Spence Children’s Anxiety Scale — Short Form

The Spence Children's Anxiety Scale (SCAS) was developed by Australian psychologist Susan Spence between 1997 and 1999. It is widely used internationally to assess anxiety symptoms and their severity in children and adolescents aged 7–18, drawing on DSM-IV criteria for anxiety disorders. The versions described here are the parent report (SCAS-P, 38 items) and the short child self-report (SCAS-S, 19 items). They cover several areas, including separation anxiety, social anxiety, obsessive-compulsive symptoms (parent version only), panic attacks, specific phobias, and generalized anxiety. SCAS is used to screen for childhood anxiety disorders, support diagnostic assessment, evaluate treatment outcomes, and screen mental health in schools.

The parent (SCAS-P) and self-report (SCAS-S) versions differ in four main ways. ① Respondent: a parent or guardian completes the parent version based on their observations; children complete the self-report version based on their own feelings. ② Length: the parent version has 38 items covering 6 areas, including obsessive-compulsive symptoms; the short self-report has 19 items covering 5 areas, without obsessive-compulsive symptoms. ③ Age range: the parent version is for ages 7–13, and the self-report for ages 8–18. ④ Perspective: the parent version focuses more on visible behavior, such as avoidance and crying, while self-report captures internal experiences such as worry and fear. Using both can provide a fuller picture. Research indicates that parent and child scores can differ; those differences may themselves be clinically useful, revealing how a family understands and communicates about the child's anxiety.

SCAS uses a four-point response scale from 0 to 3: Never (0), Sometimes (1), Often (2), and Always (3). Total scores range from 0–114 for the parent version (38×3) and 0–57 for the self-report version (19×3). ① The total reflects overall anxiety, with higher scores indicating greater severity. ② Scores for individual areas show where anxiety is more pronounced, such as separation or social anxiety. ③ There is no single diagnostic cutoff, but research suggests that scores above the 90th percentile for the same age group—higher than about 90% of peers—may indicate clinically significant anxiety. ④ Comparing scores over time can help track change or treatment outcomes. Results should be considered alongside clinical interviews and other assessments; a score alone cannot diagnose an anxiety disorder.

SCAS assesses several forms of childhood anxiety. ① Separation anxiety: excessive distress about being apart from parents, such as refusing school, being afraid to sleep alone, or worrying that something will happen to a parent. ② Social anxiety: fear of performing or being judged by others, such as avoiding speaking in class or social activities. ③ Obsessive-compulsive symptoms (parent version only): recurring thoughts and behaviors such as checking, handwashing, or specific rituals. ④ Panic attacks: sudden intense fear with physical symptoms such as a racing heart, breathing difficulties, or dizziness. ⑤ Specific phobias: excessive fear of particular things or situations, such as darkness, animals, or heights. ⑥ Generalized anxiety: excessive worry about many things, such as school, family, or the future. Scores in these areas help identify the pattern and severity of anxiety and inform targeted support. An especially high score in one area suggests that it may be the main concern.

Approaches to helping anxious children include: ① Cognitive behavioral therapy (CBT), described as the gold standard for childhood anxiety. It helps children identify and change anxious thoughts, gradually face feared situations, and learn coping skills; research finds it very effective. ② Family involvement: parents' attitudes and actions matter. Learn to support children without overprotecting them, and encourage facing fears rather than avoiding them. ③ Relaxation skills such as deep breathing, progressive muscle relaxation, and mindfulness. ④ Gradual exposure: begin with the least frightening situations and increase the challenge as confidence grows. ⑤ Social skills training for children with social anxiety. ⑥ Medication for severe anxiety, where appropriate under a child psychiatrist's supervision. Seek professional counseling or treatment for children. Early intervention is more effective and can help prevent anxiety from continuing into adulthood.

Consider professional help if your child's SCAS results or daily behavior show any of the following: ① A total or area score well above age norms, such as above the 90th percentile. ② Symptoms lasting a long time, such as over 6 months, without improvement. ③ Anxiety that substantially disrupts daily life, including school refusal, inability to join normal activities, poorer school performance, or relationship difficulties. ④ Frequent headaches, stomachaches, or nausea without an organic cause identified in medical examinations. ⑤ Avoidance, such as refusing activities, not wanting to leave parents, or being afraid to be alone. ⑥ Other difficulties alongside anxiety, such as depression, behavior problems, or learning difficulties. ⑦ A large gap between parent and child scores, which may suggest communication difficulties or differences in perception. A child counselor or child psychiatrist can provide an accurate assessment and effective treatment. Childhood anxiety is treatable; early support helps children develop healthily and reduces the risk of lifelong effects.