Child entering a cartoon MRI machine

Easing MRI Anxiety in Kids: A Simple Scale Makes a Big Difference

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Discover how a modified anxiety scale can predict and improve MRI success in children, reducing the need for anesthesia."

Magnetic Resonance Imaging (MRI) is a vital diagnostic tool, but for children, it often means sedation or anesthesia. This is because the confined spaces, loud noises, and the need to stay perfectly still can trigger anxiety, making it hard to complete the scan. But what if there was a way to predict which kids could handle an MRI without needing to be put under?

A growing trend focuses on non-drug strategies to help children through MRIs. Things like MRI-compatible video goggles and having child life specialists (CCLSs) on hand have shown promise. These methods create a more comfortable environment, but they don't always work for children with high anxiety levels.

That's where the modified Yale Preoperative Anxiety Scale (mYPAS) comes in. This quick assessment tool helps identify children who are likely to benefit from preparation and support, potentially avoiding the need for anesthesia. This article explores how mYPAS works and why it could be a game-changer for pediatric MRI.

mYPAS: Your MRI Success Predictor

The modified Yale Preoperative Anxiety Scale (mYPAS) is a simple, observational tool used to assess a child's anxiety level before a medical procedure. Trained CCLSs use it to evaluate five key areas:

The mYPAS assessment focuses on the following key areas:

Activity: How active or restless the child is.
Vocalizations: What the child is saying – are they expressing fear or distress?
Emotional Expressivity: How the child is showing their feelings through facial expressions and body language.
State of Apparent Arousal: How alert and agitated the child seems.
Use of a Parent: How much the child relies on their parent for comfort and reassurance.

A score above 30 indicates significant anxiety. Research shows that children with pre-simulation mYPAS scores above 33 were highly likely to require anesthesia for their MRI, even after preparation and support. In fact, the study found that mYPAS accurately predicted the need for anesthesia in a significant number of cases.

The Future of Calmer Scans

The mYPAS offers a quick and effective way to screen children before their MRI. By identifying those at higher risk of anxiety, hospitals can tailor their approach, providing extra support and preparation to those who need it most. This means fewer children needing anesthesia, a safer and more comfortable experience for everyone, and more efficient use of medical resources.

While this study highlights the benefits of mYPAS, further research could explore even better ways to support anxious children. This might involve testing different mYPAS thresholds or using technology like virtual reality to prepare children for the MRI experience remotely.

The goal is to make MRI scans less stressful for children and their families. By using tools like mYPAS and embracing innovative preparation techniques, healthcare providers can create a more positive and successful imaging experience.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jacr.2017.12.022, Alternate LINK

Title: The Utility Of The Modified Yale Preoperative Anxiety Scale For Predicting Success In Pediatric Patients Undergoing Mri Without The Use Of Anesthesia

Subject: Radiology, Nuclear Medicine and imaging

Journal: Journal of the American College of Radiology

Publisher: Elsevier BV

Authors: Arlyne Thung, Dmitry Tumin, Joshua C. Uffman, Joseph D. Tobias, Tricia Buskirk, Whitney Garrett, Arleen Karczewski, Haleh Saadat

Published: 2018-09-01

Everything You Need To Know

What is the modified Yale Preoperative Anxiety Scale (mYPAS)?

The modified Yale Preoperative Anxiety Scale (mYPAS) is a tool used to assess a child's anxiety before an MRI. Trained Child Life Specialists (CCLSs) observe the child and evaluate them across five key areas: Activity, Vocalizations, Emotional Expressivity, State of Apparent Arousal, and Use of a Parent. Each area is scored, and the total score indicates the level of anxiety. A score above 30 suggests significant anxiety, and can indicate a high likelihood of needing anesthesia during the Magnetic Resonance Imaging (MRI) scan.

Why is the modified Yale Preoperative Anxiety Scale (mYPAS) important?

The modified Yale Preoperative Anxiety Scale (mYPAS) is crucial because it helps identify children who might struggle with the MRI process. This early identification allows for tailored support and preparation, potentially preventing the need for anesthesia. By using the mYPAS, hospitals can create a more comfortable and less stressful experience for children undergoing MRI, and it also helps optimize the use of medical resources.

What are the five key areas assessed by the modified Yale Preoperative Anxiety Scale (mYPAS)?

The five key areas assessed by the modified Yale Preoperative Anxiety Scale (mYPAS) are: Activity (the child's restlessness), Vocalizations (what the child is saying, especially signs of distress), Emotional Expressivity (facial expressions and body language indicating feelings), State of Apparent Arousal (how alert and agitated the child appears), and Use of a Parent (the child's reliance on a parent for comfort). These observations provide a comprehensive view of the child's anxiety level, enabling accurate assessment.

What does a score above 30 on the modified Yale Preoperative Anxiety Scale (mYPAS) mean?

If a child scores above 30 on the modified Yale Preoperative Anxiety Scale (mYPAS), it indicates a significant level of anxiety. Research has shown that children scoring above 33 before the MRI simulation are very likely to need anesthesia. This information allows medical professionals to prepare the child with extra support and strategies, potentially avoiding the need for sedation during the Magnetic Resonance Imaging (MRI) scan.

What are the implications of using the modified Yale Preoperative Anxiety Scale (mYPAS)?

The use of the modified Yale Preoperative Anxiety Scale (mYPAS) has several implications. Firstly, it helps create a less stressful experience for children undergoing Magnetic Resonance Imaging (MRI), reducing the need for anesthesia and its associated risks. Secondly, it allows Child Life Specialists (CCLSs) and medical staff to focus resources on the children who need the most support. Finally, by identifying children who can handle the procedure without anesthesia, it contributes to a more efficient use of medical resources, allowing for more scans to be performed and reducing costs.