English CHILD self-report 41-item form; original three-month recall; PhenX 121802
Population
Children and adolescents ages 8–18; younger children need source-specified assistance and a separate parent form
Respondent
Child or adolescent self-report
Recall period
Last three months
Purpose
Screen anxiety symptoms to guide clinical assessment
Assessment tool
Below is a list of sentences that describe how people feel. Read each phrase and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True” for you. Then, for each sentence, select the response that seems to describe you for the last 3 months.
Clinician administration: for children ages 8–11 explain all questions or have the child complete the form with an adult available. The source protocol requires both child and parent versions below age 12; collect the separate parent questionnaire as well. Collect both versions for older children whenever possible. Do not combine the two respondents’ scores.
Developed by Boris Birmaher and colleagues, Western Psychiatric Institute and Clinic, University of Pittsburgh. Birmaher B et al. (1999), Journal of the American Academy of Child and Adolescent Psychiatry 38(10):1230–1236. Source: PhenX 121802.
Responses stay in this page’s memory. Reset or leave the page to clear them. No patient identifiers are collected.
Interpretation & limitations
The total is the sum of all 41 ratings, range 0–82. A total of 25 or greater reaches the source screening guide; scores above 30 are more specific, but neither establishes an anxiety diagnosis.
The five subscale guides are: panic/somatic 7, generalized anxiety 9, separation anxiety 5, social anxiety 8, and school avoidance 3. Each is a guide for further assessment.
All 41 responses are required for this website’s score report. Symptoms, functional impact, respondent differences and clinical context must be reviewed.
Missing responses are not evidence that a symptom is absent. No automatic diagnosis, medication change or declaration of safety.
