Spence Children's Anxiety Scale (Parent Report)
Your Name
*
Your Child's Name
*
Today's Date
Below is a list of items that describe children. For each item please choose the response that best describes your child. Please answer all items.
*
Never
Sometimes
Often
Always
My child worries about things
Never
Sometimes
Often
Always
My child is scared of the dark
Never
Sometimes
Often
Always
When my child has a problem, they complain of having a funny feeling in their stomach
Never
Sometimes
Often
Always
My child complains of feeling afraid
Never
Sometimes
Often
Always
My child would feel afraid of being on their own at home
Never
Sometimes
Often
Always
My child is scared when they I have to take a test
Never
Sometimes
Often
Always
My child feels afraid when they have to use public toilets or bathrooms
Never
Sometimes
Often
Always
My child worries about being away from my us/me
Never
Sometimes
Often
Always
My child feels afraid that they will make a fool of themselves in front of people
Never
Sometimes
Often
Always
My child worries that they will do badly at my school
Never
Sometimes
Often
Always
My child worries that something awful will happen to someone in our family
Never
Sometimes
Often
Always
My child complains of suddenly feeling as if they can't breathe when there is no reason for this
Never
Sometimes
Often
Always
My child has to keep checking that they have done things right (like the switch is off, or the door is locked)
Never
Sometimes
Often
Always
My child is scared if they have to sleep on their own
Never
Sometimes
Often
Always
My child has trouble going to school in the mornings because they feel nervous or afraid
Never
Sometimes
Often
Always
My child is scared of dogs
Never
Sometimes
Often
Always
My child can't seem to get bad or silly thoughts out of their head
Never
Sometimes
Often
Always
When my child has a problem, they complain of their heart beating really fast
Never
Sometimes
Often
Always
My child suddenly starts to tremble or shake when there is no reason for this
Never
Sometimes
Often
Always
My child worries that something bad will happen to them
Never
Sometimes
Often
Always
My child is scared of going to the doctors or dentists
Never
Sometimes
Often
Always
When my child have a problem, they feel shaky
Never
Sometimes
Often
Always
My child is scared of heights (e.g., being at the top of a cliff)
Never
Sometimes
Often
Always
My child has to think of special thoughts (like numbers or words) to stop bad things from happening
Never
Sometimes
Often
Always
My child feels scared if thy have to travel in the car, or on a bus or a train
Never
Sometimes
Often
Always
My child worries what other people think of them
Never
Sometimes
Often
Always
My child is afraid of being in crowded places (like shopping centres, the movies, buses, busy playgrounds)
Never
Sometimes
Often
Always
All of a sudden my child feels really scared for no reason at all
Never
Sometimes
Often
Always
My child is scared of insects or spiders
Never
Sometimes
Often
Always
My child complains of suddenly becoming dizzy or faint when there is no reason for his
Never
Sometimes
Often
Always
My child feels afraid if they have to talk in front of the class
Never
Sometimes
Often
Always
My child complains of their heart suddenly starting to beat too quickly for no reason
Never
Sometimes
Often
Always
My child worries that they will suddenly get a scared feeling when there is nothing to be afraid of
Never
Sometimes
Often
Always
My child is afraid of being in small closed places, like tunnels or small rooms
Never
Sometimes
Often
Always
My child has to do some things over and over again (like washing their hands, cleaning or putting things in a certain order)
Never
Sometimes
Often
Always
My child gets bothered by bad or silly thoughts or pictures in their head
Never
Sometimes
Often
Always
My child has to do certain things in the right way to stop bad things happening
Never
Sometimes
Often
Always
My child would feel scared if they had to stay away from home overnight
Never
Sometimes
Often
Always
Is there anything else your child is really afraid of?
Yes
No
Please write down what it is, and how often they are afraid of this thing:
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