Screening Resources

Vanderbilt

This tool is used to identify symptoms including disruptive behavior, inattention, impulsivity and hyperactivity in different settings for children age 6-12 years old. It includes a 55-item parent-report form as well as a 43-item teacher form. The forms are free and require approximately 10 minutes to complete.

For more information and to download the VANDERBILT: click here

ACE-Q: Center for Youth Wellness Adverse Childhood Experiences Questionnaire

This brief tool assesses adverse childhood experiences that may impact physical and mental health of children and adolescents. There are separate parent-report versions for children (ages 0-12) and teens (ages 13-19) in both English and Spanish. A teen self-report version is also available.

For additional information and to access the ACE-Q: click here

PEARLS: The Pediatric ACEs and Related Life Events Screener

The Pediatric ACEs and Related Life Events Screener (PEARLS) was developed for use in primary care, is free to use, and can be completed in 5 minutes. The PEARLS is appropriate for use in youth ages 0-19. There are three versions of the screening tool including a child (0-11) report to be completed by the caregiver, an adolescent (12-19) self-report and an adolescent caregiver report. The PEARLS is available in 17 languages.

For more information and to access the PEARLS: click here

M-CHAT-R/F: Modified Checklist for Autism in Toddlers, Revised, With Follow-Up

The M-CHAT-R/F is a validated screening tool designed for use with toddlers age 16 months - 30 months of age, to assess risk for autism spectrum disorders (ASD). The 20-item parent-report form can be administered and scored as part of a well-child check-up or used by specialists or other professionals to assess risk for ASD.  The M-CHAT can be scored in less than two minutes.

*Note: this tool was developed to maximize sensitivity and may lead to a false positive score, meaning not all children who score at risk will be diagnosed with ASD. However, those scoring at risk should be evaluated for other developmental delays or disorders.

For more information about screening for autism and to download the MCHAT and scoring instructions (available in multiple languages): click here

Preschool Feelings Checklist

The Preschool Feelings Checklist was developed for use in primary care settings with children ages 3-6, to screen for depression. This 16-item parent-report form can be scored quickly by the provider. To score the measure, sum all items in which the respondent selected yes. A score of 3 or more indicates the need for further mental health evaluation.

To access the Preschool Feelings Checklist: click here

For additional information about the development and scoring of this tool: click here

CES-DC: The Center for Epidemiological Studies Depression Scale for Children

This tool screens children and adolescents age 8-17 for depression. The 20-item self-report form takes only a few minutes to complete and a brief time for the provider to score.  Possible scores range from 0 to 60 and higher scores indicate increased levels of possible depression.

For more information and to download the CES-DC: click here

PHQ-9: Patient Health Questionnaire 9 Depression Screening Tool

The PHQ-9 screens adolescents (11-17 years old) and adults for depression. It is a brief self-report form, which takes only a few minutes to complete and a brief time for the provider to score. This tool is available in several languages.

To download the version of the PHQ-9 that has been modified for use with teens: click here

Pediatric Symptom Checklist (PSC)

The Pediatric Symptom Checklist is a brief psychosocial screen designed to facilitate the recognition of cognitive, emotional, and behavioral problems so that appropriate interventions can be initiated as early as possible. Two versions of the tool exist, the parent-report version (PSC) which can be used for children beginning at age 6 and the youth self-report (Y-PSC) which can be administered to adolescents ages 11 and up. Following positive screening results it is recommended that the child be referred for evaluation by a mental health professional.

For more information about the PSC or the Y-PSC and to download the tool: click here

Pediatric Intake Form

The Pediatric Intake Form is a brief questionnaire completed by families of pediatric patients regarding family history and functioning. The questionnaire directly assesses parental depression, parental substance use, domestic violence, child maltreatment and social supports. To monitor family and parental well-being, it is recommended to administer this form annually.

To access the Pediatric Intake Form: click here

Edinburgh Postnatal Depression Scale (EPDS)

The Edinburg Postnatal Depression Scale is a 10-item questionnaire used to evaluate postpartum depression. Mothers who score above 13 on the scale may be experiencing significant depressive symptoms and should be referred for additional evaluation and treatment.

To access the EPDS: click here

Perinatal Anxiety Screening Scale (PASS)

The Perinatal Anxiety Screening Scale assesses a broad range of anxiety symptoms for pregnant and new mothers. The questionnaire is 31-items and can be completed and scored in 10 minutes. A score below 20 signifies minimal anxiety, 21-41 represents mild to moderate anxiety, and 42 or more signifies severe anxiety. Additional referral for evaluation and treatment should be provided as appropriate.

To access the PASS: click here

BEARS

The BEARS screens for sleeping problems based on  5 major sleep domains and age range

For more information and to download the tool: Click here

Safe Environment for Every Kid (SEEK)

The SEEK Parent Questionnaire-R (PQ-R) is a 16-item questionnaire to screen for prevalent and targeted psychosocial problems such as parental depression and substance use. A 'yes' to any question indicates a positive screen.

For more information and to download the tool: Click here

WECARE

The WECARE Survey screens for unmet social needs and determines whether parents would like assistance with any of their unmet needs. This 10-item self-report form takes only a few minutes to complete and a brief time for the provider to score.

For more information and to download: Click here

Protocol for Responding to and Assessing Patient Assets, Risks and Experiences (PRAPARE)

PRAPARE is a 21-item questionnaire that assesses four core measures: personal characteristics, family/home, money/resources, and social/emotional health. This form takes around 5 minutes to complete and is translated in 25+ languages.

For more information and to download the tool: Click here

CRAFFT

The CRAFFT is a 6-item self-report form used to screen for high risk alcohol and other drug use disorders simultaneously. It is designed to assess whether a more in-depth assessment around alcohol or other drug use is warranted. The CRAFFT is recommended by the American Academy of Pediatrics' Committee on Substance Abuse for use with adolescents, ages 12-21.

For more information about the CRAFFT and to download the tool: click here

Ask Suicide-Screening Questions (ASQ)

The Ask Suicide-Screening Questions (ASQ) is a 5-item self-report questionnaire designed to assess suicide risk. Suicidal ideation is best assessed by first meeting with the patient alone as they are more likely to respond openly. A “yes” to any of the 5 ASQ items requires further assessment to determine the appropriate response. PCPs should inquire about: past and present suicidal thoughts/gestures, whether the youth has a detailed plan, and whether they have access to lethal means. After assessment, pediatric patients should be made aware that their responses will need to be shared with family members and other healthcare professionals, as necessary. The PCP should then bring the family in to create a safety plan together with the youth. Contact emergency services if imminent danger to self or others is suspected.

For more information and to access the ASQ: click here

To access a safety plan template: click here