Covert video monitoring in the assessment of medically unexplained symptoms in children

Abstract

Objective: Diagnosis of medically unexplained symptoms (MUS) occurs after thorough evaluations have failed to identify a physiological cause for symptoms. However, families and providers may wonder if something has been missed, leading to reduced confidence in behavioral treatment. Confidence may be improved through the use of technology such as covert video monitoring to better assess functioning across settings. Methods: A 12-year-old male presented with progressive neurological decline, precipitated by chronic pain. After thorough evaluation and the failure of standard treatments (medical, rehabilitative, and psychological) covert video monitoring revealed that the patient demonstrated greater abilities when alone in his room. Negative reinforcement was used to initiate recovery, accompanied by positive reinforcement and a rehabilitative approach. Covert video monitoring assisted in three subsequent cases over the following 3 years. Results: and Conclusions: In certain complex cases, video monitoring can inform the assessment and treatment of MUS. Discussion includes ethical and practical considerations. © 2011 The Author. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.