Part 1. Taking a pain history from a child.

Dr Cylie Williams, PhD

We have all experienced pain as adults. It is different for kids. When they see you and are in pain, it actually may be the first time or the most pain they have experienced.

Our language and how we talk about pain needs to change when working with kids as opposed to teenagers and then again with adults. We ask adults questions about burning, throbbing, pins and needles. We also ask them to quantify it on a scale of 0-10 where 0 is no pain and 10 is the worst pain ever. These things don’t work with kids.

We need to use kid friendly descriptors, tools and analogies to make it easier for kids to understand and give a real and accurate answers.

One of the first tools to use are kid friendly pain scales like the Wong-Baker FACES pain rating scale. This scale is specifically designed for kids. Word of warning though, some kids have the "Hurts Worst" pain but and want to mark it at the saddest face but will tell you that their pain doesn’t make them cry. Please reassure them that some kids don’t cry even though it is the worst pain ever.


Then there are analogues, does it hurt like when you skin your knee? What about feeling like an ant or a bee bite? Can you remember getting a needle and it was really sharp and hurt but then it stopped? Have you ever touched something hot and burned your finger or hand and it stay sore for a while? Have you ever broken anything and can remember what it felt like? This helps us understand if it is stinging, throbbing, aching and intensity.

Pain is subjective to the individual and we need to ensure that we use language appropriate to the child before moving onto the parent for a functional descriptor of how the pain is affecting the child. Most of all, spending time with the child talking about their pain, engages them in how to fix it. It gives the child control and makes it a consultation with them, rather than about them.

Some other interesting reads are: