Screen for Child Anxiety Related Disorders (SCARED)

What is the Screen for Child Anxiety Related Disorders (SCARED)?

The Screen for Child Anxiety-Related Disorders (SCARED) is a comprehensive questionnaire designed to assess and identify anxiety disorders in children. Developed to address the critical need for early detection of childhood anxiety disorders (sometimes called pediatric anxiety disorders), this screening tool plays a pivotal role in understanding and addressing the complexities of anxiety-related emotional disorders in the pediatric population.

The SCARED questionnaire delves into various aspects of child anxiety, covering a spectrum of disorders such as separation anxiety disorder, panic disorder, generalized anxiety, and school phobia. It is tailored for children and their parents, acknowledging the significance of obtaining insights from multiple perspectives to ensure a holistic evaluation.

The importance of the SCARED lies in its ability to uncover subtle signs of anxiety in children that might go unnoticed. Childhood anxiety, if left unaddressed, can manifest into more severe emotional disorders, impacting academic performance, social interactions, and overall quality of life. By providing a structured framework to evaluate child behavior and anxiety symptoms, the SCARED tool facilitates early intervention and targeted healthcare strategies.

The child and parent versions of the SCARED enable a collaborative approach between healthcare professionals, parents, and the child, fostering a more comprehensive understanding of the child's emotional well-being. Integrating the SCARED scores with other assessment tools, such as the Child Behavior Checklist, enhances diagnostic precision, enabling healthcare providers to tailor interventions based on individual needs.

How to use the Screen for Child Anxiety-Related Disorders (SCARED)?

The Screen for Child Anxiety-Related Disorders is a valuable tool for assessing anxiety disorders in children in child psychiatry practices. It has distinct versions for both the child and the parent. This step-by-step process involves carefully evaluating 41 statements, each associated with child anxiety-related emotional symptoms and social phobia, to gauge the child's emotional well-being over the last three months.

Child version

Reading and understanding

The child reads and comprehends sentences describing emotional states, deciding if each statement is "not true or hardly ever true," "somewhat true or sometimes true," or "very true or often true."

Categorizing responses

For each statement, the child marks the corresponding circle with a 0, 1, or 2, reflecting their perceived level of agreement with the statement.

Repeating the process

This assessment is repeated for all 41 statements, covering a spectrum of anxiety-related issues such as separation anxiety, panic disorder, and generalized anxiety.

Scoring and totaling

The child's total score is calculated by adding the circled numbers to measure their anxiety symptoms. Higher scores may indicate a greater likelihood of an anxiety disorder.

Parent version

Reading and reflecting

The parent carefully reads each statement related to their child's behavior and emotional state, assessing if it is "not true or hardly ever true," "somewhat true or sometimes true," or "very true or often true."

Marking responses

Like the child's version, the parent marks the appropriate circle (0, 1, or 2) for each statement, representing their child's experiences over the past three months.

Completing the assessment

The parent completes the process for all 41 statements, providing a comprehensive overview of their child's anxiety symptoms.

Scoring and interpretation

The total score is obtained by summing up the circled numbers. A higher score may indicate a higher likelihood of anxiety-related emotional disorders. This information aids healthcare professionals in understanding the child's emotional well-being and tailoring interventions accordingly.

Additional notes

For children aged 8 to 11, clinicians are recommended to explain all questions or have the child answer the questionnaire sitting with an adult if they have any questions.

The SCARED Rating Scale Scoring Aide further assists in interpreting and understanding the scores obtained, facilitating a more nuanced analysis of the child's anxiety levels.

The SCARED questionnaire, with its child and parent versions, provides a structured and thorough approach to identifying and assessing anxiety symptoms in children, supporting early intervention and targeted healthcare strategies.

It's recommended to use both versions to get a sense of the parent-child agreement concerning the child's anxiety symptoms.

How do you score the Screen for Child Anxiety-Related Disorders (SCARED)?

The scoring of the SCARED questionnaire involves tallying the responses from both the child and parent versions based on the provided scoring aide. Here's a breakdown of the scoring process:

SCARED total score calculation

Add up the circled numbers for all 41 items on the questionnaire. This total score represents the child's overall level of anxiety symptoms.

Interpretation

A total score of ≥ 25 may suggest the presence of an anxiety disorder. Scores higher than 30 are considered more specific indicators of an anxiety disorder.

Specific indicators for subtypes

• Panic disorder or significant somatic symptoms: A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, and 38 may suggest the presence of Panic Disorder or significant somatic symptoms.
• Generalized anxiety disorder: A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder.
• Separation anxiety disorder: A score of 5 for items 4, 8, 13, 16, 20, 25, 29, and 31 may suggest the presence of Separation Anxiety Disorder.
• Social anxiety disorder: A score of 8 for items 3, 10, 26, 32, 39, 40, and 41 may indicate Social Anxiety Disorder.
• Significant school avoidance: A score of 3 for items 2, 11, 17, and 36 may suggest significant school avoidance.

Clinical considerations

Scores on specific items may offer insights into potential anxiety disorders, helping clinicians tailor interventions accordingly. Higher scores on subtype-indicative items guide clinicians in identifying specific anxiety-related challenges faced by the child.

What are the benefits of using the Screen for Child Anxiety-Related Disorders (SCARED)?

Using the SCARED tool offers the following benefits:

Early detection and intervention

SCARED serves as a valuable screening tool for the early detection of child anxiety and related emotional disorders. Identifying symptoms in their early stages allows for timely intervention, reducing the risk of these issues escalating. Early detection is crucial for implementing targeted strategies and support, promoting better mental health outcomes for children.

Comprehensive assessment

With its 41-item structure, SCARED provides a comprehensive assessment of various anxiety-related emotional disorders in children. This allows healthcare professionals to gain a nuanced understanding of the child's emotional well-being, going beyond a generic evaluation and enabling tailored interventions based on specific anxiety symptoms.

Psychometric properties and reliability

SCARED boasts strong psychometric properties, ensuring its reliability and validity in measuring anxiety severity. The scale construction and rigorous testing of its psychometric characteristics contribute to its credibility as a clinically reliable tool. This reliability is particularly crucial when assessing clinically referred children or those at risk of anxiety disorders.

Differentiation from non-anxiety disorders

SCARED offers specificity in identifying anxiety-related emotional disorders, distinguishing them from non-anxiety disorders. This is vital for healthcare professionals to diagnose and address anxiety-related challenges in children accurately. The tool's ability to differentiate ensures that interventions are tailored to the specific needs of children with anxiety disorders.

Use in research and clinical settings

SCARED is widely recognized in research and clinical settings and published in reputable journals like the Journal of Child Psychology and Psychiatry and the Journal of the American Academy of Child and Adolescent Psychiatry. Its acceptance in academic circles highlights its credibility and applicability for studying and understanding adolescent anxiety disorders.

Child and parent perspectives

SCARED's inclusion of both child and parent versions allows for a dual perspective on the child's anxiety symptoms. This enhances the overall assessment by capturing a more holistic view of the child's emotional experiences. The collaboration between child and parent reports facilitates a nuanced understanding and aids clinicians in considering multiple viewpoints for a comprehensive evaluation.

These advantages collectively contribute to its effectiveness as a valuable tool in the assessment and intervention of child and adolescent anxiety disorders.