Based on available evidence , the NRS-11 , FPS-R , and CAS were strongly recommended for self-report of acute pain .
Only weak recommendations could be made for self-report measures for postoperative and chronic pain .
No measures were recommended for children younger than 6 years , identifying a need for further measurement refinement in this age range .
Abstract In 2006 , PAIN published a systematic review of the measurement properties of self-report pain intensity measures  in children and adolescents ( Stinson JN , Kavanagh T , Yamada J , Gill N , Stevens B. Systematic review of the psychometric properties , interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents .
Key developments in pediatric pain necessitate an up date of this work , most notably growing use of the 11-point numeric rating scale ( NRS-11 ) .
Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old .
A secondary aim was to develop evidence -based recommendations for measurement of child and adolescent self-report of acute , postoperative , and chronic pain .
The Wong-Baker Pain FACES Scale Measures Pain, Not Fear
Objective The Wong-Baker FACES Pain Rating Scale ( WBS ) is preferred by parents and patients for reporting pain severity . However , it is speculated that the “ no hurt ” and “ hurts worst ” anchors confound pain measurement with nonnociceptive states . The objective of our study was to determine if fear confounds reporting of pain severity on the WBS . We hypothesized that the WBS would correlate with a psychometrically different pain severity scale ( the visual analog scale [ VAS ] ) and not correlate with a fear measure , the Child Medical Fear Scale ( CMFS ) . Methods This was a prospect i ve observational study of children 7 to 12 years presenting to a university-based suburban pediatric ED with acute pain . Patients rated pain severity on the WBS ordinal scale and a 100-mm unhatched VAS with marked end points of “ no pain ” and “ worse pain ever . ” Patients also completed a 26-item CMFS . Correlations between the WBS and VAS with the CMFS total score were assessed with Spearman correlation and exploratory factor analysis . Results All 3 scales were completed in 197 children .  Correlation between the severity scales ( WBS-VAS ) was moderate : 0.63 ( 95 % confidence interval [ CI ] , 0.54–0.71 ) . However , correlations between the WBS-CMFS and VAS-CMFS were poor : −0.02 ( 95 % CI , −0.16 to −0.12 ) and 0.01 ( 95 % CI , −0.13 to 0.15 ) , respectively . Correlations did not differ by sex , grade , pain location , or cause of pain ( traumatic vs atraumatic ) . Exploratory factor analysis demonstrated excellent loadings within 2 factors : pain and fear . Conclusions The WBS demonstrates moderate correlation with another measure of pain ( VAS ) and is not mistaken for fear among school-aged patients presenting to the ED with pain
Based on available evidence , the NRS-11 , FPS-R , and CAS were strongly recommended for self-report of acute pain .
Only weak recommendations could be made for self-report measures for postoperative and chronic pain .
No measures were recommended for children younger than 6 years , identifying a need for further measurement refinement in this age range .
Abstract In 2006 , PAIN published a systematic review of the measurement properties of self-report pain intensity measures  in children and adolescents ( Stinson JN , Kavanagh T , Yamada J , Gill N , Stevens B. Systematic review of the psychometric properties , interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents .
Key developments in pediatric pain necessitate an up date of this work , most notably growing use of the 11-point numeric rating scale ( NRS-11 ) .
Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old .
A secondary aim was to develop evidence -based recommendations for measurement of child and adolescent self-report of acute , postoperative , and chronic pain .