Approximately 20% of youth undergoing major surgery develop chronic post-surgical pain (CPSP). Rates for pain persistence in youth with acute musculoskeletal injury are 30-40%. Growing evidence from surgical and acute injury populations identify psychosocial factors, such as anxiety and low mood, as driving forces for poor pain outcomes. Psychosocial assessment during pre-surgical or acute pain period can inform early intervention and treatment to improve pain outcomes. This symposium will explore risk factors for elevated symptomatology which impact recovery and the development of screening measures to identify those at risk of developing chronic pain. Patient partner, Gillian Newman, will provide her lived experience with adolescent spinal fusion surgery and the development of CPSP. Dr. Rabbitts (anesthesiologist) will present on dynamic risk factors of the development of CPSP in youth. Dr. Holley (psychologist) will present data on psychosocial screening and predictors of poor pain outcomes after acute musculoskeletal injury. Dr. Rosenbloom (psychologist) will present on the development of a pre-surgical screening measure for CPSP. We will conclude with a panel discussion that includes all presenters around risk factors, potential barriers regarding timing assessment of risk factors in the clinical environment, and the ethical and clinical implications of when risk is identified.