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Screening for an Anxiety Disorder: Children
Does your child have a distinct and ongoing fear of social situations involving unfamiliar people?
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Yes
No
Sometimes
Does your child worry excessively about a number of events or activities?
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Yes
No
Sometimes
Does your child have a persistent and unreasonable fear of an object or situation, such as flying, heights, or animals.
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Yes
No
Sometimes
When encounting the feared object or situation, does he react by freezing, clinging, or having a tantrum?
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Yes
No
Sometimes
Does your child worry excessively about her competence and quality of performance?
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Yes
No
Sometimes
Does your child cry, have tantrums, or refuse to leave a family member or other familiar person when necessary?
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Yes
No
Sometimes
Has your child experienced a decline in classroom performance, refuse to go to school, or avoided age-appropriate social activities?
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Yes
No
Sometimes
Does your child have exaggerated and irrational fears of people, places, objects or situations that interfere with his or her social and academic life?
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Yes
No
Sometimes
Does your child experience a great number of nightmares, headaches, or stomachaches?
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Yes
No
Sometimes
Does your child repetitively use toys to re-enact scenes from a disturbing event?
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Yes
No
Sometimes
Does your child redo tasks because of exessive dissatisfaction with less-than-perfect performance?
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Yes
No
Sometimes
Does your child spend at least one hour each day repeating things over again, such as hand washing, checking, arranging, or counting?
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Yes
No
Sometimes
Does your child often appear anxious when interacting with peers, or try to avoid them?
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Yes
No
Sometimes
Does your child experience age-appropriate social relationships with family members and other familiar people?
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Yes
No
Sometimes
Does your child experience shortness of breath or a racing heart for no apparent reason?
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Yes
No
Sometimes