Library Services: Pediatric pain guide for caregivers: Pain assessment tools

What you can do

This page lists pain scales and behaviours that can indicate how much pain your child is feeling.

The following pages from SickKids Hospital provide key points on pain assessment, depending on your child's age and kind of pain:

Your health care team will suggest the best pain scale to help your child or youth communicate about their pain.

Which pain tool to use is based on your child's:
- Age and understanding,
- Ability to share their experience, and
- Need for others to assess through observation
When you use these pain tools, you (or others) rate how much pain you have.
Consider the context when assessing for pain. Is the pain impacting your child’s ability to play, to move, to eat, or to sleep? What impact is the pain causing?

If your child can self-assess their pain (point on a scale), they may use:

If your child is young, non-verbal or not able to self-assess, they may use:

Faces, Legs, Activity, Consolability, Cry Revised (r-FLACC) Scale (age 2 months +)
The Pediatric Pain Profile (age 1 - 18 years) - to download, you will need to provide your name, email, country, and role (parent)

You know your child best. Please share any behaviour changes you notice with your child's health care team.

Chronic pain is like… The clinical use of analogy and metaphor in the treatment of chronic pain in children, by Rachael Coakley and Neil Schechter. Pediatric Pain Letter 15.1 (2013): 1-8. In this article, the authors outline different ways to describe chronic pain using metaphor. These explanations may be easier for children to understand.
Pain: How to talk to kids about their pain (by SickKids Hospital). This page explains how to ask your child about how much pain they are feeling. It also lists physical coping strategies, like relaxation, and distraction techniques.

GrrrOUCH! Pain is like a grouchy bear by Cathryn Morgan
Call Number: JUNIOR FM 800 MOR 2011
This picture book encourages children to communicate their feelings and to explore, visualize and describe their pain using words and images to validate their personal pain experiences.
For ages 6-10
When Your Child Hurts by Rachael Coakley
Call Number: GK 285 COA 2016
This guide offers strategies for managing a child's pain along with expert advice for fostering long-term comfort. The author is a clinical pediatric psychologist who works exclusively with families of children with chronic or recurrent pain. This book provides research-proven strategies to achieve positive results.

If your child’s pain gets worse, or if the recommended treatments do not help:

Phone the healthcare provider at BC Children's that is supporting your child's follow-up care. Use the phone number that you received at discharge.
OR
Phone your family doctor or nurse practitioner.
If you cannot reach either contact, call HealthLink BC (8-1-1) to speak to a registered nurse. Tell them your child’s pain is not being managed with the approaches recommended.