Eastern Area Health Education Center

Screeners 0-3

Brief Early Childhood Screening Assessment (ECSA)

Ages: To be used for children ages 18-60 months.

Description: A 22 item parent-report screening tool designed to detect the need for further assessment in children for emotional and behavioral needs. The last two questions address the caregiver depressive mood. Designed with consideration of being used in a primary care setting. The original version is a 40 item questionnaire. Parents are asked to rate the frequency of the behavior (0-2) and if they are particularly concerned about the behavior by circling a “+” on the last column. 

PDF: Brief English Version

Scoring:The child sum score is the sum of the circled numbers of items 1-22 with a maximum of 44. The cut off score is 9 or higher. The score plus clinical judgement should help determine the need for further assessment. Any item indicated as a concern for the parent should be followed up on for further assessment. Scores higher than 0 on items 23 and 24 should also be followed up on for the caregiver.

Recommendations: Positive screens should be referred to appropriate resource depending on family’s primary need. Follow up with handouts from Bright Futures (www.brightfutures.org/mentalhealth/) or Zero to Three (www.zerotothree.org).

Languages: English.

Permissions/License: Available to photocopy for pediatrician offices. Permissions information

 

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Edinburgh Postnatal Depression Screen (EPDS)

Ages: 1, 2, 4, and 6 months

Description: This screener is a 10 item self-report scale to be used with a primary caregiver (validated for mothers and fathers) of an infant to indicate if that caregiver has symptoms found to be typical in women with depression and anxiety. This screener is not intended to diagnose and is focused on the cognitive elements of depression, excluding the physical symptoms that are often experienced during pregnancy and after childbirth. Can be used for fathers with a lower cut off (equal to or greater than 8).

PDF: Edinburgh Postnatal Depression Screen

Scoring information: Edinburgh Scoring Guide

Recommendations: This screener is to be completed with a health professional. It is recommended that a practice have an integrated behavioral health clinicians to follow up with a positive screen or a strong referral process in place if needed.

Languages available: multiple (20+)

For AHEC use only- Permissions/License info: Noted in the bottom of the screener if attributed correctly that users must respect the copyright by quoting the names of the authors, the title, and the source in the paper in all reproduced copies. 

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M-CHAT-R/F

Ages: Validated for ages between 16 and 30 months of age

Description:  This is an updated version of the MCHAT. This updated screener is a 20-item questionnaire used to assess risk for autism spectrum disorders. While the primary goal of this instrument was to detect as many cases of ASD as possible leading to a possibly high false positive rate if using the questionnaire only, the revised version has a decreased rate of false positives. The screener should be filled out by the parent or caregiver.

PDF: M-CHAT-R/F Questionnaire and Interview Downloads

Scoring information: M-CHAT-R/F Scoring Guide

Recommendations: This screener must be used in its entirety. The authors of the instrument note that it is used to be highly sensitive making a high false positive rate, and therefore the structured follow up interviews offered by the authors should be employed. Even with false positives there may be other developmental concerns that are not necessarily autism spectrum disorder and should be followed up on.

For AHEC use only Permissions/License info: For clinician purposes, they are welcome to incorporate this instrument into their EMR for patient purposes free of charge as long as, “…just for use in your own office’s medical record. You must follow the requirements that you do not alter the intstrument’s name, instructions, items, item order, or the copyright notice at the bottom….”

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Parents’ Assessment of Protective Factors

Ages: To be used for the caregiver when the youngest child is between birth and 8 years old

Description: A parent/caregiver self-report of a 35 item survey instrument developed within the Strengthening Families Approach and Protective Factors Framework, to assess the presence, strength, and growth of parents’ self-reported beliefs, feelings, and behaviors. Utilizes a likert scale of “this is not at all like me or what I believe” which is the 0 value through “this is very much like me or what I believe” which is a value of 4.

PDF:  Parents Assessment of Protective Factors

Scoring information: PAPF Scoring Sheet  After scoring the following scores can be reported: A protective factor index (total score), parental resilience (PR, items 11-19), social connections (SC, items 20-28), concrete support in times of need (CS, items 29-37), social and emotional competence of children (SE, items 38-46). Designed to be hand-scored. Average scores should be used as the subscale and PFI scores. A scoring sheet is provided in the User Guide. 

Recommendations: Caregiver should have at least a fifth grade reading level. Designed to be self-administered, but a staff person can administer and no formal training  is required. If delivered by a staff person the User’s Guide should be reviewed before administering in a practice.

Languages: Spanish

For AHEC use only- Permissions/License info: Usage permission noted in the User Guide (page 2).

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Spence Pre-school Anxiety Scale

Ages: To be used for children 31 to 83 months.

Description: This scale is a parent report questionnaire of 29-34 items developed to assess the severity of anxiety symptoms. This scale includes subscales for OCD, social anxiety, separation anxiety, physical injury fears, generalized anxiety with a total possible score of 112. Questions 30-34 only need to be answered if a parent answers “yes” to question 29 and are for clinical usage only.

PDF: Preschool Anxiety Scale

Scoring information: Preschool Anxiety Scale Scoring Instructions

Recommendations: N/A

Languages: English, Spanish (European), Chinese, German, Syrian (Arabic), Armenian, Danish, French, Hebrew, Portuguese, Russian, Slovenian, Turkish

For AHEC use only- Permissions/License info: See the instrument website.

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The Survey of Well-being of Young Children

Ages: To be used for children from 2 through 66 months.

Description: Assesses (not diagnostic) three domains including the child’s developmental domain, emotional/behavioral domain, and family context domain. For the developmental domain, all parents have a developmental milestones checklist, and parents of children ages 16-35 months also complete the Parent’s Observations of Social Interactions (POSI) screener geared specifically towards autism screening. For parents of children from birth through 18 months, they also complete a section entitled the Baby Pediatric Symptom Checklist, and parents of children 18-60 months complete the Preschool Pediatric Symptom Checklist. All of these subscales are included in the main questionnaire. Parents are also asked if they have any concerns about their child’s behavior, learning or development. Approximately 10 minutes to take.

PDF: Age-Specific Forms for SWYC

Scoring information: Scoring can be done by hand or electronically and can be linked with the milestones calculator on the website.

Recommendations: The Tufts Children’s Hospital website notes that several revisions have occurred since the user’s manual was released in 2016. Please attend to this website for the user’s manual and also notations on versions and changes to the scoring process. The users manual also references utilizing their calculation table to make sure the child’s age is calculated correctly so the correct form is utilized. While the SWYC is designed to be administered as a package with each applicable assessment interval, it is also acceptable for a clinician to administer an individual section. (eg Preschool Pediatric Symptom Checklist).

Languages available: Spanish, Khmer, Burmese, Nepali, Portuguese, Haitian-Creole, Arabic, Somali, and Vietnamese.

For AHEC use only- Permissions/License info: Copyrighted, but may be used free of charge as long as nothing is altered. For further reference please see their website.

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Multidimensional Scale of Perceived Social Support

Ages: To be used for caregivers

Description: A 12 item self-report measure including three sub-scales: family, friends, and significant other.

PDF: Multidimensional Scale of Perceived Social Support

Scoring information: Scoring Instructions [2nd page of document]

Measure website

Recommendations: Used extensively, but continuing to undergo adaptations so that it is culturally relevant for collectivist cultures vs. the individualistic culture in which it was created.

Languages available: Thai, Malaysian, Swedish, Polish, Chinese, Spanish – several others per the measure website.

For AHEC use only- Permissions/License info: Free to use as long as the following reference is credited

Zimet, GD, Dahlem, NW, Zimet SG, Farley, GK – The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 1988, 52:30-41

Screeners 3-5

Brief Early Childhood Screening Assessment (ECSA)

Ages: To be used for children ages 18-60 months.

Description: A 22 item parent-report screening tool designed to detect the need for further assessment in children for emotional and behavioral needs. The last two questions address the caregiver depressive mood. Designed with consideration of being used in a primary care setting. The original version is a 40 item questionnaire. Parents are asked to rate the frequency of the behavior (0-2) and if they are particularly concerned about the behavior by circling a “+” on the last column. 

PDF: Brief English Version

Scoring:The child sum score is the sum of the circled numbers of items 1-22 with a maximum of 44. The cut off score is 9 or higher. The score plus clinical judgement should help determine the need for further assessment. Any item indicated as a concern for the parent should be followed up on for further assessment. Scores higher than 0 on items 23 and 24 should also be followed up on for the caregiver.

Recommendations: Positive screens should be referred to appropriate resource depending on family’s primary need. Follow up with handouts from Bright Futures (www.brightfutures.org/mentalhealth/) or Zero to Three (www.zerotothree.org).

Languages: English.

Permissions/License: Available to photocopy for pediatrician offices. Permissions information

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Pediatric Symptom Checklist (PSC)

Ages: To be used for children ages 4-16 years.

Description: This is a brief 35 item parent-report questionnaire to help identify and assess changes in emotional and behavioral problems in children. It is not intended to be diagnostic. It is designed to fit into the workflow of a pediatric practice, but can also be used in mental health practices. It can be used to measure change over time.

PDF: English / Spanish

Scoring information: Extensive scoring instructions and subscale will need to be summarized in a created pdf document for upload. Instructions are here: Scoring Instructions

“A score of 28+ identifies children as being at risk (Jellinek et al., 1999; Murphy et al., 2016)” 

Recommendations: Parents are able to take this report prior to the visit, at check-in, as well as during the pediatric visit.  If score is in the “at-risk” range, discuss symptoms further with patient/family; consider offering a follow-up visit for further evaluation with primary care provider or referral to a mental health professional. Watchful waiting is also a recommended approach depending on the severity and capacity for the family to seek additional support and referrals. Depending on a patient’s cultural group, it should be kept in mind that the absence of a positive screen does not indicate an absence of problems. 

Languages available: 24 languages available, pictorial version, and shortened 17-item version. Cut-off scores will vary depending on the translation version.

Permissions/License info: Available for free use per Massachusetts General Hospital Website indicates that it is “broadly available” and also states that Mental Health America provides the PSC with online score reports free. Mental Health America online version of PSC

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Spence’s Children’s Anxiety Scale (SCAS) Pre-School

Ages: 2.5-6.5, Pre-School Scale

Description: This scale is a parent report used to assess the severity of anxiety symptoms in children.

PDF:

English https://www.scaswebsite.com/portfolio/scas-pre-school-download-scale/

Spanish  https://www.scaswebsite.com/spanish/ 

Scoring: A total score of 60 or above indicates elevated anxiety. *Insert link to scoring guide

Recommendations: “This scale can provide an indication of whether children are showing elevated levels of anxiety, and should be used in combination with a clinical diagnostic interview if a diagnosis is required” 

Permission/License: The scales are intended for research or for clinical use under the supervision and care of a trained mental health clinician. Their clinical use for any particular case is the responsibility of the clinician and the author does not accept any liability with respect to their use.

Information from the site, including the Spence Children’s Anxiety Scales, may currently be downloaded and used free of charge by researchers and individual practitioners. Commercial organizations and for-profit clinical services should contact the author to discuss a commercial license arrangement before use. Not-for-profit and government agencies should seek prior permission from the author to use the scale within their organizations, and a charge may apply.

The scales are copyrighted to the author and may not be reprinted in full in any publication nor resold for commercial purposes. The scales are copyright documents and they are not in the public domain. They cannot be modified, such as changing the wording of questions, the response format, nor by adding or removing questions. The creation of translations of the scales into other languages or for conversion into electronic format requires prior approval from the author.

Screeners 5-13

Refer back to screeners already provided in 0-5:

  • ECSA
  • Spence’s Anxiety Scale (pre-school)
  • Multidimensional Scale of Perceived Social Support
  • Pediatric Symptom Checklist (PSC)

Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD)

Ages: To be used for children 12-17 years

Description: A brief screener often used in pediatric settings that identifies problematic tobacco, alcohol, and marijuana use in adolescents. The screener asks frequency questions for past year use of alcohol, tobacco, and marijuana. Patients who report using any of these three substances are then asked questions about additional substance use. If a PDF or hard copy of the instrument is used, clinicians should note that the order of the questions depends on the age of the child. For children 12-14 years of age, questions regarding friend use are asked first as a way to enter into the conversation in a less threatening way. For adolescents 15 and above (as well as 14 years old but in high school), the questions regarding personal use are asked first. The version on the NIDA website will automate the questions.

Online Link to instrument: https://nida.nih.gov/ast/bstad/#/

Scoring information: On the website version responses are automatically categorized into levels of risk with each risk level being mapped onto suggested clinical actions. Follow up screeners and additional assessment might be recommended but links are provided.

Validity of Brief Screening Instrument for Adolescent Tobacco, Alcohol, and Drug Use (2014) Pediatrics Article

Recommendations: This instrument can be used as part of an SBIRT algorithm. It is intended for use under a medical provider’s supervision and is not intended to guide self-assessment or take the place of a healthcare provider’s clinical judgement.

Languages available: English only

For AHEC use only- Permissions/License info: freely accessible through the NIH National Institute of Drug Abuse

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Children’s Revised Impact of Event Scale (CRIES – 8)

Ages: 8+ who are able to read independently

Description: For children to measure re-experiencing and avoidance of a traumatic event and the feelings to which it gave rise. Consists of 4 items measuring Intrusion and 4 items measuring Avoidance.

PDF: https://www.childrenandwar.org/wp-content/uploads/2019/11/English-CRIES-8.pdf

Scoring Information: Self-completed, can be administered in groups if needed. 8 items on a scale Not at all = 0, Rarely = 1, Sometimes = 3, Often = 5. Two Subscales – Intrusion = sum of items 1+3+6+7; Avoidance = sum of items 2+4+5+8.

Recommendations: Do not make a clinical diagnosis from scores on the self-completed scales alone but through structured interview to assess presence and severity of stress symptoms and child’s overall social functioning.  

Languages available: English, Arabic, Bangla, Bosnian, Brazilian/Portuguese, Chinese (traditional & simplified), Danish, Dutch, Farsi, Finish, French, German, Greek, Hindi, Indonesian, Japanese, Kurdish/Sorani, Malaysia (Bahasa), Nepali, Norwegian, Portuguese, Italian, Russian, Spanish, Swedish, Turkish, Ukranian

Free to clinicians and researchers through this website:  https://www.childrenandwar.org/projectsresources/measures

Dyregrov, A., & Yule, W. (1995). Screening measures –the development of the UNICEF screening battery. Paper presented at the Fourth European Conference on Traumatic Stress. Paris, May 7–11.

These instruments are provided free of costs thanks to the generosity of our donors. We are however, very happy to receive donations to continue to develop new methods. If you would like to make a donation please click here.

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Columbia Depression Scale (CDS)

Ages: Adolescents 11+

Description: The Columbia Depression Scale (DCS) is a 22-item self-report that screens adolescents ages 11 and older for both depression and suicide.  Questions focus on feelings & behaviors over the past four weeks. There are parallel instruments for youth and parents.  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

PDF: https://www.mdaap.org/pdf/Bi_Ped_CDSteen.pdf

Scoring information: Scoring directions provide a level of risk and percentage of youth who score within each risk range. 

Recommendations:

Languages available:

For AHEC Use Only – Permissions/License Info:  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

© Copyright 2022. DISC Development Group of Columbia University. Do not reproduce without permission. September 13, 2022. For additional free copies of this instrument, contact: Columbia DISC Development Group, 1051 Riverside Drive, New York, NY 10032

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Columbia Impairment Scale (Global Assessment of Functioning) – children and adolescents

Ages: 9-17 years

Description: A 13 item scale that has both a youth and a parent component, which the questions are identical, available. Items are rated on a 0 to 4 likert scale and it is best described as a measurement of functional impairment.

PDF: Youth Version

Parent Version

Scoring Information: Items are scored 0 to 4, total score ranging from 0 to 52, with a total of 15 or more on a parent’s scale indicating impairment.

Recommendations:

Languages available: English and Spanish 

For AHEC Use Only – Permissions/License Info: 

Bird, H. R., Shaffer, D., Fisher, P., Gould, M. S., et al. (1993). The Columbia Impairment Scale (CIS): Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3(3), 167–176.

The above excerpted from Child and Adolescent Psychiatry: The Essentials, (2005), Edited by Kathleen Myers and Keith Cheng, pg. 41, Chapter 3, Rating Scales

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Columbia-Suicide Severity Rating Scale (C-SSRS)

Ages: 5 years and up

Description: A tool that supports suicide risk assessment through a series of items and answers that helps users identify whether someone is at risk for suicide and assess the severity and immediacy of that risk. Completion of a 30-minute, on-line training is necessary to use the tool and provides a two-year certification. More information on the administration of the scale can be found on the main CSSRS website

PDF: http://cssrs.columbia.edu/wp-content/uploads/C-SSRS_Pediatric-SLC_11.14.16.pdf

Scoring information: N/A

Recommendations: For use by those who have received training on how to administer this assessment. https://practiceinnovations.org/resources/scorm/cssrs this is an online training module for the C-SSRS. The Lighthouse Project website has protocols and suggestions for use in healthcare settings, as well as other settings. See this link for additional information and helpful downloads.

Languages available: 140 languages available

For AHEC use only- Permissions/License info: copyright by The Research Foundation for Mental Hygiene, Inc. Freely accessible, though for reprints and inquiries on training see below:

  • Universal. The Columbia Protocol is suitable for all ages and special populations in different settings and is available in more than 140 country-specific languages
  • Free. The protocol and the training on how to use it are available free of charge for use in community and healthcare settings, as well as in federally funded or nonprofit research.

For reprints of the C-SSRS contact Kelly Posner, Ph.D., New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York, 10032; inquiries and training requirement contact posnerk@nyspi.columbia.edu.

Disclaimer:

This scale is intended to be used by individuals who have received training in its administration. The questions contained in the Columbia-Suicide Severity Rating Scale are suggested probes. Ultimately, the determination of the presence of suicidal ideation or behavior depends on the judgment of the individual administering the scale.

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CRAFFT (2.1)

Ages: 12-18 years

Description: The CRAFFT is a behavioral health screening tool for use with children and adolescents through age 20 years. The CRAFFT is meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and other drug use is warranted. This tool is recommended by the American Academy of Pediatrics’ Committee on Substance Abuse for use with adolescents. There is a clinician interview form and a self-administered version. More information is available on the main CRAFFT website.

PDF: Reproduction of the instrument will be granted after submission of the provider request.

Scoring information: Scoring algorithm 

Recommendations: The self-administered version is recommended. It is recommended that the adolescent complete it independently to ensure more truthful reporting. Additional administration information.

Languages available: Translated into over 30 languages.

For AHEC use only – Permissions/License info:

REPRODUCE THE CRAFFT

The CRAFFT questions are copyright protected by Boston Children’s Hospital; however, a goal of CABHRe is to make the CRAFFT widely available to qualified clinicians and researchers, and we welcome reproductions of this screening tool.

The following conditions must be met in order to use the CRAFFT screen in your work:

  1. You must submit a final draft of your reproduction (either a reprint, screen shot or electronic program) with a description of the intended context for use as an attachment to crafft@childrens.harvard.edu. Please also let us know which version of the CRAFFT you have reproduced, and if you are using the Self-Administered Questionnaire or the Clinician interview in your program.
  2. All CRAFFT questions must stay in their original order with no substitutions or omissions. However, you may choose to reproduce only the first page of the CRAFFT Clinician interview.
  3. The following language must be printed at the bottom/end of the program:
    1. NOTICE TO CLINIC STAFF AND MEDICAL RECORDS:
      The information on this page is protected by special federal confidentiality rules (42 CFR Part 2), which prohibit disclosure of this information unless authorized by specific written consent.

      © John R. Knight, MD, Boston Children’s Hospital, 2020.
      Reproduced with permission from the Center for Adolescent Behavioral Health Research (CABHRe), Boston Children’s Hospital.
      crafft@childrens.harvard.edu
      www.crafft.org
      For more information and versions in other languages, see www.crafft.org.

  4. The reproduction you produce cannot be sold separately from the reprint or electronic program.
  5. Any changes made after approval require a separate approval.

All submissions will be reviewed and you will be notified by email of approval with an official approval letter.  Please allow 1-2 weeks for review. The CRAFFT administrative team reserves the right to refuse permission for any reason.

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CRAFFT (2.1+N)

Ages: 12-18 years

Description: Similar to the CRAFFT above, however includes information around nicotine and tobacco use. More information is available on the main CRAFFT website.

PDF: Reproduction of the instrument will be granted after submission of the provider request.

Scoring information: Scoring algorithm

Recommendations: It is recommended that the adolescent complete it independently to ensure more truthful reporting. Additional administration information.

Languages available: Translated into over 30 languages.

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Center for Epidemiological Studies Depression Scale for Children (CES-DC)

Ages: 6 to 17 years

Description: The Center for Epidemiological Studies Depression Scale for Children (DSC) is a 20-item self-report focused on the feelings over the past week. This tool is included in the Bright Futures protocol. The tool takes about five minutes to complete.

PDF: The tool and brief instructions for scoring are available at Center for Epidemiological Studies Depression Scale for Children (CES-DC) .

Website for PDF download

Scoring Information:  Available on the instrument itself. Items are rated on a 4 point likert scale. A score of 15 or more can be indicative of significant levels of depressive symptoms (Weis et al., 1980).

Recommendations: N/A

Languages available: English

For AHEC use only- Permissions/License info:

Weissman, M. M., Orvaschel, H., & Padian, N. (1980). Children’s Symptom and Social Functioning Self-Report Scales Comparison of Mothers’ and Children’s Reports. The Journal of nervous and mental disease, 168(12), 736-740.

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(Birleson) Depression Self-Rating Scale for Children (DSRS)

Ages: 8 -14 years

Description: The Center for Epidemiological Studies Depression Scale for Children (DSC) is a 20-item self-report focused on the feelings over the past week. The tool takes about five minutes to complete. PDF: DSRS pdf

Scoring Information: Instructions on scoring included in PDF

Recommendations: The instrument may be used together with other information from parents, school or other sources to make a clinical diagnosis, to identify children with dysphoric mood in response to environmental stress and to measure change in emotional status.

Languages available: English, Arabic, Chinese, Dari, Hindi, Italian, Japanese, Norwegian, Pashto, Russian

For AHEC use only- Permissions/License info: The DSRS-C may be freely used for clinical or research purposes provided due acknowledgement is made about its origin.

Permissions use website

References:  Birleson P. (1981) The Validity of Depressive Disorder in Childhood and the Development of a Self-Rating Scale: A Research Report. J. Child Psychology Psychiatry 22, 73/88.

Birleson P. Hudson I, Grey-Buchanan D, Wolff S. (1987) Clinical Evaluation of a Self-Rating Scale for Depressive Disorder in Childhood (Depression Self-Rating Scale). J. Child Psychology Psychiatry 28, 43/60.

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Patient Health Questionnaire (PHQ-9) Modified for Adolescents

Ages: 11-17 years

Description:  Brief screener for depression in adolescents

PDF: IHC MHI Depression Fact Sheet: Children and Adolescents

Scoring information: scored on a 0 to 3 scale with 3 being “nearly every day” for depression symptoms. See PDF for instructions on scoring correlations with diagnoses.

Recommendations: Self-assessment that is then scored by a professional

Languages available: English and Spanish

For AHEC use only- Permissions/License info: Freely accessible through the American Psychological Association (APA) and no permission required to reproduce, translate, display, or distribute.

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.

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Pediatric Symptom Checklist (PSC-35/17)

Ages: 4-16

Description: Brief questionnaire to recognize psychosocial problems and improve treatment in children. Assesses changes in emotional and behavioral problems in children. Scoring info listed with downloadable forms

PDF: https://www.massgeneral.org/psychiatry/treatments-and-services/pediatric-symptom-checklist or https://screening.mhanational.org/screening-tools/parent/ for parental assessment of child

Scoring information: Each item receives zero, one, or two points. With the scores on all 35 items summed for the total score. A score of 28 or above indicates some psychosocial impairment in children ages 6-17. See Mass General website above for more details

Recommendations: Can be administered at any point in pediatric care but generally used during well-child visits. No one recommendation for administration; can be administered prior to the visit, at check-in; during the visit; or outside the visit.

Languages available: English, Chinese, Japanese, Spanish, Pictoral

For AHEC use only- Permissions/License info: freely accessible

https://www.massgeneral.org/psychiatry/treatments-and-services/pediatric-symptom-checklist

How to Complete the PSC

The PSC can be completed online for free. After you complete the PSC, you can download the printable report to share with your child’s pediatrician or teacher. Both the PSC score and report are anonymous and confidential. Your child’s scores from these online versions will not be shared with anyone else.

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Post-traumatic Cognitions Inventory – child version (CPTCI & CPTCI-S)

Ages: 6-18

Description: To assess how a child has been thinking and feeling since a frightening event

PDF: https://www.childrenandwar.org/wp-content/uploads/2020/11/CPTCI-25-item-CPTCI-S-10-item.pdf

Scoring information:  Scoring 1, 2, 3, 4 (for Don’t agree at all, Don’t agree a bit, Agree a bit, and Agree a lot, respectively). No reverse scored items. For 25 item screen CPTCI 2 sub-scales for “disturbing and permanent change” (13 items including items 4, 6, 8, 13, 14, 16, 17, 19, 20, 21, 22, 23, 24) and “feeble person in a scary world” (12 items including items 1, 2, 3, 5, 7, 9, 10, 11, 12, 15, 18, 25). For the10 item screener CPTCI-S – 2 sub-scales for “permanent and disturbing change” (6 items; items 1, 3, 6, 8, 9, 10) and “fragile person in a scary world” (4 items; items 2, 4, 5, 7).

Recommendations: 25 or 10 question option.  Screens for trauma-related cognitions that could be considered problematic but not to be used for assessing post-traumatic stress.

Languages available: English, Arabic, Bengali, Brazilian Portuguese, Chinese Mandarin, Danish, Dutch, Farsi, French, German, Hindi, Indonesian, Italian, Russian, Swedish

For AHEC use only- Permissions/License info: Free to use without permission

25 item version – McKinnon, A., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., Dixon, C., Nixon, R. D. V., & Meiser-Stedman, R. (2016). An Update on the Clinical Utility of the Children’s Post-Traumatic Cognitions Inventory. Journal of Traumatic Stress, 29(3), 253-258. doi: 10.1002/jts.22096

Meiser-Stedman, R., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., & Nixon, R. D. V. (2009). Development and Validation of the Child Post-Traumatic Cognitions Inventory (CPTCI). Journal of Child Psychology and Psychiatry, 50(4), 432-440. doi: 10.1111/j.1469-7610.2008.01995.x

10 item version – McKinnon, A., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., Dixon, C., Nixon, R. D. V., & Meiser-Stedman, R. (2016). An Update on the Clinical Utility of the Children’s Post-Traumatic Cognitions Inventory. Journal of Traumatic Stress, 29(3), 253-258. doi: 10.1002/jts.22096

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Screen for Child Anxiety Related Disorders (SCARED)

Ages: 8-18 years

Description: A 41 item questionnaire available both online and on printed versions for child and parent to measure child anxiety. It includes four domains including panic/somatic, separation anxiety, generalized anxiety, and school phobia. There is a screener for the child, as well as for the parent to fill out for the child. Should take approximately 10 minutes to complete.

PDF: English Screener with Scoring Included

Scoring information: see above

Recommendations:  For children ages 8 to 11, it is recommended to have an adult sit with them while they answer in case they have any questions.

Languages available: Multiple languages available from the website.

For AHEC use only- Permissions/License info:

The SCARED is available at no cost at www.pediatricbipolar.pitt.ecu under resources/instruments.

January 19, 2018

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Screening to Brief Intervention (S2BI)

Ages: Adolescents

Description: brief screening focused on alcohol, tobacco, synthetic drug, and marijuana use among adolescents with information about how to discuss interventions for clinicians. Online form provides immediate suggestions and resources once completed.

PDF: https://nida.nih.gov/ast/s2bi/#/ link to website for online screener

https://www.mcpap.com/pdf/S2Bi%20Toolkit.pdf more extensive pdf for clinicians or other healthcare providers which includes the questionnaire, sample scenarios, and outlines for plans to reduce or eliminate substance use.

https://massclearinghouse.ehs.state.ma.us/PROG-BSAS-SBIRT/SA3542.html pdf for screener only download

https://massclearinghouse.ehs.state.ma.us/PROG-BSAS-SBIRT/SA1099.html pdf for provider toolkit only download

Scoring information: N/A; brief questionnaire. For answers other than “never,” there is information on how to discuss reducing or stopping use of substances.

Languages available: English only

For AHEC use only- Permissions/License info: freely accessible

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SNAP-IV 26-Item Teacher and Parent Rating Scale

Ages: 6-18 years

Description: A 26 item measure that assesses for inattention, hyperactivity/inattention, as well as oppositional defiant disorder. Has three different versions, one for parent, one for teacher, and one for therapist.

PDF: http://www.shared-care.ca/files/Scoring_for_SNAP_IV_Guide_26-item.pdf

Scoring information: Symptom severity is rated on a four point scale.

Recommendations:  N/A

Languages available: English

For AHEC use only- Permissions/License info: *Waiting from response from author.

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Spence Children’s Anxiety Scale

Ages: 8-12 years

Description: A 44-item scale to assess anxiety with domains indicating generalized anxiety, panic/agoraphobia, social phobia, separation anxiety, obsessive compulsive disorder, and physical injury fears. Should take approximately 10 minutes to complete. Children rate the frequency of their experience on a scale of 1-4. It is not intended to be a diagnostic instrument when used in isolation of other clinical judgement.

PDF: https://www.scaswebsite.com/wp-content/uploads/2021/07/scas.pdf

Scoring information: Scoring Instruction Website

Recommendations: If the child needs assistance reading, the scale may be read aloud by an adult as long as the reading is objective and questions are read without influence. Scoring interpretation for boys and girls is noted, by the author, as different and should be interpreted with the appropriate norming data.

Languages available: Many translations available. 

For AHEC use only-Permissions/License info:  May be used by individual clinicians or researchers . “Commercial organizations and for-profit clinical services should contact the author to discuss a commercial license arrangement before use. Not-for-profit and government agencies should seek prior permission from the author to use the scale within their organizations, and a charge may apply.” https://www.scaswebsite.com/

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Suicide Assessment Five-Step Evaluation and Triage (SAFE-T)

Ages: children and adolescents

Description:  Process includes identifying risk factors, identifying protective factors, and conducting suicide inquiry. This is a document that helps in providing a suicide assessment.

PDF: https://store.samhsa.gov/product/SAFE-T-Pocket-Card-Suicide-Assessment-Five-Step-Evaluation-and-Triage-for-Clinicians/sma09-4432

Scoring information: N/A

Recommendations: For use by a clinician

Languages available: English only

For AHEC use only- Permissions/License info: freely accessible through SAMHSA.

 

Some Additional Screeners 5-13 with a Cost Associated

Bright Futures Tool and Resource Kit from American Academy of Pediatrics and Maternal Child Health Bureau

Ages: 11-14

Description: Provides pediatric providers with an organized compilation of current forms and materials that relate to preventative health supervision and health screening for infants, children, and adolescents. Requires purchase of materials, $375

PDF: https://shop.aap.org/bright-futures-tool-and-resource-kit-2nd-edition/

Scoring information: largely interview-based and does not have a systematic scoring system

Recommendations:  For use by pediatric clinicians at well-child visits but includes forms that can be filled out by the parent and child prior to the visit.

Languages available: English and Spanish

For AHEC use only- Permissions/License info: requires materials to be purchased before use

 

 

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Child and Adolescent Functional Assessment Scale (CAFAS)

Ages: 5-19

Description: Described as the gold standard for assessing youth’s day to day functioning, this practitioner completed tool can be used both as an assessment and as a measurement of improvement over time. Measures domains such as school, thinking problems, behavior towards others, self-harm, mood/emotions, substance use, home, community, as well as two questions addressing caregiver well-being. Website states completed in approximately 10 minutes, but no special indication for use in primary care.

PDF: Available for a fee see website https://www2.fasoutcomes.com/Content.aspx?ContentID=12

Scoring Information: Available online with purchase – see website. Scores are calculated instantly and a profile is provided with clinical markers. The software also provides space to create goals or a treatment plan that can be provided to the family/patient.

Languages available:   

For AHEC use only – Permissions/License info: Requires a purchase for the materials to be used by clinicians and other professionals.

 

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Rapid Assessment for Adolescent Preventative Services (RAAPS)

Ages: 9-12 (Older Child); 13-18 (Standard)

Description: identifies youths most at risk for dropping out of school and uses factors such as discrimination, abuse, and access to tangible needs (i.e., food, water, electricity) that contribute to morbidity, mortality, and social problems

PDF: https://possibilitiesforchange.org/raaps-assessment-preview/ you can preview the form but you must enter in your information first. For full access to the screener and resources you must contact for pricing https://possibilitiesforchange.org/pricing/

Scoring information: N/A; online program that scores automatically

Languages available: English and Spanish

For AHEC use only- Permissions/License info: Requires a purchase for the materials to be used by clinicals and other professionals

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Strengths and Difficulties Questionnaire (SDQ)

Ages: 3-17

Description: A brief behavioral screening questionnaire that assesses 25 attributes, some positive and some negative, divided among 5 scales, and sometimes includes an impact scale

PDF: https://www.sdqinfo.org/py/sdqinfo/b3.py?language=Englishqz(USA)

Scoring information: Recommended to score through a computer and not by hand. https://sdqscore.org/sdqplus/ This has no additional charge, but they do recommend new self-entered assessments of SDQplus which cost $1.00 each but include better PDF reports and are able to be emailed.

Recommendations: Can be performed by a parent, teacher, researcher, or a self-assessment if appropriate

Languages available: 40+ languages including ASL

For AHEC use only- Permissions/License info: copyright to Youth in Mind but can be downloaded and copied for non-commercial use. If you want to modify the documents, you must contact support@youthinmind.com to receive authorization to create and distribute forms

Notes about downloading documents

The Strengths and Difficulties Questionnaires, whether in English or in translation, are copyrighted documents that may not be modified in any way. Paper versions may be downloaded and subsequently photocopied without charge for non-commercial purposes.

All documents are in Adobe Acrobat and require the Acrobat Reader. This is available from Adobe free of charge.

Screeners 13-18

Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD)

Ages: To be used for children 12-17 years

Description: A brief screener often used in pediatric settings that identifies problematic tobacco, alcohol, and marijuana use in adolescents. The screener asks frequency questions for past year use of alcohol, tobacco, and marijuana. Patients who report using any of these three substances are then asked questions about additional substance use. If a PDF or hard copy of the instrument is used, clinicians should note that the order of the questions depends on the age of the child. For children 12-14 years of age, questions regarding friend use are asked first as a way to enter into the conversation in a less threatening way. For adolescents 15 and above (as well as 14 years old but in high school), the questions regarding personal use are asked first. The version on the NIDA website will automate the questions.

Online Link to instrument: https://nida.nih.gov/ast/bstad/#/

Scoring information: On the website version responses are automatically categorized into levels of risk with each risk level being mapped onto suggested clinical actions. Follow up screeners and additional assessment might be recommended but links are provided.

Recommendations: This instrument can be used as part of an SBIRT algorithm. It is intended for use under a medical provider’s supervision and is not intended to guide self-assessment or take the place of a healthcare provider’s clinical judgement.

Languages available: English only

Validity of Brief Screening Instrument for Adolescent Tobacco, Alcohol, and Drug Use (2014) Pediatrics Article

For AHEC use only- Permissions/License info: freely accessible through the NIH National Institute of Drug Abuse

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Columbia Depression Scale

Ages: Adolescents 11+

Description: The Columbia DISC Depression Scale is a 22-item self-report that screens adolescents ages 11 and older for both depression and suicide.  Questions focus on feelings & behaviors over the past four weeks. There are parallel instruments for youth and parents.  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

PDF: https://www.mdaap.org/pdf/Bi_Ped_CDSteen.pdf

Scoring information: Scoring directions provide a level of risk and percentage of youth who score within each risk range. For example, when using the child report form a score between 0-6 indicates a very unlikely chance of depression.

Recommendations: N/A

Languages available: EnglishFor AHEC Use Only – Permissions/License Info:  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

© Copyright 2022. DISC Development Group of Columbia University. Do not reproduce without permission. September 13, 2022. For additional free copies of this instrument, contact: Columbia DISC Development Group, 1051 Riverside Drive, New York, NY 10032

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Columbia Depression Scale

Ages: Adolescents 11+

Description: The Columbia DISC Depression Scale is a 22-item self-report that screens adolescents ages 11 and older for both depression and suicide.  Questions focus on feelings & behaviors over the past four weeks. There are parallel instruments for youth and parents.  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

PDF: https://www.mdaap.org/pdf/Bi_Ped_CDSteen.pdf

Scoring information: Scoring directions provide a level of risk and percentage of youth who score within each risk range. For example, when using the child report form a score between 0-6 indicates a very unlikely chance of depression.

Recommendations: N/A

Languages available: EnglishFor AHEC Use Only – Permissions/License Info:  This tool is copyrighted by Columbia Teen Screen but may be used at no cost with permission from the authors. Contact Prudence Fisher.

© Copyright 2022. DISC Development Group of Columbia University. Do not reproduce without permission. September 13, 2022. For additional free copies of this instrument, contact: Columbia DISC Development Group, 1051 Riverside Drive, New York, NY 10032

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Columbia Impairment Scale (Global Assessment of Functioning) – children and adolescents

Ages: 9-17 years

Description: A 13 item scale that has both a youth and a parent component, which the questions are identical, available. Items are rated on a 0 to 4 likert scale and it is best described as a measurement of functional impairment.

PDF: Youth Version

Parent Version

Scoring Information: Items are scored 0 to 4, total score ranging from 0 to 52, with a total of 15 or more on a parent’s scale indicating impairment.

Recommendations:

Languages available: English and Spanish 

For AHEC Use Only – Permissions/License Info: 

Bird, H. R., Shaffer, D., Fisher, P., Gould, M. S., et al. (1993). The Columbia Impairment Scale (CIS): Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3(3), 167–176.

The above excerpted from Child and Adolescent Psychiatry: The Essentials, (2005), Edited by Kathleen Myers and Keith Cheng, pg. 41, Chapter 3, Rating Scales

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Columbia-Suicide Severity Rating Scale (C-SSRS)

Ages: 5 years and up

Description: A tool that supports suicide risk assessment through a series of items and answers that helps users identify whether someone is at risk for suicide and assess the severity and immediacy of that risk. Completion of a 30-minute, on-line training is necessary to use the tool and provides a two-year certification. More information on the administration of the scale can be found on the main CSSRS website

PDF: http://cssrs.columbia.edu/wp-content/uploads/C-SSRS_Pediatric-SLC_11.14.16.pdf

Scoring information: N/A

Recommendations: For use by those who have received training on how to administer this assessment. https://practiceinnovations.org/resources/scorm/cssrs this is an online training module for the C-SSRS. The Lighthouse Project website has protocols and suggestions for use in healthcare settings, as well as other settings. See this link for additional information and helpful downloads.

Languages available: 140 languages available

For AHEC use only- Permissions/License info: copyright by The Research Foundation for Mental Hygiene, Inc. Freely accessible, though for reprints and inquiries on training see below:

  • Universal. The Columbia Protocol is suitable for all ages and special populations in different settings and is available in more than 140 country-specific languages
  • Free. The protocol and the training on how to use it are available free of charge for use in community and healthcare settings, as well as in federally funded or nonprofit research.

For reprints of the C-SSRS contact Kelly Posner, Ph.D., New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York, 10032; inquiries and training requirement contact posnerk@nyspi.columbia.edu.

Disclaimer:

This scale is intended to be used by individuals who have received training in its administration. The questions contained in the Columbia-Suicide Severity Rating Scale are suggested probes. Ultimately, the determination of the presence of suicidal ideation or behavior depends on the judgment of the individual administering the scale.

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CRAFFT (2.1)

Ages: 12-18 years

Description: The CRAFFT is a behavioral health screening tool for use with children and adolescents through age 20 years. The CRAFFT is meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and other drug use is warranted. This tool is recommended by the American Academy of Pediatrics’ Committee on Substance Abuse for use with adolescents. There is a clinician interview form and a self-administered version. More information is available on the main CRAFFT website.

PDF: Reproduction of the instrument will be granted after submission of the provider request.

Scoring information: Scoring algorithm 

Recommendations: The self-administered version is recommended. It is recommended that the adolescent complete it independently to ensure more truthful reporting. Additional administration information.

Languages available: Translated into over 30 languages.

For AHEC use only – Permissions/License info:

REPRODUCE THE CRAFFT

The CRAFFT questions are copyright protected by Boston Children’s Hospital; however, a goal of CABHRe is to make the CRAFFT widely available to qualified clinicians and researchers, and we welcome reproductions of this screening tool.

The following conditions must be met in order to use the CRAFFT screen in your work:

  1. You must submit a final draft of your reproduction (either a reprint, screen shot or electronic program) with a description of the intended context for use as an attachment to crafft@childrens.harvard.edu. Please also let us know which version of the CRAFFT you have reproduced, and if you are using the Self-Administered Questionnaire or the Clinician interview in your program.
  2. All CRAFFT questions must stay in their original order with no substitutions or omissions. However, you may choose to reproduce only the first page of the CRAFFT Clinician interview.
  3. The following language must be printed at the bottom/end of the program:
    1. NOTICE TO CLINIC STAFF AND MEDICAL RECORDS:
      The information on this page is protected by special federal confidentiality rules (42 CFR Part 2), which prohibit disclosure of this information unless authorized by specific written consent.

      © John R. Knight, MD, Boston Children’s Hospital, 2020.
      Reproduced with permission from the Center for Adolescent Behavioral Health Research (CABHRe), Boston Children’s Hospital.
      crafft@childrens.harvard.edu
      www.crafft.org
      For more information and versions in other languages, see www.crafft.org.

  4. The reproduction you produce cannot be sold separately from the reprint or electronic program.
  5. Any changes made after approval require a separate approval.

All submissions will be reviewed and you will be notified by email of approval with an official approval letter.  Please allow 1-2 weeks for review. The CRAFFT administrative team reserves the right to refuse permission for any reason.

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CRAFFT (2.1+N)

Ages: 12-18 years

Description: Similar to the CRAFFT above, however includes information around nicotine and tobacco use. More information is available on the main CRAFFT website.

PDF: Reproduction of the instrument will be granted after submission of the provider request.

Scoring information: Scoring algorithm

Recommendations: It is recommended that the adolescent complete it independently to ensure more truthful reporting. Additional administration information.

Languages available: Translated into over 30 languages.

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Depression Scale for Children (DSC)

Ages: 6 to 17 years

Description: The Center for Epidemiological Studies Depression Scale for Children (DSC) is a 20-item self-report focused on the feelings over the past week. The tool takes about five minutes to complete. PDF: The tool and brief instructions for scoring are available at Center for Epidemiological Studies Depression Scale for Children (CES-DC) .

https://dpi.wi.gov/sspw/mental-health/mental/behavioral-health-screening/behavioral-health-screening/tools#adsi

Scoring Information: 

Recommendations:

Languages available:

For AHEC use only- Permissions/License info:

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(Birleson) Depression Self-Rating Scale for Children (DSRS)

Ages: 8 -14 years

Description: The Center for Epidemiological Studies Depression Scale for Children (DSC) is a 20-item self-report focused on the feelings over the past week. The tool takes about five minutes to complete. PDF: DSRS pdf

Scoring Information: Instructions on scoring included in PDF

Recommendations: The instrument may be used together with other information from parents, school or other sources to make a clinical diagnosis, to identify children with dysphoric mood in response to environmental stress and to measure change in emotional status.

Languages available: English, Arabic, Chinese, Dari, Hindi, Italian, Japanese, Norwegian, Pashto, Russian

For AHEC use only- Permissions/License info: The DSRS-C may be freely used for clinical or research purposes provided due acknowledgement is made about its origin.

Permissions use website

References:  Birleson P. (1981) The Validity of Depressive Disorder in Childhood and the Development of a Self-Rating Scale: A Research Report. J. Child Psychology Psychiatry 22, 73/88.

Birleson P. Hudson I, Grey-Buchanan D, Wolff S. (1987) Clinical Evaluation of a Self-Rating Scale for Depressive Disorder in Childhood (Depression Self-Rating Scale). J. Child Psychology Psychiatry 28, 43/60.

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Patient Health Questionnaire (PHQ-9) Modified for Adolescents

Ages: 11-17 years

Description:  Brief screener for depression in adolescents

PDF: IHC MHI Depression Fact Sheet: Children and Adolescents

Scoring information: scored on a 0 to 3 scale with 3 being “nearly every day” for depression symptoms. See PDF for instructions on scoring correlations with diagnoses.

Recommendations: Self-assessment that is then scored by a professional

Languages available: English and Spanish

For AHEC use only- Permissions/License info: Freely accessible through the American Psychological Association (APA) and no permission required to reproduce, translate, display, or distribute.

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.

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Pediatric Symptom Checklist (PSC-35/17)

Ages: 4-16

Description: Brief questionnaire to recognize psychosocial problems and improve treatment in children. Assesses changes in emotional and behavioral problems in children. Scoring info listed with downloadable forms

PDF: https://www.massgeneral.org/psychiatry/treatments-and-services/pediatric-symptom-checklist or https://screening.mhanational.org/screening-tools/parent/ for parental assessment of child

Scoring information: Each item receives zero, one, or two points. With the scores on all 35 items summed for the total score. A score of 28 or above indicates some psychosocial impairment in children ages 6-17. See Mass General website above for more details

Recommendations: Can be administered at any point in pediatric care but generally used during well-child visits. No one recommendation for administration; can be administered prior to the visit, at check-in; during the visit; or outside the visit.

Languages available: English, Chinese, Japanese, Spanish, Pictoral

For AHEC use only- Permissions/License info: freely accessible

https://www.massgeneral.org/psychiatry/treatments-and-services/pediatric-symptom-checklist

How to Complete the PSC

The PSC can be completed online for free. After you complete the PSC, you can download the printable report to share with your child’s pediatrician or teacher. Both the PSC score and report are anonymous and confidential. Your child’s scores from these online versions will not be shared with anyone else.

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Post-traumatic Cognitions Inventory – child version (CPTCI & CPTCI-S)

Ages: 6-18

Description: To assess how a child has been thinking and feeling since a frightening event

PDF: https://www.childrenandwar.org/wp-content/uploads/2020/11/CPTCI-25-item-CPTCI-S-10-item.pdf

Scoring information:  Scoring 1, 2, 3, 4 (for Don’t agree at all, Don’t agree a bit, Agree a bit, and Agree a lot, respectively). No reverse scored items. For 25 item screen CPTCI 2 sub-scales for “disturbing and permanent change” (13 items including items 4, 6, 8, 13, 14, 16, 17, 19, 20, 21, 22, 23, 24) and “feeble person in a scary world” (12 items including items 1, 2, 3, 5, 7, 9, 10, 11, 12, 15, 18, 25). For the10 item screener CPTCI-S – 2 sub-scales for “permanent and disturbing change” (6 items; items 1, 3, 6, 8, 9, 10) and “fragile person in a scary world” (4 items; items 2, 4, 5, 7).

Recommendations: 25 or 10 question option.  Screens for trauma-related cognitions that could be considered problematic but not to be used for assessing post-traumatic stress.

Languages available: English, Arabic, Bengali, Brazilian Portuguese, Chinese Mandarin, Danish, Dutch, Farsi, French, German, Hindi, Indonesian, Italian, Russian, Swedish

For AHEC use only- Permissions/License info: Free to use without permission

25 item version – McKinnon, A., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., Dixon, C., Nixon, R. D. V., & Meiser-Stedman, R. (2016). An Update on the Clinical Utility of the Children’s Post-Traumatic Cognitions Inventory. Journal of Traumatic Stress, 29(3), 253-258. doi: 10.1002/jts.22096

Meiser-Stedman, R., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., & Nixon, R. D. V. (2009). Development and Validation of the Child Post-Traumatic Cognitions Inventory (CPTCI). Journal of Child Psychology and Psychiatry, 50(4), 432-440. doi: 10.1111/j.1469-7610.2008.01995.x

10 item version – McKinnon, A., Smith, P., Bryant, R., Salmon, K., Yule, W., Dalgleish, T., Dixon, C., Nixon, R. D. V., & Meiser-Stedman, R. (2016). An Update on the Clinical Utility of the Children’s Post-Traumatic Cognitions Inventory. Journal of Traumatic Stress, 29(3), 253-258. doi: 10.1002/jts.22096

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Screen for Child Anxiety Related Disorders (SCARED)

Ages: 8-18 years

Description: A 41 item questionnaire available both online and on printed versions for child and parent to measure child anxiety. It includes four domains including panic/somatic, separation anxiety, generalized anxiety, and school phobia. There is a screener for the child, as well as for the parent to fill out for the child. Should take approximately 10 minutes to complete.

PDF: English Screener with Scoring Included

Scoring information: see above

Recommendations:  For children ages 8 to 11, it is recommended to have an adult sit with them while they answer in case they have any questions.

Languages available: Multiple languages available from the website.

For AHEC use only- Permissions/License info:

The SCARED is available at no cost at www.pediatricbipolar.pitt.ecu under resources/instruments.

January 19, 2018

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Screening to Brief Intervention (S2BI)

Ages: Adolescents

Description: brief screening focused on alcohol, tobacco, synthetic drug, and marijuana use among adolescents with information about how to discuss interventions for clinicians. Online form provides immediate suggestions and resources once completed.

PDF: https://nida.nih.gov/ast/s2bi/#/ link to website for online screener

https://www.mcpap.com/pdf/S2Bi%20Toolkit.pdf more extensive pdf for clinicians or other healthcare providers which includes the questionnaire, sample scenarios, and outlines for plans to reduce or eliminate substance use.

https://massclearinghouse.ehs.state.ma.us/PROG-BSAS-SBIRT/SA3542.html pdf for screener only download

https://massclearinghouse.ehs.state.ma.us/PROG-BSAS-SBIRT/SA1099.html pdf for provider toolkit only download

Scoring information: N/A; brief questionnaire. For answers other than “never,” there is information on how to discuss reducing or stopping use of substances.

Languages available: English only

For AHEC use only- Permissions/License info: freely accessible

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Severity Measure for Generalized Anxiety Disorder

Ages: 11-17 years

Description: Part of the American Psychiatric Association’s “emerging measures” effort in 2013. Intended to be used at the initial patient interview and ongoing to enhance clinical decision making. APA is asking for any research that is done to be shared with them at this link http://www.dsm5.org/Pages/Feedback-Form.aspx

The item itself is a 10-item questionnaire designed to be self-administered by the child AFTER being given a diagnosis of generalized anxiety disorder. The measure itself may be used to track status over time. Clinicians should review each question with the patient as well.

PDF: Severity Measure for Generalized Anxiety Disorder

Scoring information: Items are rated on a five-point scale with a total range of score from 0 to 40 with the higher the score indicating the increase in severity. Items should be given a raw score. Clinicians should also calculate an average score which then provides them an overall severity perspective on a five-point scale.

Recommendations:  N/A

Languages available: English

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SNAP-IV 26-Item Teacher and Parent Rating Scale

Ages: 6-18 years

Description: A 26 item measure that assesses for inattention, hyperactivity/inattention, as well as oppositional defiant disorder. Has three different versions, one for parent, one for teacher, and one for therapist.

PDF: http://www.shared-care.ca/files/Scoring_for_SNAP_IV_Guide_26-item.pdf

Scoring information: Symptom severity is rated on a four point scale.

Recommendations:  N/A

Languages available: English

For AHEC use only- Permissions/License info: *Waiting from response from author.