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Updated: Jun 19, 2026

Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior
Published on: June 10, 2013
Behavioral pain assessment and the Face, Legs, Activity, Cry and Consolability instrument
Terri Voepel-Lewis1, Shobha Malviya, Sandra Merkel
1Department of Anesthesiology, CS Mott Children's Hospital, University of Michigan Health Systems, F3900 Box 0211, 1500 E. Medical Ctr. Dr., Ann Arbor, MI 48109 0211, USA. terriv@umich.edu
Abstract:
Difficulties assessing pain in individuals who cannot use self-report scales has led to their exclusion from clinical trials and rendered them vulnerable to undertreatment of pain. Although several observational pain scales are available for use in these populations, many lack the characteristics necessary for routine implementation into practice or research. The Face, Legs, Activity, Cry And Consolability pain scale was developed as a simple measure of pain intensity in young children. It has been validated in the postoperative setting in children 2-7 years of age and children aged 4-18 years with varying degrees of cognitive impairment. With minor revisions, the Face, Legs, Activity, Cry and Consolability pain scale may be useful to assess acute pain across populations of children and adults who are unable to self-report their pain.

