Last reviewed May 6, 2026 by NPBoardSlay Medical Review Board

FLACC

Non-Verbal Pain Assessment

Five behaviors × 0/1/2 = 0-10 pain score for patients who can't self-report.

For the FNP boards, FLACC is the assessment tool for any patient who cannot self-report pain — preverbal infants, intubated adults, advanced dementia. Five behaviors scored 0, 1, or 2 each: Face (no expression to constant grimace), Legs (relaxed to kicking), Activity (lying quietly to thrashing), Cry (no cry to constant), Consolability (content to inconsolable). Total runs 0-10 to map onto the standard pain scale. AANP exam vignettes use FLACC to test whether you assess pain in nonverbal patients at all — a frequent failure point in the literature — and whether you treat based on observed score rather than waiting for a verbal report that will not come.

F
Face
Relaxed (0) / Grimace (1) / Clenched jaw (2).
L
Legs
Relaxed (0) / Restless (1) / Kicking (2).
A
Activity
Quiet (0) / Squirming (1) / Rigid / arched (2).
C
Cry
None (0) / Moaning (1) / Steady cry or scream (2).
C
Consolability
Content (0) / Distracted by touch (1) / Inconsolable (2).

Clinical Context

Pain scale for patients who can't self-report — children 2 months to 7 years, and nonverbal adults (dementia, developmental delay, intubated). Each behavior scores 0-2 for a total 0-10, corresponding to the standard 0-10 self-report pain scale.

Reassess after every intervention. Remember: a crying infant isn't always in pain — hunger, tiredness, wet diaper, and overstimulation mimic. Use clinical judgment alongside the FLACC score. AANP pediatric and geriatric pain-assessment questions rely on this scale.