From Practice to Innovation: OT Professor Leads the Way in Pediatric Pain Treatment

Assistant Professor Megan Silvia develops an assessment tool to help occupational therapists efficiently measure the effectiveness of treatment in youth.

Occupational therapy professor Dr. Megan Silvia isn't just improving lives — she's rewriting the playbook on pediatric pain rehabilitation.

While teaching courses at Massachusetts College of Pharmacy and Health Sciences (MCPHS), Dr. Silvia, OTD, OTR, is developing an assessment tool to help children and adolescents manage chronic pain stemming from headaches.

"Pediatric chronic pain is lesser known—it's not necessarily in all of the curricula. But there is a large gap that needs to be filled with this population," Dr. Silvia said.

A clinical rotation at Boston Children's Hospital (BCH) introduced Dr. Silvia to occupational therapy’s (OT) role in the pediatric side of chronic pain. In this setting, OT helps youth with everyday tasks, such as managing sensory sensitivities and completing self-care, and returning to school and extracurricular activities. She said the goal is to teach the patients how to manage their pain so they can function in their environment.

Working with the young patients at BCH was so fulfilling that Dr. Silvia stayed for five years. "I just fell in love with the population, the individuals, and the team I was working on and their approach," she said.

At MCPHS, Dr. Silvia teaches courses that include Motor Performance, Clinical Reasoning, OT Management, and Capstone. Her clinical research focus continues to be managing pain for youth with chronic headaches, which is the bulk of her published work. Dr. Silvia holds several additional roles at MCPHS, including Interprofessional Education (IPE) representative on the Worcester campus and the occupational therapy program's liaison to MCPHS Admissions and its social media coordinator.

Filling a need in clinical practice

Dr. Silvia's recent research is in collaboration with the Pediatric Headache Program at BCH, where she noticed the lack of a standardized assessment questionnaire to measure the effectiveness of treatment. To address this, she developed two questionnaires measuring visual and auditory sensitivity in patients experiencing headaches. Patients rate symptoms on a 1 to 4 scale, from "never" to "always."

"There are many different assessment tools out there, but there were no validated tools that I found really fit this population. And so, I set off on this venture to develop assessment tools that clinicians can use," Dr. Silvia said.

The next step is to make them more clinically useful for therapists. Dr. Silvia plans to publish the final phase soon and expects the tool to be used by other pediatric pain rehabilitation programs nationwide.

Dr. Silvia collaborates with a multidisciplinary team at BCH, including neurologists, psychologists, and nurse practitioners. In the classroom, she encourages her students to make similar strides in research and collaboration.

"As OTs, you can conduct research and create assessment tools," Dr. Silvia said. It's a process, but it's something they can and should do. It's important for them to see that they can also be researchers in our field."

A memorable recovery

One of the patients who inspired Dr. Silvia to create her assessment tool was an adolescent who suffered from visual and auditory sensitivity and headaches after a concussion. As a result, he was unable to continue his graphic design hobby, stopped attending school, and dealt with debilitating anxiety.

However, Dr. Silvia said that gradually increasing his exposure to light and sound during treatment sessions resulted in a significant improvement in just five weeks of participation in the rehabilitation program at BCH.

"I received an email from him a few weeks after he returned home to share that he was back at school, signed up for driver's education, and restarted his small business in graphic design. It was a lovely reminder that occupational therapy can help to make a profound positive impact on someone's life," she said.