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SPENCE CHILDREN’S ANXIETY SCALE

Your Name: DATE:

1. I WORRY ABOUT THINGS......................................................…………........…................

2. AM SCARED OF THE DARK......................................................…………........…..............

3. WHEN I HAVE A PROBLEM, I GET A FUNNY FEELING IN MY STOMACH…............…............

4. I FEEL AFRAID...................................................................………..………....................

5. I WOULD FEEL AFRAID OF BEING ON MY OWN AT HOME......…………………...................

6. I FEEL SCARED WHEN I HAVE TO TAKE A TEST.......................………………....................

7. I FEEL AFRAID IF I HAVE TO USE PUBLIC TOILETS OR BATHROOMS...........……..................

8. I WORRY ABOUT BEING AWAY FROM MY PARENTS......................………………..............

9. I FEEL AFRAID THAT I WILL MAKE A FOOL OF MYSELF IN FRONT OF PEOPLE.......................

10. I WORRY THAT I WILL DO BADLY AT MY SCHOOL WORK...............…………..…..............

11. I AM POPULAR AMONGST OTHER KIDS MY OWN AGE.................……………..….............

12. I WORRY THAT SOMETHING AWFUL WILL HAPPEN TO SOMEONE IN MY FAMILY.................

13. I SUDDENLY FEEL AS IF I CAN’T BREATHE WHEN THERE IS NO REASON FOR THIS...............

14. I HAVE TO KEEP CHECKING THAT I HAVE DONE THINGS RIGHT (LIKE THE SWITCH

IS OFF, OR THE DOOR IS LOCKED).....……………………………………......................

15. I FEEL SCARED IF I HAVE TO SLEEP ON MY OWN....................……………….…...............

16. I HAVE TROUBLE GOING TO SCHOOL IN THE MORNINGS BECAUSE I FEEL NERVOUS

OR AFRAID...................................................…………………………........................

17. I AM GOOD AT SPORTS....................................………………........................................

18. I AM SCARED OF DOGS.....................................................……………….......................

19. I CAN’T SEEM TO GET BAD OR SILLY THOUGHTS OUT OF MY HEAD...………….................

20. WHEN I HAVE A PROBLEM, MY HEART BEATS REALLY FAST....………………..................

21. I SUDDENLY START TO TREMBLE OR SHAKE WHEN THERE IS NO REASON FOR THIS............

22. I WORRY THAT SOMETHING BAD WILL HAPPEN TO ME...…........………………................

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File Number:

(Replace this text with Clinician's Name)

Administered By:

SCAS Boys 8-11

SPENCE CHILDREN’S ANXIETY SCALE

DATE:

23. I AM SCARED OF GOING TO THE DOCTORS OR DENTISTS.........…………………...............

24. WHEN I HAVE A PROBLEM, I FEEL SHAKY...............................……………….................

25. I AM SCARED OF BEING IN HIGH PLACES OR LIFTS (ELEVATOR)…………………..............

26. I AM A GOOD PERSON......................................................…………...…….....................

27. I HAVE TO THINK OF SPECIAL THOUGHTS TO STOP BAD THINGS FROM HAPPENING

(LIKE NUMBERS OR WORDS).......................………………………….…...................

28. I FEEL SCARED IF I HAVE TO TRAVEL IN THE CAR, OR ON A BUS OR A TRAIN.....................

29. I WORRY WHAT OTHER PEOPLE THINK OF ME......................…………………..................

30. I AM AFRAID OF BEING IN CROWDED PLACES (LIKE SHOPPING CENTRES, THE

MOVIES, BUSES, BUSY PLAYGROUNDS).........…………………………………..........

31. I FEEL HAPPY...............................................................................………......................

32. ALL OF A SUDDEN I FEEL REALLY SCARED FOR NO REASON AT ALL……………..............

33. I AM SCARED OF INSECTS OR SPIDERS.....................................……………….................

34. I SUDDENLY BECOME DIZZY OR FAINT WHEN THERE IS NO REASON FOR THIS....................

35. I FEEL AFRAID IF I HAVE TO TALK IN FRONT OF MY CLASS.....…………………................

36. MY HEART SUDDENLY STARTS TO BEAT TOO QUICKLY FOR NO REASON…………............

37. I WORRY THAT I WILL SUDDENLY GET A SCARED FEELING WHEN THERE IS NOTHING

TO BE AFRAID OF....................................…………………………….......................

38. I LIKE MYSELF................................................................……………...........................

39. I AM AFRAID OF BEING IN SMALL CLOSED PLACES, LIKE TUNNELS OR SMALL ROOMS.......

40. I HAVE TO DO SOME THINGS OVER AND OVER AGAIN (LIKE WASHING MY HANDS,

CLEANING OR PUTTING THINGS IN A CERTAIN ORDER)...………………………..........

41. I GET BOTHERED BY BAD OR SILLY THOUGHTS OR PICTURES IN MY MIND…………..........

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File Number:

SPENCE CHILDREN’S ANXIETY SCALE

DATE:

42. I HAVE TO DO SOME THINGS IN JUST THE RIGHT WAY TO STOP BAD THINGS

HAPPENING................................................…………………….……......................

43. I AM PROUD OF MY SCHOOL WORK.......................................…….……….....................

44. I WOULD FEEL SCARED IF I HAD TO STAY AWAY FROM HOME OVERNIGHT………............

45. Is there something else that you are really afraid of? .....…………...............................

46. PLEASE WRITE DOWN WHAT IT IS:

HOW OFTEN ARE YOU AFRAID OF THIS THING?

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File Number:

______________________________________

(Replace this text with Clinician's Name)

Administered By: ______________________________________

Client Signature:

______________________________________

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Adult Guardian:

Parent:

STOP. You have completed the SCAS.

SPENCE CHILDREN’S ANXIETY SCALE

CLIENT’S NAME: DATE:

SCORE RESULTS

PANIC ATTACK AND AGORAPHOBIA: …...................

SEPARATION ANXIETY: ………………....................

PHYSICAL INJURY FEARS: ……………....................

SOCIAL PHOBIA: ………………………...................

OBSESSIVE COMPULSIVE: ……………....................

GENERALIZED ANXIETY DISORDER: ……................

TOTAL SCAS SCORE: …………………...................

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File Number:

(Replace this text with Clinician's Name)

Administered By: ______________________________________

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SCAS Boys 8-11

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