Wong-Baker FACES Foundation, 1983

Wong-Baker FACES Pain Scale

Pediatric pain self-assessment using a 6-point 0–10 scale. Ask the child to choose how much they hurt right now.

©1983 Wong-Baker FACES Foundation. Used with permission. www.WongBakerFACES.org
How to administer: Show the child the scale below and say: "These faces show how much something can hurt. This face [point to 0] shows no pain at all. These faces show more and more pain [point to each] up to this one [point to 10] which shows the worst possible pain. Point to the face that shows how much you hurt right now."
Recommended for children ≥3 years who can self-report.

Select Pain Level

ⓘ Face graphics above are simple geometric representations for reference. For the official illustrated FACES, visit www.WongBakerFACES.org.

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Frequently Asked Questions About the FACES Pain Scale

The Wong-Baker FACES Pain Scale was developed in 1983 by Donna Wong and Connie Moraine Baker for use with children who have difficulty expressing pain verbally. It uses a series of faces ranging from happy (no pain) to crying (worst possible pain), mapped to a 0–10 numeric scale. It is one of the most widely used pain assessment tools for children aged 3 and older.

©1983 Wong-Baker FACES Foundation. Used with permission. www.WongBakerFACES.org

The FACES scale is validated for self-report pain assessment in children ≥3 years of age who can understand and communicate pain by pointing. For children <3 years or those who cannot self-report, behavioral pain scales (such as FLACC or CRIES) are more appropriate. The FACES scale can also be used in adults and older patients who prefer a visual pain assessment tool.

While exact thresholds vary by institution, a common framework is:

  • 0: No pain. No intervention needed
  • 1–3: Mild pain. Comfort measures, reassess
  • 4–6: Moderate pain. Non-opioid analgesics, consider opioids per protocol
  • 7–10: Severe pain. Prompt analgesic intervention, consider opioids, reassess frequently

Pain management decisions should be individualized and guided by institutional protocols. A score alone should not determine treatment. Clinical context, patient age, vital signs, and patient/caregiver report all factor in.

Reassessment timing depends on context: (1) Before and after analgesic intervention (30–60 minutes after oral, 15–30 minutes after IV medication); (2) Hospitalized patients: at least every 4–8 hours or with significant change; (3) Acute settings: more frequently as clinically indicated. Trend in pain score over time is clinically important, not just a single measurement.

Yes. Children may: choose happy faces to appear brave or avoid treatment; choose sad faces to gain attention or analgesics; have difficulty distinguishing between adjacent faces; be influenced by the faces' appearance rather than pain intensity (some choose the crying face simply because it looks sad). Developmental stage, anxiety, and parental presence all affect self-report. Use in conjunction with behavioral observation and parental/caregiver input for the most accurate pain assessment.