APPENDIX 1

Behavioral and Emotional Screening Measures for Use in Primary Care in the Public Domaina

CategoryScreening ToolAge GroupNo. of itemsAvailable FormsReported Psychometrics/OtherLink
General Behavioral Screens
Young children (0–5)Baby Pediatric Symptom Checklist2–17 mo12Parent completedRetest reliability and internal reliability >0.7https://sites.google.com/site/swycscreen
Preschool Pediatric Symptom Checklist18–60 mo18Parent completedhttps://sites.google.com/site/swycscreen
Strengths and Difficulties Questionnaire3–17 y25 itemsParent/teacher 3(4)-y-old; parent/teacher 4–10-y-old; parent/teacher follow-up forms availableVariable across cultural groups; sensitivity: 63%–94%, specificity: 88%–96%; available in >70 languageshttp://www.sdqinfo.org
School-age and adolescent childrenStrengths and Difficulties Questionnaire3–17 y25 itemsParent/teacher 4–10-y-old; parent/teacher 11–17-y-old; youth self report 11–17-y-old; parent/teacher/self follow-up forms availableVariable across cultural groups; sensitivity: 63%–94%, specificity: 88%–96%; available in >70 languageshttp://www.sdqinfo.org
Pediatric Symptom Checklist—174–16 y17 itemsParent completed; youth self-report >10 y; pictorial version availableVariable psychometrics for detection of psychiatric problems; available in multiple languageshttp://www.massgeneral.org/psychiatry/services/psc_home.aspx
Pediatric Symptom Checklist—354–16 y35 itemsParent completed; youth self-report >10 y; pictorial version availableSensitivity: 80%–95%, specificity: 68%–100%; available in multiple languageshttp://www.massgeneral.org/psychiatry/services/psc_home.aspx
Psychosocial Screens
WE-CARE (Well-Child Care Visit, Evaluation, Community Resources, Advocacy, Referral, Education)Parent10 itemsParent completedhttp://pediatrics.aappublications.org/content/120/3/547.full#sec-1
Family Psychosocial ScreenParent∼50 itemsParent completedVariable psychometrics for detection of specific psychosocial problems; cut points for various domains recommendedhttp://depts.washington.edu/dbpeds/Screening%20Tools/FamPsychoSocQaire.pdf
Survey of Wellbeing in Young ChildrenParent9 itemsParent completedPreliminary findings show promisehttps://sites.google.com/site/swycscreen/parts-of-the-swyc/family-questions
Adverse Childhood Experience ScoreParent10 itemsParent completedIncreasing score associated with many adverse physical and mental health outcomeshttp://acestoohigh.com/got-your-ace-score
Screens for Specific Disorders
Parental or adolescent depressionEdinburgh Maternal DepressionParent (mother)10 itemsParent self-reportSensitivity 86%; specificity 78%http://www.fresno.ucsf.edu/pediatrics/downloads/edinburghscale.pdf
2 Question Screen (Modification of the Patient Health Questionnaire—2Parent, adolescents2 itemsParent or adolescent self-reportSensitivity: 83%–87%; specificity: 78%–92%http://www.uphp.com/Two_Question_Screen.pdf; http://www.cqaimh.org/pdf/tool_phq2.pdf
Patient Health Questionnaire (PHQ)—9Parent9 itemsParent or Adolescent self-reportSensitivity: 88% for major depression; specificity: 88% for major depressionhttp://www.integration.samhsa.gov/images/res/PHQ%20-%20Questions.pdf
Center for Epidemiologic Studies Depression ScaleParent; adolescents >14 y (modified version for children as young as 6 available)20 itemsParent completed; youth self-reportCoefficient α >.9; sensitivity 91%; specificity 81%. Psychometrics for children <14 indicate measure may not discriminate well between depressed and nondepressed youth.http://cesd-r.com
Mood and Feelings QuestionnaireHas been used about children as young as 7Short version; 9 items; long version: 34 itemsParent completed; youth self-reportParent report version has shown a sensitivity of 75%–86% and specificity of 73%–87%http://devepi.mc.duke.edu/mfq.html
Substance abuseCRAFFT (Car, Relax, Alone, Forget, Friends, Trouble)11–21 y oldThree screener questions, then 6 itemsInterview of youth; youth self-report version availableSensitivity 76%–93%, specificity 76% to 94%; available in multiple languageshttp://www.ceasar-boston.org/CRAFFT
CAGE-AIDAdolescents4 itemsYouth self-reportOne or more positive answers is associated with a sensitivity of 79% and specificity of 77%, ≥2 answers 70% and 85%http://www.integration.samhsa.gov/images/res/CAGEAID.pdf
AnxietyScreen for Child Anxiety Related Disorders (SCARED)≥8 y41 itemsParent completed; youth self-reportCoefficient α: .9http://www.psychiatry.pitt.edu/research/tools-research/assessment-instruments
Spence Children’s Anxiety Scale (SCAS)2.5–6.5 y and 8–12 y45 itemsParent completed 2.5–6.5 y; youth self-report 8–12 yHigh internal consistency and adequate test–retest reliability in adolescentshttp://www2.psy.uq.edu.au/~sues/scas
ADHDVanderbilt ADHD Diagnostic Rating Scales4–18 y55-items parent scale; 43-items teacher scaleParent, teacher completed; follow-up forms availableSensitivity 80%, specificity 75%, retest reliability >0.80http://www.nichq.org/toolkits_publications/complete_adhd/03VanAssesScaleParent%20Infor.pdf; http://www.brightfutures.org/mentalhealth/pdf/professionals/bridges/adhd.pdf
Strengths and Weaknesses of ADHD Symptoms (SWAN)6–18 y30 items (18-item available)Parent, teacher completedhttp://www.adhd.net
SNAP-IV6–18 y90 items (18-item version available)Parent, teacher completedCoefficient α >.90; available in multiple languageshttp://www.adhd.net
  • CAGE-AID, CAGE Questions (Cut Down, Annoyed, Guilty and Eye Opener) adapted to include drug use; Swanson, Nolan and Pelham Questionnaire, Version IV (SNAP-IV).

  • a This list is not meant to be exhaustive but representative of a range of screening instruments suitable for primary care that are in the public domain. Psychometrics may vary based on the findings of different studies and there is considerable variability in the strength of psychometric reliability between measures.