The consistency of young children's assessment of remembered painful events.

Clinicians need to know the consistency of a child's report of his pain in order to assess the intensity of that pain. To explore an age cutoff above which children are consistent in reporting their pain, we tested the consistency of children's reports of recalled pain, using a variety of scales. We interviewed 91 children, three to eight years of age, and obtained each child's report of two of his own painful experiences. In two separate sessions, we asked each child to compare those specific experiences in several ways, using two picture scales, a block-based scale, triads, and the simple question, "which hurt you more?" Results show that children older than seven years are more consistent in reporting the relative pain intensity of remembered events than younger ones (range 50-100% vs. 20-55%, p less than 0.001), and that the simple question provides the most consistent answer. However, no age group tested was consistent more than 80% of the time on all measures. We conclude that children are able to report remembered pain intensity consistently with increasing age but that we cannot establish a firm cutoff between the ages of three and eight years with our data.