
4.
BalagueF.NordinM.SkovronM. L.DutoitG.YeeA.WaldburgerM. (1994). Non-specific low-back pain among schoolchildren: A field survey with analysis of some associated factors. Journal of Spinal Disorders, 7, 374–379.
5.
BestJ. R.MillerP. H.NaglieriJ. A. (2011). Relations between executive function and academic achievement from ages 5 to 17 in a large, representative national sample. Learning and Individual Differences, 21, 327–336.
6.
BlauJ.Mac GregorE. (1988). Classification and diagnostic criteria for headache disorders, cranial neuralgia and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia, 8, 1–96.
7.
BoeyC. C.OmarA.Arul PhillipsJ. (2003). Correlation among academic performance, recurrent abdominal pain and other factors in Year-6 urban primary-school children in Malaysia. Journal of Paediatric and Child Health, 39, 352–357.
8.
BoeyC. C. M.YapS. B. (1999). An epidemiological survey of recurrent abdominal pain in a rural Malay school. Journal of Paediatric and Child Health, 35, 303–305. doi:10.1046/j.1440-1754.1999.00366.x
9.
BullR.ScerifG. (2001). Executive functioning as a predictor of children’s mathematics ability: Inhibition, switching, and working memory. Developmental Neuropsychology, 19, 273–293.
10.
CampoJ. V.ComerD. M.Jansen-McWilliamsL.GardnerW.KelleherK. J. (2002). Recurrent pain, emotional distress, and health service use in childhood. The Journal of Pediatrics, 141, 76–83.
11.
DevanarayanaN. M.de SilvaD. G.de SilvaH. J. (2008). Recurrent abdominal pain syndrome in a cohort of Sri Lankan children and adolescents. Journal of Tropical Pediatrics, 54, 178–183. doi:10.1093/tropej/fmm114
12.
DewaldJ. F.MeijerA. M.OortF. J.KerkhofG. A.BögelsS. M. (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14, 179–189.
13.
DurmazY.AlayliG.CanbazS.ZahirogluY.BilgiciA.IlhanliI.KuruO. (2013). Prevalence of juvenile fibromyalgia syndrome in an urban population of Turkish adolescents: Impact on depressive symptoms, quality of life and school performance. Chinese Medical Journal, 126, 3705–3711.
14.
EryilmazG.OzdemirF.PasinliogluT. (2010). Dysmenorrhea prevalence among adolescents in eastern Turkey: Its effects on school performance and relationships with family and friends. Journal of Pediatric and Adolescent Gynecology, 23, 267–272. doi:10.1016/j.jpag.2010.02.009
15.
Felder-PuigR.GrieblerR.SamdalO.KingM. A.FreemanJ.DuerW. (2012). Does the school performance variable used in the International Health Behavior in School-Aged Children (HBSC) Study reflect students’ school grades?Journal of School Health, 82, 404–409.
16.
FerlaJ.ValckeM.SchuytenG. (2010). Judgments of self-perceived academic competence and their differential impact on students’ achievement motivation, learning approach, and academic performance. European Journal of Psychology of Education, 25, 519–536.
17.
GustafssonJ.-E.Allodi WestlingM.ÅkermanA.ErikssonC.ErikssonL.FischbeinS.…OgdenT. (2010). School, learning and mental health: A systematic review. Stockholm, Sweden: The Royal Swedish Academy of Sciences.
HaraldstadK.SorumR.EideH.NatvigG. K.HelsethS. (2011). Pain in children and adolescents: Prevalence, impact on daily life, and parents’ perception, a school survey. Scandinavian Journal of Caring Sciences, 25, 27–36. doi:10.1111/j.1471-6712.2010.00785.x
20.
HjernA.AlfvenG.OstbergV. (2008). School stressors, psychological complaints and psychosomatic pain. Acta Paediatrica, 97, 112–117. doi:10.1111/j.1651-2227.2007.00585.x
21.
HoG. H.BennettS. M.CoxD.PooleG. (2009). Brief report: Cognitive functioning and academic achievement in children and adolescents with chronic pain. Journal of Pediatric Psychology, 34, 311–316. doi:10.1093/jpepsy/jsn077
22.
HuguetA.HaydenJ. A.StinsonJ.McGrathP. J.ChambersC. T.TougasM. E.WozneyL. (2013). Judging the quality of evidence in reviews of prognostic factor research: Adapting the GRADE framework. Systematic Reviews, 2, 71. doi:10.1186/2046-4053-2-71
23.
Kashikar-ZuckS.LynchA. M.GrahamT. B.SwainN. F.MullenS. M.NollR. B. (2007). Social functioning and peer relationships of adolescents with juvenile fibromyalgia syndrome. Arthritis and Rheumatism, 57, 474–480. doi:10.1002/art.22615
24.
KingS.ChambersC. T.HuguetA.MacNevinR. C.McGrathP. J.ParkerL.MacDonaldA. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain, 152, 2729–2738. doi:10.1016/j.pain.2011.07.016
25.
LarssonB.CarlssonJ.FichtelÅ.MelinL. (2005). Relaxation treatment of adolescent headache sufferers: Results from a school-based replication series. Headache: The Journal of Head and Face Pain, 45, 692–704.
26.
LoganD. E.CataneseS. P.CoakleyR. M.ScharffL. (2007). Chronic pain in the classroom: Teachers’ attributions about the causes of chronic pain. Journal of School Health, 77, 248–256.
27.
LoganD. E.SimonsL. E.SteinM. J.ChastainL. (2008). School impairment in adolescents with chronic pain. The Journal of Pain, 9, 407–416. doi:10.1016/j.jpain.2007.12.003
28.
Low KapaluC. M.HallJ. J.WallaceD. P. (2018). Neuropsychological functioning of youth receiving intensive interdisciplinary pain treatment. Journal of Pediatric Psychology. doi:10.1093/jpepsy/jsy034
29.
MerskeyH.BogdukN. (1994). Classification of chronic pain: Description of chronic pain syndroms and definitions of pain terms. Seattle: IASP press.
30.
MetsähonkalaL.SillanpääM.TuominenJ. (1998). Social environment and headache in 8- to 9-year-old children: A follow-up study. Headache: The Journal of Head and Face Pain, 38, 222–228. doi:10.1046/j.1526-4610.1998.3803222.x
31.
ModinB.KarvonenS.RahkonenO.ÖstbergV. (2015). School performance, school segregation, and stress-related symptoms: Comparing Helsinki and Stockholm. School Effectiveness and School Improvement, 26, 467–486. doi:10.1080/09243453.2014.969738
32.
MoherD.LiberatiA.TetzlaffJ.AltmanD. G.GroupP. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6, e1000097.
PecorK.KangL.HendersonM.YinS.RadhakrishnanV.MingX. (2016). Sleep health, messaging, headaches, and academic performance in high school students. Brain & Development, 38, 548–553. doi:10.1016/j.braindev.2015.12.004
36.
PetersenS.HagglofB. L.BergstromE. I. (2009). Impaired health-related quality of life in children with recurrent pain. Pediatrics, 124, e759–e767. doi:10.1542/peds.2008-1546
37.
ReesD. I.SabiaJ. J. (2011). The effect of migraine headache on educational attainment. The Journal of Human Resources, 46, 317–332.
38.
Rocha-FilhoP. A. S.SantosP. V. (2014). Headaches, quality of life, and academic performance in schoolchildren and adolescents. Headache: The Journal of Head and Face Pain, 54, 1194–1202. doi:10.1111/head.12394
39.
RosvallP.-Å.NilssonS. (2016). Challenges of engagement with health services in Sweden’s schools: Listening to the views of school nurses and students with recurrent pain. Pastoral Care in Education, 34, 3–12.
40.
SabiaJ. J.ReesD. I. (2011). Individual heterogeneity and reverse causality in the relationship between migraine headache and educational attainment. Economic of Education Review, 30, 913–923. doi:10.1016/j.econedurev.2011.04.015
41.
SantinelloM.VienoA.De VogliR. (2009). Primary headache in Italian early adolescents: the role of perceived teacher unfairness. Headache, 49, 366–374. doi:10.1111/j.1526-4610.2008.01208.x
42.
ShannonR. A.BergrenM. D.MatthewsA. (2010). Frequent visitors: Somatization in school-age children and implications for school nurses. The Journal of School Nursing, 26, 169–182.
43.
SheaB. J.ReevesB. C.WellsG.ThukuM.HamelC.MoranJ.…KristjanssonE. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, j4008.
44.
ShehabD. K.Al-JarallahK. F. (2005). Nonspecific low-back pain in Kuwaiti children and adolescents: Associated factors. Journal of Adolescent Health, 36, 32–35. doi:10.1016/j.jadohealth.2003.12.011
Solberg NesL.RoachA. R.SegerstromS. C. (2009). Executive functions, self-regulation, and chronic pain: A review. Annals of Behavorial Medicine, 37, 173–183. doi:10.1007/s12160-009-9096-5
47.
SwainM. S.HenschkeN.KamperS. J.GobinaI.Ottová-JordanV.MaherC. G. (2014). An international survey of pain in adolescents. BMC Public Health, 14, 447.
48.
TegethoffM.BelardiA.StalujanisE.MeinlschmidtG. (2015). Comorbidity of mental disorders and chronic pain: Chronology of onset in adolescents of a national representative cohort. The Journal of Pain, 16, 1054–1064.
49.
TreedeR.-D.RiefW.BarkeA.AzizQ.BennettM. I.BenolielR.…FirstM. B. (2015). A classification of chronic pain for ICD-11. Pain, 156, 1003.
50.
ValrieC. R.BrombergM. H.PalermoT.SchanbergL. E. (2013). A systematic review of sleep in pediatric pain populations. Journal of Developmental and Behavioral Pediatrics: JDBP, 34, 120.
51.
VervoortT.LoganD. E.GoubertL.De ClercqB.HubletA. (2014). Severity of pediatric pain in relation to school-related functioning and teacher support: An epidemiological study among school-aged children and adolescents. Pain, 155, 1118–1127. doi:10.1016/j.pain.2014.02.021
52.
WaldieK. E.WelchD. (2007). Cognitive function in tension-type headache. Current Pain and Headache Reports, 11, 454–460.
53.
YunusM. B.MasiA. T. (1985). Juvenile primary fibromyalgia syndrome. A clinical study of thirty-three patients and matched normal controls. Arthritis and Rheumatism, 28, 138–145.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
