New Tool Helps Rate Kids' Fear of Needles

February 22, 2012 - News Release

For children, having a needle is among the most feared and painful experiences. A new tool to measure kids’ fear of needles and other medical procedures may one day help doctors ease those fears, according to a study co-authored by a University of Guelph psychologist.

The Children’s Fear Scale (CFS) asks children to indicate how fearful they are during, say, a needle, said psychology professor Meghan McMurtry.

“Children undergo painful procedures frequently, but in many cases their pain and fear is still not measured and managed very well,” McMurtry said. “This is a problem. Research has shown there are negative consequences both immediately, during the procedure, and also more long-term when pain and distress aren’t managed. Given the subjective nature of fear and pain, a child’s own rating of these should be taken into account whenever possible.”

Adapted from the Faces Anxiety Scale for assessing anxiety in adults, the new CFS pairs one of five faces with a child’s emotional state. Children and parents are known to prefer “face scales” over other scales; face scales are considered easier for children to interpret than numerical rating scales often used with adults.

The researchers observed blood draws on 100 children aged five to 10 in an outpatient blood lab of a pediatric health-care centre. The children and their parents completed the CFS and two other rating scales for fear and pain, and answered questions about previous procedures.

Researchers monitored the children for signs of distress and positive coping (talking about something else, taking a deep breath).

Unlike self-reported pain measures, few confirmed and simple measures are available for assessing children’s fear during needles, McMurtry said.

“I believe that a measure which can be used with a broad age range would improve the current state of the research. At present, it is difficult to compare results across studies and age groups.”

The study is available online.

McMurtry said this preliminary study may help improve measurement and ultimately reduce children’s fear of needles.

“A well-validated, easy to complete, one-item measure of fear could be useful in other contexts, such as treatment for anxiety and for children in hospital. But of course this requires further testing. I wanted to make this measure available for other researchers to test it, so it is available on our Pediatric Pain, Health and Communication website.”

McMurtry is now studying children aged seven to 12 and their parents, using stories to assess kids’ fear and pain ratings.

She recently received almost $125,000 from the Canada Foundation for Innovation for behavioural research on pain and distress management in children and parents.

For more information, visit

Prof. Meghan McMurtry
Department of Psychology
University of Guelph
519-824-4120, Ext. 52499

For media questions, contact Communications and Public Affairs: Lori Bona Hunt, 519-824-4120, Ext. 53338, or, or Shiona Mackenzie, Ext. 56982, or

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