Ages Scales Description/indicators Websites and references Validity Preterm to full-term infants Premature Infant Pain Profile (PIPP) Gestational age, behavioral state before painful stimulus, change in heart rate during stimulus, change in oxygen saturation, brow bulge, eye squeeze nasolabial furrow http://www.cebp.nl/vault_public/filesystem/?ID=1467 Stevens et al., [14 , 86 ] Preterm to full-term infants Neonatal Facial Coding System (NFCS) Brow bulge, eye squeeze, nasolabial furrow, open lips, stretched mouth (horizontal or vertical), lip purse, tout tongue, and chin quiver http://www.cebp.nl/vault_public/filesystem/?ID=1425 Grunau et al., [18 ] Preterm to full-term infants Neonatal Infant Pain scale (NIPS) Face, cry, breathing pattern, arms, legs, and state of arousal http://www.cebp.nl/vault_public/filesystem/?ID=1426 Lawrence et al., [20 ] 32–60 weeks Crying Requires Increased vital signs Expression Sleeplessness (CRIES) Crying, increased oxygen requirements, expression, vitals signs, sleeping http://www.cebp.nl/vault_public/filesystem/?ID=1295 Krechel and Bildner, [15 ] Infants Maximally discriminate facial movement coding system (MAX) Brow, eye, and mouth movement Izard C. Maximally Discriminate Facial Coding System,1983 Izard [23 ] 1–7 years Chidren’s Hospital of Eastern Ontario Pain Scale (CHEOPS) Cry, facial, child verbal, torso, touch, legs http://www.cebp.nl/vault_public/filesystem/?ID=1274 .McGrath et al., [28 ] Infancy to 7 years The Faces Legs Activity Cry Consolability Scale (FLACC) Face, legs, activity, cry, and consolability http://www2.massgeneral.org/painrelief/pcs_pain_files/app_d_flacc.pdf .Merkel et al., [29 ] 1–4 years Observational Pain Scale Facial expression, cry, breathing, torso, arms and fingers, legs and toes, and states of arousal https://www.cebp.nl/vault_public/filesystem/?ID=1451 .Boelen-Ven der Loo et al., [38 ] 1–5 years Toddler-Preschooler Postoperative Pain Scale (TPPPS) Vocal pain expression, facial pain expression, bodily pain expression http://www.cebp.nl/vault_public/filesystem/?ID=1490 .Tarbell et al., [40 ] 1–6 years Child Facial Coding System (CFCS) Facial actions: brow lower, squint, eye squeeze, blink, flared nostril, nose wrinkle, nasolabial furrow, cheek raiser, open lips, upper lip raise, lip corner puller, vertical mouth stretch, and horizontal mouth stretch. Manual: Pediatric Pain-Science Helping Children, IWK Grace Health Centre, Dalhousie University & the University of British Columbia C.T. (copyright 1996) Gilbert et al., [47 ] 3–7 years COMFORT Scale Calmness/agitation, respiratory response, physical movement, blood pressure, heart rate, muscle tone, and facial tension http://painconsortium.nih.gov/pain_scales/COMFORT_Scale.pdf Ambuel 1990 [31 ]
3 yearsFaces Pain Scale Pain intensity Faces correspond to pain intensity http://painconsortium.nih.gov/pain_scles/index.html , http://www.usask.ca/childpain/fpsr/ Wong and Baker, [51 ], Hicks et al., [45 ] 3–13 years The Observational Scale of behavioral Distress (OSBD) Eleven behaviors related to pain and/or anxiety Elliot 1987 [34 ], Tucker et al., [35 ] 4–13 years Poker Chip Tool Pain intensity Poker chips represent “pieces of pain” http://www.painresearch.utah.edu/cancerpain/attachb7.html Hester et al., [49 ]
5 yearsOucher Scale Pain intensityFaces correspond to pain intensity http://www.oucher.org/the_scales.html Beyer et al., [56 ] 7 years Visual Analogue Scale (VAS) Pain intensity (numeric, color) http://www.cebp.nl/vault_public/filesystem/?ID=1478 .8–17 years Pediatric Pain Questionnaire Information seeking, problem solving, seeking social support, positive self-statements, behavioral distraction, cognitive distraction, externalizing, internalizing/ http://www.seattlechildrens.org/pdf/pediatric_pain_questionnaire.pdf Varni et al., [58 ] 8–17 years Adolescent Pediatric Pain Tool (APPT) Intensity, location, and quality of pain Savedra et al., [59 ]
12 yearsMcGill Pain Questionnaire Sensory and affective pain experience http://www.cebp.nl/vault_public/filesystem/?ID=1400 Melzack, [68 ]
