Anxiety Scale - Child
Anxiety Scale - Child
Anxiety Scale - Child
Name:
Date:
Directions:
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,
fill in one circle that corresponds to the response that seems to describe you for the last 3 months.
0 1 2
Not True or Somewhat Very True
Hardly True or or Often
Ever True Sometimes True
True
0 1 2
Not True or Somewhat Very True
Hardly True or or Often
Ever True Sometimes True
True
SCORING:
A total score of ≥ 25 may indicate the presence of an Anxiety Disorder. Scores higher that 30 are more specific.
A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate Panic Disorder or Significant
Somatic Symptoms.
A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder.
A score of 5 for items 4, 8, 13, 16, 20, 25, 29, 31 may indicate Separation Anxiety Disorder.
A score of 8 for items 3, 10, 26, 32, 39, 40, 41 may indicate Social Anxiety Disorder.
A score of 3 for items 2, 11, 17, 36 may indicate Significant School Avoidance.
*For children ages 8 to 11, it is recommended that the clinician explain all questions, or have the child answer the
questionnaire sitting with an adult in case they have any questions.
Developed by Boris Birmaher, M.D., Suneeta Khetarpal, M.D., Marlane Cully, M.Ed., David Brent M.D., and Sandra McKenzie, Ph.D., Western
Psychiatric Institute and Clinic, University of Pgh. (10/95). E-mail: birmaherb@msx.upmc.edu