This is based on the presence of symptoms and the severity of the pain (Connelly 157). Tension-type headache (TTH) is diagnosed much more often in pediatric and adolescent children because there is much more information about this problem. A TTH is a headache that occurs less than 15 days per month but as frequently as 12 days per year up to 179 days per year. With the main onset of headaches occurring in children older than 7 years (Parisi 491). A TTH can have many of the same symptoms as migraines, including photophobia, but with migraines the pain is aggravated by physical activity. An episode generally begins with children in the afternoon at school and very often the child is still able to carry on with their favorite activities despite the pain. These TTHs are rare or absent during holidays or a long period of absence from school. (Parisi 492). This gives reason to believe that TTHs are under some sort of tension while the child is at school and evaluation for a diagnosis should occur during this time. In contrast to a TTH, migraine pain is so severe that a child would not consider continuing to play even when it is their favorite activity. In general, migraine refers to a headache that can last from 1 to 72 hours and is accompanied by at least one of the