Many parents are surprised, and often unaccepting, when they learn their child's frequent headaches are caused by stress or difficulties in dealing with life rather than an identifiable medical problem.

"Most headaches in older children are a 'growing up' problem, a type of adaptation to stress," says Dr. William Bell, professor of pediatric neurology in the University of Iowa College of Medicine.

Situations that may be difficult for children to cope with include moving to a new community, changing schools, conflict with a sibling, feeling anxiety when a sibling leaves home, or when there are changes or disturbances in parent-child or husband-wife relationships.

Bell cites the example of a child who tries to achieve perfection in everything she does. When the child finds she can't make all A's in school she develops headaches. The symptom becomes an acceptable excuse for missing school, which then justifies the lower grades.

This kind of headache, which occurs most often between the ages of 10 and 16 years, can be marked by low spirits, despondency, chronic fatigue, frequent crying, and withdrawn behavior.

The second most common headache type in children is migraine. Bell says they are common in children but are different from adult migraines.

While most adult migraines occur in women, migraines in children occur commonly in either sex. There is a greater frequency of nausea and vomiting in children, but the headaches are usually shorter in length. In most cases there is a family history of migraines.

Though children usually don't experience the visual abnormalities that adults have preceding migraine headaches, they can experience temporary numbness or weakness in one side of the body. A few children may experience severe confusion and difficulty in walking and talking during such attacks.

Headaches that are a result of a serious organic medical problem represent only a small percent of children's headaches.

"Anything that increases pressure in the head can cause headaches, such as a swollen brain, a brain tumor or a collection of blood," says Bell. He says headaches caused by such disorders can usually be identified by accompanying symptoms such as increasing visual problems, vomiting, uncooridination or sleepiness.

The symptoms of this type of headache should not be confused with the occasional headaches a child may have along with childhood illnesses like mumps, chickenpox, flue and sore throats with fever.

Bell says children can get occasional headaches just as adults do. He suggests that the child should receive aspirin and rest until the headache ends.