New method for measuring young children's self-report of fear and pain

The purposes of this paper are (a) to describe the conceptual development of the Children's Global Rating Scale (CGRS), a technique for measuring young children's self-report of such constructs as pain and fear that was designed to address the methodological limitations of existing techniques, and (b) to report the findings of a study investigating the convergent and predictive validity of the CGRS in a sample of children undergoing an invasive medical procedure. Anticipatory procedural distress in 145 children between the ages of 4 and 8 was assessed in outpatient phlebotomy using three independent rating sources: children, parents, and a trained clinical observer. Phlebotomists' ratings as to whether or not children's distress during the actual procedure extended the time it usually takes to perform the procedure was used as the outcome criterion in a discriminate analysis in determining the degree to which anticipatory ratings would predict actual clinical distress during the medical procedure. Results provide preliminary support for the convergent and predictive validity of the CGRS revealing significant correlations with the other independent measures of children's anticipatory distress and also revealed that the CGRS was one of the significant variables in predicting children who extended and did not extend the medical procedure.