**6. Implications for headache service for children and adolescents**

Empowering patient education has long‐lasting positive outcomes for paediatric health care services. It implies giving the child, adolescent and involved parents a platform for experi‐ mental and interactive learning, where the child's right to autonomy and self‐determination is respected and the child's motivation considered. Setting aside a sufficient amount of time is necessary for the various phases of a high‐quality empowering educational programme, which include: examination, planning, education, implementation and, finally, evaluation and feedback. This involves managing a variety of communication and interactive methods. A child/adolescent‐friendly atmosphere with pleasant social activities is empowering. These features combined mean that the staff who lead and manage the educational programmes must be prepared and have the necessary training. The organisation should also be able to encom‐ pass the complexity of the programme in order to live up to WHO and EU Health Parliament standards.

The educational content for children and adolescents with primary TTH is linked to general and specific health knowledge and skills. The strategies needed work to reduce psycho‐ physiological overload. Muscle load is seen leading to prolonged nociceptive input to pain pathways with subsequent hypersensitivity and chronic pain. Sufficient amounts of aerobic power achieved through training and outdoor play enhance health, and can also be used as active stress‐coping strategies. Stress, sleep and nutrition hygiene also work to help accumulate the resources needed to cope with the demands of daily life and to reduce a psycho‐physio‐ logical load.

Specific strength training, especially of the upper trapezius, might reverse negative muscular consequences from repetitive work with electronic devices. It is also necessary to reach a sufficient volume of training.

Relaxation training with SEMG and visual and auditory feedback is another interactive, effective learning process for children, which also tends to reduce prolonged nociceptive input. Awareness of and training on how to modulate workloads, posture, breathing and heart rate provides the knowledge and skills to self‐regulate mind‐body interactions in daily life.
