The effects of training on the accuracy of preschool children's self-report ratings of pictures depicting painful situations

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Donald K. Routh - Committee Chair


The present study was designed to assess the effectiveness of a training procedure on increasing the accuracy of preschool children's ratings of the Charleston Pediatric Pain Pictures, a set of drawings depicting potentially painful situations, using a commonly used self-report rating scale, the Oucher. Thirty-two four and five year old children were recruited from three preschools and randomly assigned to one of two conditions in order to counterbalance for the order of picture administration. Results showed that the training procedure did help to improve the accuracy of the ratings across time for a significant group of the children. Specifically, the children made significantly fewer errors in rating the last set of pictures shown to them, than in rating the first set of pictures. They also made significantly fewer errors in rating the third set of pictures than in rating the first set of pictures. The training procedure improved the children's ability to significantly differentiate all four levels of pain depicted in the Charleston Pediatric Pain Pictures. There were no relationships found among age, previous experience with the events depicted in the pictures, and the number of errors made. The present findings support the hypothesis that a subset of children in the age range of four to five years old can benefit from brief training in order to increase the accuracy of their ratings with the Oucher. Further work is needed to identify which subset of children benefit the most from training, and which type of training will be the most helpful. In addition, the training procedure needs to be applied to real medical situations to evaluate its effectiveness in improving children's ratings of actual pain experiences.


Psychology, Clinical

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