title: Predictors of a child's ability to use a visual analogue scale.
abstract: BACKGROUND
  Visual analogue scales (VAS) are used to assess the strength of perceptions of both children and adults in many clinical and research settings. Although the VAS has been shown by some authors to be reliable for use by children aged 5 years and older, others have proposed that young children, generally < or =7 years of age, may not have the conceptual ability to use a VAS.
  
  
  OBJECTIVE
  To identify demographic and cognitive variables that would maximize the accuracy of predicting children's abilities to use a VAS.
  
  
  METHODS
  Forty kindergarten children performed a seriation task, used a VAS to perform a calibration task and completed the Block Design and Vocabulary subtests of the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). An estimated IQ was calculated from the WPPSI-R subtest scores. Socioeconomic status was assessed using the Hollingshead Four Factor Index of Social Status. Logistic regression was used to determine the best predictive models. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy were calculated for statistically significant predictive models.
  
  
  METHODS
  Successful completion of the calibration study by the child.
  
  
  RESULTS
  Only 42% of the subjects could use a VAS. The subject's age (> or =5.6 years), combined with estimated IQ (> or =100), was the best predictor of a child's ability to use a VAS (88% accuracy).
  
  
  CONCLUSIONS
  The majority of kindergarten children in our study could not complete a VAS accurately. Cognitive ability, combined with chronological age, was the best predictor of a child's accurate use of a VAS, as determined by logistic regression. Paediatric researchers may need to consider alternative rating scales to measure perceptions in children under 7 years of age.
authors.affiliation: Center for Injury Research and Policy, Children's Hospital, Columbus, OH 43205, USA. Shieldsb@pediatrics.ohio-state.edu
authors.forename: B J
authors.initials: BJ
authors.lastname: Shields
authors.forename: T M
authors.initials: TM
authors.lastname: Palermo
authors.forename: J D
authors.initials: JD
authors.lastname: Powers
authors.forename: S D
authors.initials: SD
authors.lastname: Grewe
authors.forename: G A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D001076:Aptitude; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D010147:Pain Measurement / Q000523:psychology*; D011237:Predictive Value of Tests; D002666:Psychology, Child; D012680:Sensitivity and Specificity