Pain Assessment in Infants & Children

Introduction

Because children have a limited range of experience and may be unable to use words that adequately express their discomfort, determining just how much pain a child is experiencing can be difficult. Cognitive, behavioral, emotional, and psychosocial factors (e.g., family learning, culture), and other factors (e.g., gender) play a role in a child's pain experiences, with children and adolescents responding to noxious experiences differently at different developmental stages. Observational pain scales have been validated for neonates and infants to allow pain assessment in those unable to verbalize their pain. These scales, though essential, also respond to distress from causes other than pain, such as hunger, fear or anxiety (e.g., from parental separation). Simple self-report scales using facial expressions or small objects to describe pieces of hurt (i.e., Poker Chip Tool) have been devised to allow preschool and school age children to more accurately describe the intensity of their pain.