Is the Verbal Numerical Rating Scale a Valid Tool for Assessing Pain Intensity in Children Below 8 Years of Age?

  • Elena Castarlenas
    Unit for the Study and Treatment of Pain – ALGOS, Centre de Recerca en Avaluació i Mesura de la Conducta, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
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  • Jordi Miró
    Address reprint requests to Jordi Miró, Departament de Psicologia, Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007 Tarragona, Spain.
    Unit for the Study and Treatment of Pain – ALGOS, Centre de Recerca en Avaluació i Mesura de la Conducta, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
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  • Elisabet Sánchez-Rodríguez
    Unit for the Study and Treatment of Pain – ALGOS, Centre de Recerca en Avaluació i Mesura de la Conducta, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
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Published:February 04, 2013DOI:


      The verbal numerical rating scale (vNRS-11) is one of the most widely used scales for assessing pediatric pain intensity. The literature shows that it is a valid instrument for assessing pain intensity in children above 8 years of age. The aim of this work was to study whether the vNRS-11 is also a valid instrument when it is used with Catalan-speaking children between 6 and 8 years old. A total of 126 schoolchildren (mean age, 6.87; SD, .68) were interviewed individually. Participants reported the maximum intensity of the most frequent pain they had experienced in the previous 3 months, and the intensity they would experience in 3 circumstances, using the vNRS-11 and other widely used scales: the Faces Pain Scale-Revised (FPS-R), the mechanical visual analog scale (VAS), and the colored analog scale (CAS). They rated their affective state in relation to the pain experience and reported their pain-related disability. Participants also indicated which of the 4 scales they preferred. The vNRS-11 showed a high convergent construct validity (r = .73–.86), adequate discriminant validity (z = 2.05–5.55), and adequate criterion-related validity (r = .45–.70). The vNRS-11 was the second most preferred scale.


      This study contributes to the increasing literature that supports the use of the vNRS-11 to assess pain intensity in children. Specifically, it shows that it can be used in children as young as 6 years of age.

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