Related Experiment Video
Updated: Mar 16, 2026
Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
Published on: July 7, 2023
Agreement between child self-reported and parent-reported scores for chronic pain secondary to specific pediatric
A Díez Rodriguez-Labajo1, E Castarlenas2, J Miró2
1Servicio de Anestesiología-Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta de Hierro, Madrid, España.
Insights
Parental reports on a child's highest pain intensity correlate well with the child's own assessment. This suggests parents can effectively report their child's peak pain when direct communication is difficult.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Child Psychology
Background:
- Parental reports are often used by anesthesiologists for children's chronic pain when direct input is unavailable.
- Children's daily pain intensity is typically reported as highest, average, and lowest.
- The validity of parental pain intensity scores compared to a child's experience is not well-established.
Purpose of the Study:
- To assess the agreement between children's and parents' reports of pain intensity in pediatric secondary chronic pain.
- To determine if parental reports are a valid indicator of a child's pain experience.
Main Methods:
- Nineteen children (6-18 years) with secondary chronic pain participated.
- Children and parents independently reported highest, average, and lowest pain intensity on a 0-10 numerical rating scale.
- Agreement was analyzed using intraclass correlation coefficient (ICC) and the Bland-Altman method.
Main Results:
- Excellent agreement (ICC=0.92) was found between children and parents for the highest pain intensity.
- Moderate agreement (ICC=0.68) was observed for average pain intensity.
- Fair agreement (ICC=0.50) was noted for the lowest pain intensity, with wide limits of agreement.
Conclusions:
- Parental reporting of a child's highest pain intensity shows excellent agreement with the child's own report.
- Highest pain intensity may be the most reliable domain for parental reporting when children cannot communicate their pain directly.
- Further research is needed to validate these preliminary findings in larger pediatric populations.
Background:
Parental report on a child's secondary chronic pain is commonly requested by anesthesiologists when the child cannot directly provide information. Daily pain intensity is reported as highest, average and lowest. However, it is unclear whether the parents' score is a valid indicator of the child's pain experience.
Methods:
Nineteen children (aged 6-18years) with secondary chronic pain attending our anesthesiologist-run pediatric pain unit participated in this study. Identification of highest, average and lowest pain intensity levels were requested during initial screening interviews with the child and parents. Pain intensity was scored on a 0-10 numerical rating scale. Agreement was examined using: (i) intraclass correlation coefficient (ICC), and (ii) the Bland-Altman method.
Results:
The ICC's between the children and the parents' pain intensity reports were: 0.92 for the highest, 0.68 for the average, and 0.50 for the lowest pain intensity domains. The limits of agreement set at 95% between child and parental reports were respectively +2.19 to -2.07, +3.17 to -3.88 and +5.15 to -5.50 for the highest, average and lowest pain domains.
Conclusions:
For the highest pain intensity domain, agreement between parents and children was excellent. If replicated this preliminary finding would suggest the highest pain intensity is the easiest domain for reporting pain intensity when a child cannot directly express him or herself.
