Our Measures

Faculty members in the Centre for Pediatric Pain Research have developed several different measures of pain:

Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) 

  • Description: The CHEOPS is an observational scale for measuring postoperative pain in children aged 1-7 yrs. It can be used to monitor the effectiveness of interventions for reducing the pain and discomfort. It includes six categories of pain behavior, each with 3-4 levels and scores range from 4 points (no pain) to 13 points (the worst pain) [McGrath, P. J., Johnson, G. I., Goodman, J. T., Schillinger, J., Dunn, J., & Chapman, J. (1985). CHEOPS: a behavioral scale for rating postoperative pain in children. In H. L. Fields (Ed.),Advances in Pain Research, 9, 395-402,New York, NY:Raven.] A recent review [von Baeyer, C. L. & Spagrud, L. J. (2007). Systematic review of observational (behavioural) measures of pain for children and adolescents aged 3 to 18 years. Pain, 127, 140-150.] recommends the CHEOPS for pain associated with medical procedures and other brief painful events (pg. 146). 
  • Validation: The scale has well established evidence of inter-rater and retest reliability and construct and concurrent validity.

Parents’ Postoperative Pain Measure (PPPM)

  • Description: The Parents’ Postoperative Pain Measure is a 15-item behavioural pain assessment tool to assist parents in the at-home assessment of their children's pain. It is the first parent measure of pediatric pain. It has been translated into 10 different languages, has been incorporated into several clinical practice guidelines, and is being used worldwide as a research tool. A recent review [von Baeyer, C. L. & Spagrud, L. J. (2007). Systematic review of observational (behavioural) measures of pain for children and adolescents aged 3 to 18 years. Pain, 127, 140-150.] recommends the PPPM for post-operative care at home and describes it as a "well-established assessment tool with hight inter-rater reliability and internal consistency, and good indices of construct validity, sensitivity, specficity, and responsivness." (pg. 147).
  • Validation: Chambers, C.T., Reid, G.J., McGrath, P.J., & Finley, G.A. (1996). Development and preliminary validation of a postoperative pain measure for parents. Pain, 68, 307-313.                                                                                                                              Chambers, C.T., Finley, G.A., McGrath, P.J., & Walsh, T.M. (2003). The Parents’ Postoperative Pain Measure: Replication and Extension to 2- to 6-Year Old Children. Pain, 105, 437-443.                                                                                                                                 Finley, G.A., Chambers, C.T., McGrath, P.J., & Walsh, T.M. (2003). Construct validity of the Parents’ Postoperative Pain Measure. Clinical Journal of Pain, 19, 329-334.
  • Permissions: For more information about the PPPM and/or to request a copy of the manual summarizing our work and how to use the PPPM, contact Dr. Christine Chambers: christine.chambers@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O.Box 9700, Halifax, Nova Scotia B3K 6R8 Canada.

Non-communicating Children’s Pain Checklist – Revised (NCCPC-R)

  • Description: The Non-communicating Children’s Pain Checklist (NCCPC-R) was designed to be used for children, aged 3 to 18 years, who are unable to speak because of cognitive (mental/intellectual) impairments or disabilities. It can be used whether or not a child has physical impairments or disabilities. The NCCPC-R was designed to be used without training by parents and caregivers. It can also be used by other adults who are not familiar with a specific child. The NCCPC has been translated into French, German, and Swedish.
  • Validation: Descriptions of the types of children used to validate the NCCPC-R can be found in: Breau, L.M., McGrath, P.J., Camfield, C.S. & Finley, G.A. (2002). Psychometric Properties of the Non-communicating Children's Pain Checklist-Revised. Pain, 99, 349-357. Additional papers are available or forthcoming: see Dr. Breau's publications or contact Dr. Breau for additional information.
  • Translations: German - click here to download [Kleinknecht, M. (2007). Reliability and validity of the german language version of the "NCCPC-R". Pflege 20 (2), 93-102.]; Swedish - click here to download. [Johansson, M., Carlberg, EB, Jylli, L. (2009). Validity and reliability of a Swedish version of the Non-Communicating Children’s Pain Checklist – Postoperative Version. Acta Paediatrica, DOI:10.1111/j.1651-2227.2009.01632.x].
  • Permissions: The NCCPC-R may be freely copied for clinical use or use in research funded by not-for-profit agencies. Please click here to download a copy of the NCCPC-R. For-profit agencies should contact Dr. Lynn Breau: lbreau@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3J 3G9 Canada.

Non-communicating Children’s Pain Checklist – Postoperative Version (NCCPC-PV)

  • Description: The NCCPC-R was intended for use for short or long-term pain in the child’s home or in a long-term residential setting. If suspected pain after surgery or pain due to procedures conducted in hospital are the reason for measuring pain, the Non-communicating Children’s Pain Checklist – Postoperative Version should be used. 
  • Validation: Breau, L.M., Finley, G.A., McGrath, P.J., & Camfield, C.S. (2002). Validation of the Non-Communicating Children's Pain Checklist - Postoperative Version, Anesthesiology, 96 (3), 528-535. Additional papers are available or forthcoming: see Dr. Breau's publications or contact Dr. Breau for additional information.
  • Translations: German - click here to download. Also, see GED-DI for a French version.
  • Permissions: The NCCPC-R may be freely copied for clinical use or use in research funded by not-for-profit agencies. Please click here to download a copy of the NCCPC-PV. For-profit agencies should contact Dr. Breau: lbreau@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3J 3G9 Canada.  

Grille d’Évaluation de la Douleur-Déficience Intellectuelle (GED-DI)

  • Desciption: This translation of the NCCPC-PV was designed for use with francophone caregivers or professionals in North America and France for assessing pain in children and adults after surgery. The validation was conducted at French-speaking centres in Montreal,  Canada and Paris, Clermont Ferrand, and Riom, France. Cut-off scores are available to detect pain.
  • Validation: Breau, L.M., Gregoire, M.C., Lévêque, C., Hennequin, M., Bureau, N., Wood, C. (2008). Validation en français de la Grille d’Évaluation de la Douleur-Déficience Intellectuelle. Douleurs : Évaluation, Diagnostic, Traitement, 9 (S4), A48. Additional papers are available or forthcoming: see Dr. Breau's publications or contact Dr. Breau for additional information.
  • Permissions: The GED-DI may be freely copied for clinical use or use in research funded by not-for-profit agencies. Please click here to download a copy of the GED-DI. For-profit agencies should contact Dr. Lynn Breau: lbreau@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3J 3G9 Canada.

Chronic Pain Scale for Nonverbal Adults With Intellectual Disabilities (CPS-NAID) 

  • Description: The CPS_NAID was adapted from the Non-communicating Children’s Pain Checklist- Revised to assess chronic pain in people over 18 years who have an intellectual disability and are unable to communicate verbally. It was designed for use by caregivers. Cut-off scores are available for determining the presence of pain.
  • Validation: For more information see Burkitt, C. & Breau L.M. (2009). Pilot study of the feasibility of the Non‐Communicating Children’s Pain Checklist –Revised for pain assessment in adults with intellectual disabilities. Journal of Pain Management, 2,(1). Additional papers are available or forthcoming: see Dr. Breau's publications or contact Dr. Breau for additional information.
  • Permissions: The CPS-NAID may be freely copied for clinical use or use in research funded by not-for-profit agencies. Please click here to download a copy of the CPS-NAID. (CPS‐NAID © 2009 Breau, Burkitt, Salsman, Sarsfield‐Turner, Mullan). For-profit agencies should contact Dr. Lynn Breau: lbreau@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3J 3G9 Canada

Batten Observational Pain Scale (BOPS)

  • Description: The BOPS was adapted from the Non-communicating Children’s Pain Checklist-Revised specifically for children and young adults with Neuronal Ceroid Lupofuscinosis (NCL). It is designed to be used by a parent, caregiver or professional. The BOPS is more sensitive to pain for this group of children with neurodegenerative disorders than the NCCXPC-R, and should be used in its place. Cut-off scores are available for determining the presence of pain.
  • Validation: Breau, L.M., Camfield, C., Camfield, P. (in press) Development and Initial Validation of the Batten`s Observational Pain Scale. Journal of Pain Management. Additional papers are available or forthcoming: see Dr. Breau's publications or contact Dr. Breau for additional information.
  • Permissions: The BOPS may be copied freely for clinical use. Please click here to download a copy of the Batten Observational Pain Scale (© 2009 L. Breau, C. Camfield, P. Camfield & Batten Disease Support and Research Association). For additional information and/or permissions to use/reproduce the BOPS other than clinically, please contact Dr. Lynn Breau: lbreau@dal.ca or Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3J 3G9 Canada.