Chart — Pediatrics
Pediatric Pain Scale Comparison Chart
The right pain scale is the one that fits the child’s developmental age. Self-report when they can manage it, behavioral observation when they can’t — and the dividing line is roughly the ability to understand numbers.
Educational use only. Pain tool selection and reassessment timing follow your facility’s policy. Pair the score with the clinical picture and treat per provider orders. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Scales by Age
| Scale | Age | Type | Method | Scoring |
|---|---|---|---|---|
| NIPS / CRIES | Neonates | Behavioral + physiologic | Score facial expression, cry, breathing, arms/legs, arousal (CRIES adds vitals + O₂ need) | Composite score; higher = more pain |
| FLACC | ~2 mo – 7 yr, or any nonverbal child | Behavioral (observed) | Face, Legs, Activity, Cry, Consolability — each 0–2 | 0–10 total (1–3 mild, 4–6 moderate, 7–10 severe) |
| Wong-Baker FACES / FPS-R | ~3 yr and up | Self-report (faces) | Child points to the face that matches how they FEEL | Faces map to 0–10 |
| Numeric Rating Scale | ~7–8 yr and up | Self-report (numeric) | Child rates 0 (none) to 10 (worst); needs numeric understanding | 0–10 |
Exam Traps
- ✦FLACC is the go-to for infants and any nonverbal child — Face, Legs, Activity, Cry, Consolability, each 0–2.
- ✦Wong-Baker FACES works from about age 3; the numeric 0–10 scale needs roughly age 7–8.
- ✦If the child can self-report, that's the most accurate measure — use it over behavioral scoring.
- ✦Neonates get NIPS or CRIES (behavioral + physiologic).
- ✦Wong-Baker rates how the child FEELS inside, not which face their expression matches — and the smiling end means 'no hurt,' not 'happy.'
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · CDC / ACIP (immunization schedule). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →