Table 2 Summary of Key Evidence to Support Response Scale Selection for the Pediatric Population
Reference, Evidence Typea, and Gradeb | Population | Response Option Type | Conclusions |
|---|---|---|---|
Matza et al. 2004 [6], Direct, B | All children; referenced data supportive of children 8Â years and older as well as younger children | Likert scales | Children 8Â years and older have been shown to accurately use the full range of 5- and 7-point Likert scales to rate their health status, whereas children 7 and younger tend to use more extreme responses. |
von Baeyer et al. 2006 [9], Direct, B | Children 5 years and older | Faces scales; Graphical scales; NRS; VAS; VRS | VRS may be appropriate for children 9 years and older as they require verbal fluency at a high level. NRS might be appropriate for children 8 years and older as they require numeracy and ability to think and express oneself in quantitative terms. VAS scales may be appropriate for children 6 years and older and have shown good psychometric properties. Faces scales may be appropriate for children 4 years and older as they may be simpler than equating one’s feelings to numbers of abstract verbal descriptors. Color scales allow children to select a color associated with level of pain and may be appropriate for children 4 years and older but have not been studied extensively. Pieces of hurt scales use 4 poker chips to represent amount of pain and may be appropriate for children 3 years and older. |
Cohen et al. 2008 [10], Direct, B | Children 3Â years and older | Faces scales; Graphical scales; VAS | Poker chip tool (children 3 to 4Â years) VAS (children 8Â years and older) Faces scales need to be considered and developed carefully given that affect portrayed (crying) might be taken literally and if the child is not crying, he/she might not select this option. |
Tomlinson et al. 2010 [8], Direct, B | Children 5Â years and older | Faces scales | For research use, the Faces scale has been recommended for children 5Â years and older on the basis of utility and psychometric features. |
D’Arcy 2011 [7], Direct, D | All children | Faces scales | The Faces scale is a reliable and valid tool that should be used in children of all ages. |
Matza et al. 2013 [2], Direct, D | All children; referenced data supportive of children as young as 8Â years old | Graphical scales; Likert scales; NRS;VAS | Studies have shown that children 8Â years and older prefer Likert scale to VAS and 10-point NRS. Expert opinion believes pictorial illustrations to be helpful for children 7Â years and younger but confirmatory research is needed. |