Certification Board for Music Therapists (CBMT) Practice Exam

When assessing pain in a 5-year-old using a faces scale, what does it indicate if the child reports significant pain but circles a mid-scale face?

1. She is exaggerating her pain level.

2. She may be hesitant to accurately report her pain.

3. She could be experiencing significant pain but not identify with a crying face.

4. She is confused by the scale.

The correct answer is: She could be experiencing significant pain but not identify with a crying face.

The selection of the answer indicating that the child could be experiencing significant pain but not identify with a crying face is valid because it takes into account the psychological and emotional factors at play when children assess and express their pain. Young children often have difficulty articulating their feelings, and their ability to communicate pain can be influenced by various factors such as fear, not wanting to appear weak, or not fully understanding the scale provided. Therefore, when a child reports significant pain but chooses a mid-scale face, it is plausible that they genuinely feel significant discomfort but may not identify with the more extreme expressions on the scale, such as a crying or extremely distressed face. They might associate those extreme faces with feelings or expressions they are unwilling to claim for themselves, leading to a selection that appears less severe. This understanding emphasizes the importance of not simply taking the face chosen at face value, as it does not necessarily reflect the child's actual level of pain but rather their interpretation of the scale and their own feelings. Thus, this response showcases the nuanced relationship between how pain is perceived and how it is communicated, particularly in younger children.