Batten Observational Pain Scale (BOPS)

The Batten Observational Pain Scale (BOPS) helps a parent, caregiver, or clinician tell whether someone with Batten disease is in pain when that person cannot say so. Batten disease, or neuronal ceroid lipofuscinosis (NCL), is a rare inherited neurodegenerative condition that progressively takes away speech, vision, and movement.

The rater watches for 17 pain behaviors over a 10-minute period — moaning, a furrowed brow, guarding a body part, stiffness, tears, changes in color — and rates how often each appeared, from not at all to very often. Items the person is physically unable to do are marked not applicable. Cut-off scores flag the likely presence of pain and distinguish moderate from severe, which matters when the usual question of "where does it hurt?" cannot be asked.

• BOPS form with scoring and cut-offs

Licensing Notes: The BOPS may be copied freely for clinical use, and the form is posted for free download by the Centre for Pediatric Pain Research. For any use or reproduction beyond clinical practice permission must be requested.

Learn More: The BOPS was adapted from the Non-communicating Children's Pain Checklist–Revised (NCCPC-R) specifically for NCL, and the developers state it is more sensitive to pain in this group than the NCCPC-R and should be used in its place.