Pe 952

Assessing Your Child’s Pain
This handout explains how pain is assessed at Seattle Children’s.
How do you assess my We use a set of tools to assess your child’s pain regularly. We do this
while we care for your child even if you are not there with them. These
child’s pain?
tools include:
• Watching your child’s behavior
• Asking questions
• Using a pain scale that is appropriate for their age and development
What are pain scales? Pain scales are tools to check on your child’s level of pain. There are
different scales based on the person’s age and development.
The developmental level of your child determines which scale is most
appropriate. The 2 scales we use for children over 3 are given below.
0-10 SCALE for children age 7 and older

We will ask your child: “On a scale of 0 to 10, with ‘0’ being no pain and ‘10’ being the worst pain you can
imagine, what number are you feeling right now?”
0 1 2 3 4 5 6 7 8 9 10
No pain Worst pain
Faces PAIN SCALE – REVISED (FPS-R) for children age 3 and older
We will ask your child: “Point to the face that tells us how you feel/how your pain is right now.”
0 2 4 6 8 10
These faces show how much something can hurt. The left-most face shows no pain. The faces show more
and more pain up to the right-most face – it shows very much pain.
1 of 2
To Learn More Free Interpreter Services

• Pain Medicine • In the hospital, ask your nurse.
• Ask your child’s healthcare provider • From outside the hospital, call the
toll-free Family Interpreting Line,
• seattlechildrens.org 1-866-583-1527. Tell the interpreter
the name or extension you need.
Assessing Your Child’s Pain
How is pain assessed in We use different pain rating scales for premature babies, full-term
babies and children who cannot speak. These special scales take us
babies or non-verbal
through a visual assessment of your child’s body movements and
children? vital signs. The list below reflects what these scales include. You,
too, can look for these signs in your child. Ask the nurse for more
information about these scales.
Behavior and body language that may show your child is in pain:
Face Frown, grimace, clench jaw, quivering chin, look scared or panicked
Hands, feet, arms and legs Clenched fists and toes, kicking, arms and legs pulled into the body
Activity Tense, squirming, jerking, shifting back and forth, restless, waking
often or sleeping too much, not eating
Soothing Hard to comfort or distract, irritable, grunting, resisting care or

comfort
Cry Crying steadily or resistant to soothing, sobbing, high-pitched or

silent screaming, whimpering, outbursts
Vital signs Fast heart and breathing rate, high blood pressure, low oxygen
saturation
How can I help with pain • Tell us if you see signs of pain in your child’s behavior and body
language.
assessment?
• Help us understand how you know when your child is in pain.
• Let us know how your child has delt with pain in the past.
Acknowledgements:
Faces Pain Scale – Revised (FPS-R) (2001) Hicks CL, von Baeyer CL, Spafford P, van Korlaar I, Goodenough B. Faces Pain Scale-Revised: Toward a
Common Metric in Pediatric Pain Measurement. Pain 93:173-183. With the instructions and translations as found on the website:
http://www.usask.ca/childpain/fpsr/. This figure has been reproduced with permission of the International Association for the Study of Pain® (IASP®). The
figure may not be reproduced for any other purpose without permission.
FLACC Pain Rating Scale Source: Merkel SI, et al. (1997) Practice applications of research. The FLACC: a behavioral scale for scoring postoperative pain in
young children. Pediatric Nursing 23(3):293-297.
N-PASS Neonatal Pain, Agitation and Sedation Scale © Loyola University Health System, Loyola University Chicago, 2009 (Rev. 2/10/09) Pat Hummel, MA,
APN, NNP, PNP. All rights reserved. No part of this document may be reproduced in any form or by any means, electronic or mechanical without written
permission of the author. This tool is currently undergoing testing for validity and reliability, and the authors cannot accept responsibility for errors or
omission or for any consequences resulting from the application or interpretation of this material.
Seattle Children’s offers free interpreter services for patients, family members and legal representatives who are deaf or hard of
hearing or speak a language other than English. Seattle Children’s will make this information available in alternate formats upon 9/22
request. Call the Family Resource Center at 206-987-2201. This handout has been reviewed by clinical staff at Seattle Children’s. PE952
However, your needs are unique. Before you act or rely upon this information, please talk with your healthcare provider.
© 2022 Seattle Children’s, Seattle, Washington. All rights reserved.
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Assessing Your Child’s Pain

This handout explains how pain is assessed at Seattle Children’s.

0-10 SCALE for children age 7 and older

No pain Worst pain

To Learn More Free Interpreter Services

Soothing Hard to comfort or distract, irritable, grunting, resisting care or

Cry Crying steadily or resistant to soothing, sobbing, high-pitched or

Patient and Family Education | Pain Medicine 2 of 2

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