The Paediatric Pain Profile is a pain assessment tool for non-verbal children with severe and complex disability. The tool incorporates a validated 20-item behaviour rating scale with scores ranging from 0 to 60. In early studies, scores of 14 and over have been associated with moderate or worse pain. The tool emphasises the need for partnership between parent and professional in assessing and managing children’s pain.
Technology No. 89-059
Paediatric Pain Profile
The PPP tool is available for download as a PDF document. If you wish to download the tool, please choose the appropriate Terms & Conditions for your usage by selecting 'View Terms' for the various licence options displayed on the left hand side of this screen.
Family carers wishing to use the PPP tool for their personal use, please access it from the following page:
Severe physical and learning impairment is a feature of many chronic and disabling conditions in children. These children have many potential sources of pain. Pains may arise from the disease process itself (e.g. neuropathic pain or muscle spasm), be secondary to the disease (e.g. musculoskeletal pain or pain from reflux oesophagitis) or incidental (e.g. a toothache or otitis media). However, because the children have difficulty in communicating their pain it can go unrecognised and untreated. It is the child's behaviour often, rather than their verbal report, which has to be interpreted to determine if they have pain. Because it can be difficult sometimes for parents and for health care professionals to distinguish which behaviours do indicate pain and to follow the progress of pain relieving treatments, we have developed a pain assessment scale specifically for this population of children.
The scale consists of 20 types of behaviour each rated on a 4 point scale (0-3) according to the extent to which a behaviour occurs within a given time frame (from “not at all” to “a great deal”. The total score will range from 0 to 60.
We have ‘packaged’ the scale along with other forms which may be used in documenting the context of the behaviours and actions taken, for instance, it is helpful to record on the “baseline” how the child behaves “at their best” or “on a good day”.
Translations into Urdu, Punjabi, Norwegian, Danish, Italian and German are also made available for download by licensed users. Some other language translations might be available from the authors. Please contact us using the button in the sidebar to enquire about other translations.
For further information about the PPP tool, please visit the PPP website.
- Perry, Crichton, Goldman, Seers, Wisbeach, Hunt (2007), Development of the paediatric pain profile: role of video analysis and saliva cortisol in validating a tool to assess pain in children with severe neurological disability, J Pain Symptom Manage, 33(3), 276-289
- Moffat, Mastroyannopoulou, Crichton, Seers, Goldman, Hunt (2004), Clinical validation of the paediatric pain profile, Dev Med Child Neurol,, 46(1), 9-18
- Seers, Goldman, Mastroyannopoulou, Hunt (2003), Not knowing-the problem of pain in children with severe neurological impairment, Int J Nurs Stud, 40(2), 171-183
- Hunt (2001), Towards an understanding of pain in the child with severe neurological impairment. Development of a behaviour rating scale for assessing pain, University of Manchester, , Manchester
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