All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .
A comparison of faces scales for the measurement of pediatric pain: children's and parents’ ratings
Faces scales have become the most popular approach to eliciting children 's self-reports of pain , although different formats are available . The present study examined : ( a ) the potential for bias in children 's self-reported ratings of clinical pain when using scales with smiling rather than neutral ' no pain ' faces ; ( b ) levels of agreement between child and parent reports of pain using different faces scales ; and ( c ) preferences for scales by children and parents . Participants were 75 children between the ages of 5 and 12 years undergoing venepuncture , and their parents . Following venepuncture , children and parents independently rated the child 's pain using five different r and omly presented faces scales and indicated which of the scales they preferred and why . Children 's ratings across scales were very highly correlated ; however , they rated significantly more pain when using scales with a smiling rather than a neutral ' no pain ' face . Girls reported significantly greater levels of pain than boys , regardless of scale type . There were no age differences in children 's pain reports . Parents ' ratings across scales were also highly correlated ; however , parents also had higher pain ratings using scales with smiling ' no pain ' faces . The level of agreement between child and parent reports of pain was low and did not vary as a function of the scale type used ; parents overestimated their children 's pain using all five scales . Children and parents preferred scales that they perceived to be happy and cartoon-like . The results of this study indicate that subtle variations in the format of faces scales do influence children 's and parents ' ratings of pain in clinical setting
All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .