1. Has difficulty stopping him/herself from worrying
2. Worries that he/she will do something to look stupid in front of other people
3. Keeps checking that he/she has done things right (e.g.‚ that he/she closed a door‚ turned off a tap)
4. Is tense‚ restless or irritable due to worrying
5. Is scared to ask an adult for help (e.g.‚ a preschool or school teacher)
6. Is reluctant to go to sleep without you or to sleep away from home
7. Is scared of heights (high places)
8. Has trouble sleeping due to worrying
9. Washes his/her hands over and over many times each day
10.Is afraid of crowded or closed-in places
11.Is afraid of meeting or talking to unfamiliar people
12.Worries that something bad will happen to his/her parents
13.Is scared of thunder storms
14.Spends a large part of each day worrying about various things
15.Is afraid of talking in front of the class (preschool group) e.g.‚ show and tell
16.Worries that something bad might happen to him/her (e.g.‚ getting lost or kidnapped)‚ so he/she won’t be able to see you again
17.Is nervous of going swimming
18.Has to have things in exactly the right order or position to stop bad things from happening
19.Worries that he/she will do something embarrassing in front of other people
20.Is afraid of insects and/or spiders
21.Has bad or silly thoughts or images that keep coming back over and over
22.Becomes distressed about your leaving him/her at preschool/school or with a babysitter
23.Is afraid to go up to group of children and join their activities
24.Is frightened of dogs
25.Has nightmares about being apart from you
26.Is afraid of the dark
27.Has to keep thinking special thoughts (e.g.‚ numbers or words) to stop bad things from happening
28.Asks for reassurance when it doesn’t seem necessary
29.Has your child ever experienced anything really bad or traumatic (e.g.‚ severe accident‚ death of a family member/friend‚ assault‚ robbery‚ disaster) YES NO
Please briefly describe the event that your child experienced ……..
If you answered NO to question 29‚ please do not answer questions 30-34. If you answered YES‚ please DO answer the following questions.
Do the following statements describe your child’s behavior since the event?
30.Has bad dreams or nightmares about the event
31.Remembers the event and becomes distressed
32.Becomes distressed when reminded of the event
33.Suddenly behaves as if he/she is reliving the bad experience
34.Shows bodily signs of fear (e.g.‚ sweating‚ shaking or racing heart) when reminded of the event
Separation anxiety‚ Physical injury fears‚ Social Anxiety‚ obsessive compulsive disorder and Generalized anxiety disorder
0= Not True at All‚ 1=Seldom True‚ 2= Sometimes True‚ 3= Quite Often True‚ 4=Very Often True
Generalized Anxiety 1 + 4 + 8 + 14 + 28‚ Social Anxiety 2 + 5 + 11 + 15 + 19 + 23‚ Obsessive Compulsive disorder 3 + 9 + 18 + 21 + 27‚ Physical Injury Fears 7 + 10 + 13 + 17 + 20 + 24 + 26‚ Separation Anxiety‚ 6 + 12 + 16 + 22 + 25
Total Score Sum of Scores for Items 1 to 28
Spence‚ S.H.‚ Rapee‚ R.‚ McDonald‚ C.‚ & Ingram‚ M. (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy‚ 39‚ 1293 - 1316.
Spence. S.H.‚ (1997). Structure of Anxiety Symptoms Among Children: A Confirmatory Factor-Analytic Study. J Abnorm Psych 106(2): 280-297.
Spence. S.H‚ Barrett. P.M‚ Turner. C.M. (2003).Psychometric Properties of the Spence Children's Anxiety Scale with Young Adolescents. J Anxiety Disord 17(6): 605-625.