Ability of 3- to 5-year-old children to use simplified self-report measures of pain intensity.

Little is known about self-report pain intensity scales best suited for young children. We tested the ability of preschool children to use two simplified scales (concrete ordinal and faces). Three- to 5-year-olds ( = 123) were asked to make binary discriminations ('less' vs 'more' pain) between response options using the Simplified Faces Pain Scale and Simplified Concrete Ordinal Scale and to complete a seriation task.

Pain in Child Health from 2002 to 2015: The early years of an international research training initiative.

: The 2018 Global Year for Excellence in Pain Education, an initiative of the International Association for the Study of Pain, brought worldwide attention to the need for education that crosses narrow disciplinary boundaries, addresses up-to-date research methods and findings, and encourages teamwork among trainees and mentors at different levels of training and with different perspectives. : This commentary describes the development of Pain in Child Health (PICH), an interdisciplinary training program for researchers in pediatric pain at the undergraduate, graduate, and postdoctoral levels of training. : Based on documentation of the structure, training processes, leadership, and membership of PICH, we outline its organization and its challenges and accomplishments over the first 12 years of its growth into a well-known international program.

Changes in Pain Score Associated With Clinically Meaningful Outcomes in Children With Acute Pain.

Background: Identifying changes in pain score associated with clinically meaningful outcomes is necessary when using self-report measures to assess pain in children. We aimed to determine the changes in pain score associated with a minimum clinically significant difference (MCSD), ideal clinically significant difference (ICSD), and patient-perceived adequate analgesia (PPAA) and to evaluate for differences based on initial pain intensity and patient characteristics.

Methods: This was a cross-sectional study of children 6 to 17 and 4 to 17 years old who were assessed using the Verbal Numerical Rating Scale (VNRS) and Faces Pain Scale-Revised (FPS-R), respectively.

Boo-boos as the building blocks of pain expression: An observational examination of parental responses to everyday pain in toddlers.

Background: Everyday pain experiences (minor bumps/scrapes) are common in early childhood and create frequent opportunities for socialization of pain behaviors. Nevertheless, everyday pain during the formative toddler period has been largely overlooked.

Aims: The aim of the current study was to describe the frequency and nature of toddlers' everyday pain experiences, child and parent responses, and the relationship between child characteristics (age, sex, temperament) and responses.

Optimizing Numeric Pain Rating Scale administration for children: The effects of verbal anchor phrases.

: The 0-10 Verbal Numeric Rating Scale (VNRS) is commonly used to obtain self-reports of pain intensity in school-age children, but there is no standard verbal descriptor to define the most severe pain. : The aim of this study was to determine how verbal anchor phrases defining 10/10 on the VNRS are associated with children's reports of pain. .

Systematic Review of Self-Report Measures of Pain Intensity in 3- and 4-Year-Old Children: Bridging a Period of Rapid Cognitive Development.

Unlabelled: Claims are made for the validity of some self-report pain scales for 3- and 4-year-old children, but little is known about their ability to use such tools. This systematic review identified self-report pain intensity measures used with 3- and/or 4- year-old participants (3-4yo) and considered their reliability and validity within this age span. The search protocol identified research articles that included 3-4yo, reported use of any pain scale, and included self-reported pain intensity ratings.

Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture.

Unlabelled: There are inadequate age-specific data to support the use of current self-report pain scales in 3- and 4-year-old children. Most preschool-aged children also lack the necessary cognitive development to use standard scales. We aimed to evaluate the validity and feasibility of 2 novel simplified scales (Simplified Faces Pain Scale, S-FPS; Simplified Concrete Ordinal Scale, S-COS) for preschool-aged children.

Young children's ability to report on past, future, and hypothetical pain states: a cognitive-developmental perspective.

Children are at times asked by clinicians or researchers to rate their pain associated with their past, future, or hypothetical experiences. However, little consideration is typically given to the cognitive-developmental requirements of such pain reports. Consequently, these pain assessment tasks may exceed the abilities of some children, potentially resulting in biased or random responses.

Psychometric Properties of the Numerical Rating Scale to Assess Self-Reported Pain Intensity in Children and Adolescents: A Systematic Review.

Objectives: The Numerical Rating Scale-11 (NRS-11) is one of the most widely used scales to assess self-reported pain intensity in children, despite the limited information on its psychometric properties for assessing pain in pediatric populations. Recently, there has been an increase in published findings regarding the strengths and weaknesses of the NRS-11 as a measure of pain in youths. The purpose of this study was to review this research and summarize what is known regarding the reliability and validity of the NRS-11 as a self-report measure of pediatric pain intensity.

Defining No Pain, Mild, Moderate, and Severe Pain Based on the Faces Pain Scale-Revised and Color Analog Scale in Children With Acute Pain.

Objectives: The aims of this study were to define the Faces Pain Scale-Revised (FPS-R) and Color Analog Scale (CAS) scores associated with no pain, mild pain, moderate pain, and severe pain in children with acute pain, and to identify differences based on age, sex, and ethnicity.

Methods: We conducted a prospective observational study in 2 pediatric emergency departments of children aged 4 to 17 years with painful and nonpainful conditions. We assessed their pain intensity using the FPS-R, CAS, and qualitative measures.

Children's Forgetting of Pain-Related Memories.

Objective: Given that forgetting negative experiences can help children cope with these experiences, we examined their ability to forget negative aspects of painful events.

Methods: 86 children aged 7-15 years participated in a retrieval-induced forgetting task whereby they repeatedly retrieved positive details of a physically painful experience, and an experimental pain task (cold-pressor task).

Results: Repeatedly retrieving positive details of a prior pain experience produced forgetting of the negative aspects of that experience.

A smartphone version of the Faces Pain Scale-Revised and the Color Analog Scale for postoperative pain assessment in children.

Background: Effective pain assessment is essential during postoperative recovery. Extensive validation data are published supporting the Faces Pain Scale-Revised (FPS-R) and the Color Analog Scale (CAS) in children. Panda is a smartphone-based application containing electronic versions of these scales.

Clinically significant differences in acute pain measured on self-report pain scales in children.

Objectives: The objective was to determine the minimum and ideal clinically significant differences (MCSD, ICSD) in pain intensity in children for the Faces Pain Scale-Revised (FPS-R) and the Color Analog Scale (CAS) and to identify any differences in these estimates based on patient characteristics.

Methods: This was a prospective study of children aged 4 to 17 years with acute pain presenting to two urban pediatric emergency departments. Participants self-reported their pain intensity using the FPS-R and CAS and qualitatively described their changes in pain.

A debate on the proposition that self-report is the gold standard in assessment of pediatric pain intensity.

Objectives And Methods: Self-report is often represented as "the gold standard" in assessment of pain intensity in children. We evaluate arguments for and against this claim and consider its implications for pain management.

Results: Those in the support of the proposition argue that, when children are able to self-report, treatment decisions should be made based on these scores in line with current evidence-based recommendations.

Training highly qualified health research personnel: the pain in Child Health consortium.

Background And Objectives: Pain in Child Health (PICH) is a transdisciplinary, international research training consortium. PICH has been funded since 2002 as a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research, with contributions from other funding partners and the founding participation of five Canadian universities. The goal of PICH has been to create a community of scholars in pediatric pain to improve child health outcomes.

Validation of self-report pain scales in children.

Background And Objectives: The Faces Pain Scale-Revised (FPS-R) and Color Analog Scale (CAS) are self-report pain scales commonly used in children but insufficiently validated in the emergency department setting. Our objectives were to determine the psychometric properties (convergent validity, discriminative validity, responsivity, and reliability) of the FPS-R and CAS, and to determine whether degree of validity varied based on age, sex, and ethnicity.

Methods: We conducted a prospective, observational study of English- and Spanish-speaking children ages 4 to 17 years.

Developmental data supporting simplification of self-report pain scales for preschool-age children.

Unlabelled: Claims regarding the ability of preschool-age children to provide accurate self-reports using standard pain scales are not well supported by age-specific evidence. Responses of children younger than 5 years are often idiosyncratic and subject to biases. Simplifying the task of self-report of pain would make it more developmentally appropriate for 3- to 5-year-olds.

A Quantitative Examination of Extreme Facial Pain Expression in Neonates: The Primal Face of Pain across Time.

Many pain assessment tools for preschool and school-aged children are based on facial expressions of pain. Despite broad use, their metrics are not rooted in the anatomic display of the facial pain expression. We aim to describe quantitatively the patterns of initiation and maintenance of the infant pain expression across an expressive cycle.