OBJECTIVES: Reviews of pictorial faces scales used for pediatric health assessment have found that simpler scales are needed for use with young children. Since research has shown that visual prompts can help children talk about their health, additional work is needed to establish suitable tools for children to use when rating their health status.

METHODS: The Pediatric Faces Scale is a novel five-point verbal descriptor scale with corresponding face illustrations. Children were recruited from various sites for in-person interviews. Participants were presented with five faces and asked to sort and match each face to response options related to pain or itching severity and explain their rationale.

RESULTS: Thirty-three children aged 5-11 (average=8.6, standard deviation [SD]=1.7) participated in interviews (n=16 and n=17 tested pain and itch versions of the scale, respectively). Most participants were able to correctly sort the faces in the hypothesized order (n=29, 87.9%); more than half of participants (n=19, 57.6%) correctly matched each response option to each face. Participants had the most difficultly matching the fourth response option “a lot [of hurt/itchy]” to Face 4; however, almost two-thirds of participants (n=21, 63.6%) correctly matched the response option to the face. Participants most commonly mixed up the two most severe response options: “a lot [of hurt/itchy]” and “[worst hurt/very itchy]” (n=9, 27.3%).

CONCLUSIONS: Unlike existing faces scales, the Pediatric Faces Scale can be adapted to measure concepts of interest across disease areas. Future research could explore interpretation of the faces scale for concepts other than pain or itching.