Date Presented 03/22/24

To improve clinical utilization, this study further examined the psychometric properties of two newly developed and validated measures of photo- and phonosensitivity-related avoidance behaviors in youth ages 8-18 with chronic headache.

Primary Author and Speaker: Megan Silvia

Contributing Authors: Allison Smith

PURPOSE: Photo- and phonosensitivity are often associated with pediatric headache disorders [1,2]. However, therapists lack tools that comprehensively assess such sensitivities and related avoidance behaviors that impact functioning in youth with headache. The Photo- and PhonoSensitivity Related Avoidance Behavior Scales (PHOTO-SABS & PHONO-SABS) were created to bridge this gap [3,4]. The purpose of this study is to further validate and improve the clinical utility of the measures, via confirmatory factor analyses (CFA), clinical reference points, and reliable change criteria (RCCrit).

DESIGN: This cross-sectional study included youth ages 8-18, presenting to a pediatric multidisciplinary outpatient specialty clinic for primary headache disorders.

METHOD: Participants (n=176; M age=14.7 years) completed the PHOTO- & PHONO-SABS via secure data collection system. CFAs were conducted in SPSS/AMOS. Clinical reference points were established by examining differences in headache-related variables by avoidance score groups. RCCrit scores were calculated via standard formula.

RESULTS: PHOTO-SABS was confirmed as an 11-item measure with two factors: Changes to Participation & Modification of Environment (CFI=0.96, RMSEA=0.08). PHONO-SABS was confirmed as a 12-item, single-factor measure (CFI=0.95, RMSEA=0.08). For both, tertile groupings (i.e., low, moderate, high avoidance behavior) offered clear cut points in total scores. The RCCrit was 6.4 points for both measures.

CONCLUSION: This study confirmed PHOTO-SABS’ and PHONO-SABS’ factor structures, identified clinical groups for score interpretation, and determined criteria for clinically significant change. Results support the utility of the measures for clinical and research purposes.

IMPACT STATEMENT: PHOTO- and PHONO-SABS are psychometrically sound tools to comprehensively evaluate sensitivity-related avoidance behavior in youth with headache, allowing therapists to interpret results and measure treatment response.

References

Headache Classification Committee of the International Headache Society (IHS). (2018). The international classification of headache disorders. Cephalalgia, 38(1), 1-211. https://doi.org/10.1177/0333102417738202

Papetti, L., Sforza, G., Tarantino, S., Moavero, R., Ruscitto, C., Ursitti, F., ... & Valeriani, M. (2021). Features and management of new daily persistent headache in developmental-age patients. Diagnostics, 11(3), 385. https://doi.org/10.3390/diagnostics11030385

Silvia, M., & Smith, A. M. (2021). Development and feasibility of the headache-related light and sound sensitivity inventories in youth. Children, 8(10), 861. https://doi.org/10.3390/children8100861

Smith, A. M., Silvia, M., Rogan, H., & Schefter, Z. J. (2023). Avoiding lights and sounds: validation of the PhotoSensitivity and PhonoSensitivity Avoidance Behavior Scales (PHOTO-SABS & PHONO-SABS) in pediatric headache. Children’s Health Care, 1-20. https://doi.org/10.1080/02739615.2023.2189117