Which pain assessment tool is used for children who can't use a 1-10 scale but can quantify pain, including nonverbal or non-English-speaking patients?

• A. FACES pain scale
• B. FLACC pain scale
• C. PAINAD pain assessment in advanced dementia
• D. Numerical rating scale

Answer: (A)

When patients can’t use a numeric 1-10 scale, you rely on tools that translate pain into simple, understandable cues. The FACES pain scale uses a line of faces ranging from a happy, no-pain expression to a very distressed, high-pain expression. The patient or caregiver selects the face that best matches their pain, giving a quantified rating without needing words or numbers. This approach is especially helpful for children who have limited verbal skills or language barriers, because a visual cue communicates intensity quickly and clearly, facilitating timely pain management.

In contrast, another common tool is the FLACC scale, which is observational and scores pain based on facial expression, leg movement, activity, crying, and consolability. While excellent for nonverbal children, it relies on clinician observation rather than patient self-report, so it’s less about the patient’s own perception of pain and more about behavior. The PAINAD scale targets adults with advanced dementia, not children. The numerical rating scale requires the patient to express a number, which isn’t feasible for those who can’t use or understand numbers.