The preoperational child's reaction to immunization.

Forty-four children, aged four to seven, who attended two midwestern metropolitan immunization clinics were studied in an attempt to ascertain their responses to a painful stimulus and to observe correlations between their behavioral responses and their subjective ratings of the experience. The children were screened with three tests--two Piaget tests for the preoperational stage development and the Denver Develoment Screening Test for normal development. The children were observed for verbal, vocal, facial, and motor behavior during diphtheria-pertussis-tetanus or diphtheria-tetanus injections. The children then rated the extent of pain during the injection by responding to two instruments, a modification of Eland's Projective Tool and Hester's Poker Chip Tool. Each behavior category was correlated with the pain rating. Significant positive correlations were found for verbal and vocal behaviors while significant negative correlations were found for facial and motor behaviors.