Pediatric Pain Profile (PPP)

The Paediatric Pain Profile is for children with severe neurological impairment who cannot say they are in pain. Their usual behaviour may already look unusual to an outsider, so the tool works by comparison: what does this particular child look like on a good day, and what do they look like now?

Twenty behaviours are rated for how much each occurred over a set period, from not at all to a great deal, giving a total from 0 to 60. Around the scale sit further forms — a pain history, a record of the child's behaviour at their best, and a chart for plotting scores over time. Those turn a single rating into ongoing monitoring, which is what this population needs.

Licensing Notes: The full document is free to download from ppprofile.org.uk.

Learn More: The baseline is the key step. Because a child with severe neurological impairment may normally grimace, arch, or vocalise, a score means nothing without knowing what that child looks like when comfortable — so the PPP asks caregivers to complete a "good day" profile first. Scores of 14 or above have been associated with moderate or worse pain.