Needle pain severity in children: Does the relationship between self-report and observed behaviour vary as a function of age?

Reactions to needle pain were observed in children aged 3 to 17 years undergoing venipuncture. The primary aim was to determine whether agreement between observer ratings and children's self-report of pain varied as a function of the age of the child. A second aim was to explore which factors predicted whether a child spontaneously chose to watch the needle, and whether looking behaviour was related to pain ratings. Results showed that correlations between behavioural and self-report measures were strongest for the 3- to 7-year-olds and weakest for the 12- to 17-year-olds. While the best predictor of self-report ratings was facial reaction for both the 8- to 11- and 12- to 17-year-olds, vocal and verbal reactions were also significant predictor variables for the 3- to 7-year-olds. The profile of a “non-looker” was a child who was older and had experienced few needles, who expected pain and was anxious about the procedure.