After discussing with the child several things that have hurt the
child in the past:
Reprinted with permission of J.M. Eland from
McCaffery and Beebe, 1989. May be duplicated for use in practice.
- Present eight crayons or markers to the child. Suggested colors
are yellow, orange, red, green, blue, purple, brown, and black.
- Ask the following questions, and after the child has answered, mark
the appropriate square on the tool (e.g., severe pain, worst hurt), and
put that color away from the others. For convenience, the word hurt is
used here, but whatever term the child uses should be substituted. Ask
the child these questions:
- "Of these colors, which color is most like the worst hurt you
have ever had, (using whatever example the child has given) or the worst
hurt anybody could ever have?" Which phrase is chosen will depend on the
child's experience and what the child is able to understand. Some
children may be able to imagine much worse pain than they have ever had,
while other children can only understand what they have experienced. Of
course, some children may have experienced the worst pain they can
- "Which color is almost as much hurt as the worst hurt (or, use
example given above, if any), but not quite as bad?"
- "Which color is like something that hurts just a little?"
- "Which color is like no hurt at all?"
- Show the four colors (marked boxes, crayons, or markers) to the
child in the order he has chosen them, from the color chosen for the
worst hurt to the color chosen for no hurt.
- Ask the child to color the body outlines where he hurts, using the
colors he has chosen to show how much it hurts.
- When the child finishes, ask the child if this is a picture of how
he hurts now or how he hurt earlier. Be specific about what earlier
means by relating the time to an event, e.g., at lunch or in the