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Validity of the Child Facial Coding System for the Assessment of Acute Pain in Children With Cerebral Palsy
Kellie L Hadden1, Sandra LeFort2, Michelle O'Brien3
1Department of Psychology, Memorial University of Newfoundland, St. John's, NF, Canada khadden@mun.ca.
Insights
The Child Facial Coding System accurately identifies pain in children with cerebral palsy during physical therapy. This validated tool helps assess pain in pediatric patients undergoing physiotherapy interventions.
Area of Science:
- Pediatric physiotherapy
- Pain assessment in children
- Child psychology
Background:
- Children with cerebral palsy often experience pain during physiotherapy.
- Accurate pain assessment is crucial for effective treatment and management.
- Existing pain measurement tools may have limitations in this population.
Purpose of the Study:
- To evaluate the concurrent and discriminant validity of the Child Facial Coding System.
- To determine if the Child Facial Coding System can reliably detect pain in children with cerebral palsy.
- To compare the Child Facial Coding System with the Numerical Rating Scale for pain assessment.
Main Methods:
- Eighty-five children with cerebral palsy were videotaped during physiotherapy sessions.
- Pain responses were assessed using the Child Facial Coding System and Numerical Rating Scale.
- Videotapes included baseline, passive joint stretch, and recovery phases.
Main Results:
- Child Facial Coding System scores strongly correlated with Numerical Rating Scale scores during passive joint stretch (r = .72, P < .01).
- Facial activity was significantly higher during passive joint stretch compared to baseline and recovery (P < .001).
- Facial activity did not correlate with developmental measures, supporting discriminant validity.
Conclusions:
- The Child Facial Coding System demonstrates concurrent and discriminant validity for assessing pain in children with cerebral palsy.
- This system provides a reliable method for identifying pain experiences during physiotherapy.
- The findings support the use of the Child Facial Coding System in clinical and research settings for pediatric pain evaluation.
Abstract:
The purpose of the current study was to examine the concurrent and discriminant validity of the Child Facial Coding System for children with cerebral palsy. Eighty-five children (mean = 8.35 years, SD = 4.72 years) were videotaped during a passive joint stretch with their physiotherapist and during 3 time segments: baseline, passive joint stretch, and recovery. Children's pain responses were rated from videotape using the Numerical Rating Scale and Child Facial Coding System. Results indicated that Child Facial Coding System scores during the passive joint stretch significantly correlated with Numerical Rating Scale scores (r = .72, P < .01). Child Facial Coding System scores were also significantly higher during the passive joint stretch than the baseline and recovery segments (P < .001). Facial activity was not significantly correlated with the developmental measures. These findings suggest that the Child Facial Coding System is a valid method of identifying pain in children with cerebral palsy.
