Protocol - Pain Intensity - Child

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This protocol consists of a single interviewer-administered question for children aged 4- to 12-years-old assessing acute pain intensity. The item is measured on an 11-point scale. This protocol was validated in individuals aged 4- to 12-years-old.

Specific Instructions

The Sickle Cell Disease Pain Working Group notes that numeric rating scales (NRS) can be used for children as young as 8 years. For studies that include older children and a mix of children and adults, the NRS might be preferable to provide continuity.

Permission for Use. Copyright of the Faces Pain Scale-Revised (FPS-R) is held by the International Association for the Study of Pain (IASP) ©2001. This material may be photocopied for non-commercial clinical, educational and research use. For reproduction of the FPS-R in a journal, book, or web page, or for any commercial use of the scale, request permission from International Association for the Study of Pain (IASP) online at www.iasp-pain.org/FPS-R.


Limited Availability


Faces Pain Scale - Revised (FPS-R)

The FPS-R shows a set of faces indicating how much pain they are in. The left side shows a face with no pain. From left to right, the faces indicate increasing levels of pain until the far right, which shows a high amount of pain. Each face has a score associated with it.

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "dont know" response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer or handheld computer to administer a computer-assisted questionnaire.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire




Children aged 4- to 12-years-old

Selection Rationale

The Faces Pain Scale-Revised (FPS-R) has been tested and found to be reliable and comparable to established measures of the same content areas. It is quick and easy to administer via paper and pencil or electronically. It captures preschool-aged children. Additionally, it has been validated in chronic, acute, and procedural patient populations.


English, Other languages available at source

Derived Variables


Process and Review

Not Applicable

Protocol Name from Source

Faces Pain Scale-Revised (FPS-R)


Hicks, C. L., von Baeyer, C. L., Spafford, P. A., van Korlaar, I., & Goodenough, B. (2001). The Faces Pain Scale-Revised: Toward a common metric in pediatric pain measurement. Pain, 93(2), 173-183.

General References

Bieri, D., Reeve, R. A., Champion, D. G., Addicoat, L., & Ziegler, J. B. (1990). The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain, 41(2), 139-150.

Birnie, K. A., Hundert, A. S., Lalloo, C., Nguyen, C., & Stinson, J. N. (2019). Recommendations for selection of self-report pain intensity measures in children and adolescents: A systematic review and quality assessment of measurement properties. Pain, 160(1), 5-18.

da Silva, F. C., Santos Thuler, L. C., & de Leon-Casasola, O. A. (2011). Validity and reliability of two pain assessment tools in Brazilian children and adolescents. Journal of Clinical Nursing, 20(13-14), 1842-1848.

Gupta, N., Naegeli, A. N., Turner-Bowker, D. M., Flood, E. M., Heath, L. E., Mays, S. M., & Dampier, C. (2016). Cognitive testing of an electronic version of the Faces Pain Scale-Revised with pediatric and adolescent sickle cell patients. The Patient, 9(5), 433-443.

Stinson, J. N., Kavanagh, T., Yamada, J., Gill, N., & Stevens, B. (2006). Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain, 125(1-2), 143-157.

Tsze, D. S., von Baeyer, C. L., Bulloch, B., & Dayan, P. S. (2013). Validation of self-report pain scales in children. Pediatrics, 132(4), e971-e979.

Protocol ID


Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX860402010000 In the past 7 days, how would you rate your more
pain on average? show less
Measure Name

Pain Intensity

Release Date

May 18, 2022


This measure assesses the magnitude of pain experienced by an individual.


Pain intensity can impact social interactions, physical and mental health, and overall quality of life. Pain is a commonly occurring symptom that affects individuals with a variety of diseases and conditions, including sickle cell disease.


PROMIS® Patient-Reported Outcomes Measurement Information System, PROMIS, National Institutes of Health, NIH, pain, Pain measurement, Pain assessment, sickle cell disease, SCD, type 1 diabetes, asthma, atopic dermatitis

Measure Protocols
Protocol ID Protocol Name
860401 Pain Intensity - Adolescent and Adult
860402 Pain Intensity - Child
860403 Pain Intensity - Toddler

There are no publications listed for this protocol.