A record of a child’s headaches can help a clinician understand timing, associated symptoms, and effects on daily life. A drawing may help a child describe an experience that is difficult to put into words. Neither a diary nor a drawing can establish the diagnosis, and recording symptoms must never delay urgent care.
Start with warning signs
Seek emergency care now for a sudden, extremely severe headache; a child who is confused or difficult to wake; new weakness or difficulty walking or speaking; or headache with fever and a stiff neck. Use your local emergency service if the child is seriously unwell. This is not a complete list: a rapidly deteriorating child needs assessment even if their symptoms do not match a checklist. The American Academy of Pediatrics explains headache warning signs for families.
Other patterns also warrant prompt medical advice. NICE recommends same-day assessment for children under 12 with features including a headache that wakes them at night, is present on waking, progressively worsens, is triggered or worsened by coughing or bending, or accompanies vomiting. Its guidance also calls for urgent neurological assessment of headaches in children under four. Read NICE’s age-specific headache referral recommendations. Contact a clinician to arrange the appropriate assessment; do not wait to fill several diary pages.
For recurring headaches without urgent features, arrange a visit if they are becoming more frequent, changing, or interfering with school, sleep, play, or family life. A familiar history of headaches does not make a new concerning symptom harmless. Royal Children’s Hospital provides family guidance on headaches and seeking care.
Record observations without assigning a diagnosis
Keep entries short and specific, using the child’s own words when possible. Include headaches on ordinary days as well as difficult ones. If you do not know an answer, write “not known” instead of guessing. A clinician can ask follow-up questions more easily from a brief accurate record than from a confident but invented explanation.
On a small screen, scroll the table sideways to read all columns.
| Record | Example of useful detail | Avoid assuming |
|---|---|---|
| Timing and duration | Date, approximate start and end, whether it interrupted sleep. | That every episode had the same duration. |
| The child’s description | Where it hurt, what it felt like, and their own words or drawing. | That a drawing proves a particular headache type. |
| Other symptoms | Nausea, vomiting, light or sound sensitivity, vision changes, fever, or other observed changes. | That an associated symptom is automatically explained by a previous diagnosis. |
| Daily impact | Stopped playing, missed a lesson, lay down, or continued usual activities. | That attending school means the pain was unimportant. |
| Context and response | Sleep, meals, illness, activities; what was tried and what happened afterward. | That one event before the headache caused it. |
The AAP suggests a diary of timing, symptoms, and possible contributing factors. If medicine was given, record its exact name, strength, amount, and time from the label or care plan; do not reconstruct a dose from memory. Bring the packaging or a clear medication list to the visit. Ask the clinician about safe use and frequency rather than using the diary to adjust treatment yourself.
Worked example: description, not interpretation
Invented example for record-keeping only: “September 2: pain started about 3:10 p.m. and ended about 3:50 p.m. Child said ‘it squeezes across my forehead.’ Stopped a game and sat in a quiet room. No vomiting observed. Ate lunch as usual; bedtime was later than usual yesterday. No medicine given. Returned to playing afterward.”
The recorded duration is approximately 40 minutes. The entry does not establish a headache type, prove that sleep caused it, or show that the quiet room was a treatment that will work next time. It gives the clinician concrete observations to compare with other episodes and the examination.
Let a drawing begin a conversation
Offer plain paper and an open invitation such as “Can you show me what it felt like?” Ask the child to explain their marks, colors, or shapes in their own words. Write that explanation alongside the picture, with a date. Avoid suggesting what they should draw or interpreting an image as a test result.
A frightening-looking drawing is not a measurement of disease severity, and a simple drawing does not show that a headache is mild. Bring it as another way for the child to be heard. The clinical assessment still matters: Royal Children’s Hospital describes a history and examination, with investigations guided by findings and warning signs. Many children do not need imaging, but a diary cannot decide who does. See the hospital’s clinical headache guideline.
Make the appointment useful for the child
Bring the diary, any drawings, a medicine list, relevant past records, and a short account of changes over time. Let the child speak directly where possible, then add observations they may not recall. Mention family history and effects on learning or activities without assuming a cause. Stress can be relevant context; it should not become a reason to dismiss pain.
Ask what the clinician thinks is most likely, whether any further assessment is needed, and which changes should prompt urgent review. Request a written plan for home and school, including medication instructions if appropriate, follow-up timing, and a contact route if the plan is not helping. Discuss regular sleep, meals, and hydration as part of the overall plan, not as a replacement for evaluation. Royal Children’s Hospital covers practical family support.
Choose a format you will actually use: open the printable one-episode diary or download blank diary columns for a spreadsheet (CSV). These resources do not collect or transmit information; store completed records as private health information.
Related resources
General educational information, researched September 5, 2026. Use your care team’s instructions for your own health, treatment, and devices.