Pediatric Anxiety Screening Guidelines
Primary Screening Recommendation
- The American Academy of Child and Adolescent Psychiatry recommends the SCARED (Screen for Child Anxiety Related Emotional Disorders) as the first-line screening tool for children and adolescents with anxiety disorders, with the parent version demonstrating superior sensitivity and specificity 1, 2
- The SCARED is freely available at https://www.pediatricbipolar.pitt.edu/resources/instruments 1, 2
Age-Specific Screening Algorithm
- For preschool-age children (under 6 years), use the Preschool Anxiety Scale (parent version only), available at https://www.scaswebsite.com 1, 2
- For school-age children and adolescents (6-18 years), use SCARED in both parent and child versions 1, 2
- For older adolescents (teen/young adult), the GAD-7 (Generalized Anxiety Disorder-7) can be used as an alternative, available at https://www.phqscreeners.com 1, 3
Alternative Validated Screening Tool
- The Spence Children's Anxiety Scale (SCAS) is an equally acceptable alternative with similar psychometric properties, available in parent and child versions at https://www.scaswebsite.com 1, 2
When to Use Structured Diagnostic Interviews Instead
- The ADIS (Anxiety Disorders Interview Schedule) is the gold standard in research settings, addressing all DSM anxiety disorders plus comorbidity screening 1, 2
- The K-SADS-PL DSM-5 is a freely available structured interview covering panic, agoraphobia, separation anxiety, social anxiety, selective mutism, specific phobia, and generalized anxiety 1, 2
Implementation in Different Settings
- In primary care or school settings, deploy general social-emotional screening first, then follow positive screens with SCARED for anxiety-specific assessment 4
- In psychiatric evaluation settings, include SCARED in intake packets along with the APA's Level 1 Cross-Cutting Symptom Measures to systematically gather information before the evaluation appointment 4