{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:29:41Z","timestamp":1766388581212,"version":"3.48.0"},"reference-count":15,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objective: The COVID-19 pandemic led to a widespread transition to online learning. Yet, it is unclear how this shift in learning format impacted school attendance in adolescents with chronic pain, a group that struggles with school absenteeism. This study compared school attendance and format (e.g., in-person, online) in patients with chronic pain attending an Intensive Interdisciplinary Pain Treatment Program (IIPT) before the pandemic to an age- and gender-matched sample of youth attending the program after the pandemic. Methods: Participants were 226 school aged adolescents (13\u201318 years; M age = 15.89, SD = 1.46) enrolled in an IIPT before and after the COVID-19 pandemic. Patients admitted before March 2020 (pre-pandemic group; n = 113) were compared to an age- and gender-matched group of patients who were admitted to the IIPT from November 2021 to November 2023 (post-pandemic group = 113). Upon admission to the program, participants completed validated measures of internalizing symptoms and functional disability. They also completed structured questions related to pain and school history. Results: Significantly more patients in the post-pandemic group were attending school through online and home-schooling options (p &lt; 0.01). Youth who attended the IIPT after the pandemic missed fewer school days (p &lt; 0.05) than those who attended before the pandemic. The groups did not differ in functional disability or internalizing symptoms. However, participants in the post-pandemic group who attended online school missed more school days (p &lt; 0.01) and experienced greater functional disability (p &lt; 0.05) than those who attended in person. Conclusions: The findings highlight how the COVID-19 pandemic may lead to sustained changes in the way adolescents with chronic pain attend school, with implications for increased functional disability and school dropout among this vulnerable population.<\/jats:p>","DOI":"10.3390\/children13010015","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:01:33Z","timestamp":1766386893000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["School Attendance Pre- and Post-Pandemic in Adolescents with Chronic Pain"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7864-0847","authenticated-orcid":false,"given":"Jasmine R.","family":"Berry","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-1862","authenticated-orcid":false,"given":"Leslie","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8371-4890","authenticated-orcid":false,"given":"Cynthia","family":"Harbeck-Weber","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/jamapediatrics.2021.5840","article-title":"School Closures During Social Lockdown and Mental Health, Health Behaviors, and Well-being Among Children and Adolescents During the First COVID-19 Wave: A Systematic Review","volume":"176","author":"Viner","year":"2022","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"352","DOI":"10.12688\/f1000research.23631.1","article-title":"School closure in response to epidemic outbreaks: Systems-based logic model of downstream impacts","volume":"9","author":"Kneale","year":"2020","journal-title":"F1000Research"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/S2352-4642(20)30186-3","article-title":"The effects of social deprivation on adolescent development and mental health","volume":"4","author":"Orben","year":"2020","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1001\/jamapediatrics.2021.2482","article-title":"Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis","volume":"175","author":"Racine","year":"2021","journal-title":"JAMA Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00004703-200002000-00011","article-title":"Impact of recurrent and chronic pain on child and family daily functioning: A critical review of the literature","volume":"21","author":"Palermo","year":"2000","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1136\/adc.2004.056820","article-title":"Children with unexplained chronic pain: Substantial impairment in everyday life","volume":"90","author":"Konijnenberg","year":"2005","journal-title":"Arch. Dis. Child."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e152","DOI":"10.1542\/peds.2004-0682","article-title":"Pain among children and adolescents: Restrictions in daily living and triggering factors","volume":"115","author":"Thyen","year":"2005","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1080\/02739610701601387","article-title":"School absenteeism in pediatric chronic pain: Identifying lessons learned from the general school absenteeism literature","volume":"36","author":"Sato","year":"2007","journal-title":"Child. Healthc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/jpepsy\/jst028","article-title":"Acceptance of pain: Associations with depression, catastrophizing, and functional disability among children and adolescents in an interdisciplinary chronic pain rehabilitation program","volume":"38","author":"Weiss","year":"2013","journal-title":"J. Pediatr. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0005-7967(98)00034-5","article-title":"A measure of anxiety symptoms among children","volume":"36","author":"Spence","year":"1998","journal-title":"Behav. Res. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/oxfordjournals.aje.a112455","article-title":"Assessing depressive symptoms in five psychiatric populations: A validation study","volume":"106","author":"Weissman","year":"1977","journal-title":"Am. J. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/0165-1781(90)90110-Q","article-title":"Using the CES-D scale to screen for depression and anxiety: Effects of language and ethnic status","volume":"31","author":"Roberts","year":"1990","journal-title":"Psychiatry Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/jpepsy\/16.3.341","article-title":"Negative life events and symptom resolution in pediatric abdominal pain patients","volume":"16","author":"Walker","year":"1991","journal-title":"J. Pediatr. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.pain.2011.02.050","article-title":"Clinical utility and validity of the Functional Disability Inventory among a multicenter sample of youth with chronic pain","volume":"152","author":"Flowers","year":"2011","journal-title":"Pain"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0304-3959(99)00242-0","article-title":"Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art","volume":"85","author":"Vlaeyen","year":"2000","journal-title":"Pain"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/15\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:26:28Z","timestamp":1766388388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,20]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["children13010015"],"URL":"https:\/\/doi.org\/10.3390\/children13010015","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,20]]}}}