SCARED (Child Anxiety Screen)
The SCARED (Screen for Child Anxiety Related Emotional Disorders) is a 41-item questionnaire, with parallel child self-report and parent-report forms, that screens for anxiety symptoms over the past three months in children and adolescents aged 8–18. It covers panic/somatic, generalized anxiety, separation anxiety, social anxiety and school avoidance, and a total of 25 or higher indicates a possible anxiety disorder.
SCARED Score Interpreter
Possible anxiety disorder; a structured clinical interview is warranted.
41 items rated 0–2 (child or parent form); total 0–82. Subscale cutoffs are evaluated separately from the total.
| Total score | Interpretation |
|---|---|
| 25+ | At or above cutoff (≥25)Possible anxiety disorder; a structured clinical interview is warranted. |
| 0–24 | Below cutoff (<25)Below the total-score threshold. A child can still screen positive on a subscale; review subscale scores and the other informant's report. |
Birmaher B et al. (1997, 1999). J Am Acad Child Adolesc Psychiatry. Conventional total-score cutoff of 25 or greater (see also Trafalis et al., 2021). Educational reference only — not a diagnostic tool.
For reference only — not an assessment, diagnosis, or medical advice. This page provides scoring reference material; interpretation and clinical decisions rest with a qualified clinician.
Foundational Context
The Screen for Child Anxiety Related Disorders was developed by Birmaher and colleagues (1997) at Western Psychiatric Institute and Clinic to address the lack of validated, comprehensive pediatric anxiety screening tools available at the time. Childhood anxiety disorders are among the most prevalent psychiatric conditions in youth, yet frequently go undetected in clinical and school settings. The SCARED was designed to distinguish anxiety from other pediatric psychiatric conditions and to differentiate among specific anxiety disorder presentations using a single scale.
The SCARED exists in two parallel versions, a child self-report form and a parent-report form, enabling multi-informant assessment, which is recommended practice in pediatric mental health evaluation. Both versions use identical item sets, allowing direct comparison of child and parent perspectives. Check the copyright holder's terms before clinical or commercial use. The SCARED has been translated into numerous languages, contributing to broad international adoption.
What the SCARED measures
The SCARED is a 41-item scale that assesses anxiety symptoms over the past three months in children and adolescents ages 8–18 across five subscales:
- Panic Disorder / Somatic Symptoms (13 items): Physical anxiety symptoms, unexpected fear, and panic-like episodes
- Generalized Anxiety Disorder (9 items): Worry across multiple domains, restlessness, difficulty controlling worry
- Separation Anxiety Disorder (8 items): Fear of separation from caregivers, school avoidance tied to separation concerns
- Social Anxiety Disorder (7 items): Fear of embarrassment, avoidance of social situations, self-consciousness
- School Avoidance (4 items): Reluctance or refusal to attend school
Each item is rated on a 3-point scale: 0 (not true or hardly ever true), 1 (sometimes true), 2 (very true or often true). Total score: 0–82.
How to administer the SCARED
- Child version appropriate for ages 8–18; parent version spans the full pediatric age range
- Self-administered in approximately 10 minutes
- Check the copyright holder's terms before clinical or commercial use
- Multi-informant administration (child + parent) is recommended and strengthens diagnostic confidence
- Administered digitally or on paper; digital formats can facilitate subscale scoring
- Should be followed by structured clinical interview when scores exceed cutoffs
SCARED scoring and interpretation
Total score threshold:
- ≥25: Suggests possible anxiety disorder; further clinical evaluation recommended
Use the score interpreter above to check a total against this threshold.
What are the SCARED subscale cutoffs?
| Subscale | Items | Cutoff |
|---|---|---|
| Panic Disorder / Somatic Symptoms | 13 | 7 or above |
| Generalized Anxiety Disorder | 9 | 9 or above |
| Separation Anxiety Disorder | 8 | 5 or above |
| Social Anxiety Disorder | 7 | 8 or above |
| School Avoidance | 4 | 3 or above |
A total score of 25 or above suggests a possible anxiety disorder. Subscale cutoffs are evaluated independently of the total — a child can screen positive on a subscale without reaching the total threshold.
Interpretation Notes:
- Subscale scores can help guide differential diagnosis of specific anxiety disorder presentations.
- Parent and child scores frequently diverge; both perspectives are clinically informative. Children tend to report internalized experiences more accurately; parents may better detect behavioural manifestations.
- A score above the total cutoff without elevated subscale scores may indicate diffuse, subthreshold anxiety rather than a discrete disorder.
- Results should always be integrated with clinical interview and developmental, family, and school history.
- The SCARED does not diagnose anxiety disorders, it identifies youth who warrant further evaluation.
Psychometric properties
Reliability
- Good internal consistency for the total and five factor scores of both forms (alpha .74 to .93) in the development sample of 341 youth and 300 parents (Birmaher et al., 1997)
- Test-retest reliability ICC .70 to .90 over an average of 5 weeks (Birmaher et al., 1997)
- Moderate parent-child agreement (r = .20 to .47) (Birmaher et al., 1997)
Validity
- Sensitivity 71%, specificity 67% at total score ≥25 for any anxiety disorder (Birmaher et al., 1997)
- Subscale validity supported for differentiating panic, social anxiety, GAD, and separation anxiety
- Discriminates anxiety from depression and disruptive behaviour disorders; correlates more strongly with internalizing than externalizing problems on the CBCL (Monga et al., 2000)
- Well-validated across diverse racial/ethnic and socioeconomic groups
Limitations
- Does not assess obsessive-compulsive disorder (OCD) or PTSD, separate measures are required for these conditions
- Age-normed cutoffs are not well-established; current cutoffs were derived from initial validation samples
- Subscale specificity is moderate, overlapping symptoms across anxiety disorders reduce distinct subscale differentiation
- School avoidance may be driven by factors other than anxiety (e.g., peer conflict, learning difficulties), requires contextual clarification
- Self-report accuracy may be reduced in younger children (ages 8–10) due to limited metacognitive awareness
This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.
Frequently Asked Questions
What total SCARED score suggests an anxiety disorder?
A total SCARED score of 25 or above suggests that an anxiety disorder may be present and warrants further clinical evaluation. This threshold was established in the original 1997 validation study by Birmaher and colleagues, with sensitivity of 71% and specificity of 67% for detecting any anxiety disorder in a clinical sample. Exceeding this threshold does not constitute a diagnosis; it indicates that a structured clinical interview is warranted.
Is the SCARED self-report or clinician-administered?
The SCARED is a self-report questionnaire. It exists in two parallel forms — one completed by the child or adolescent (ages 8–18) and one completed by a parent or caregiver — using the same 41 items and scoring. Clinicians are not required to administer it directly, though they review and interpret the results. Multi-informant administration (both child and parent versions) is recommended to capture differing perspectives on the child's anxiety.
Can the SCARED diagnose anxiety disorders?
No. The SCARED is a screening tool designed to identify children and adolescents who may warrant further evaluation, not to provide a diagnosis. A score at or above the total or subscale cutoffs indicates elevated anxiety symptoms consistent with a possible disorder, but diagnosis requires a structured clinical interview incorporating developmental, family, and contextual history.
How is the SCARED scored and what is the maximum score?
Each of the 41 items is rated on a 3-point scale: 0 (not true or hardly ever true), 1 (sometimes true), or 2 (very true or often true). All items are summed to produce a total score ranging from 0 to 82. Subscale scores are calculated by summing items within each of the five subscale groups: Panic Disorder/Somatic (13 items), Generalized Anxiety (9 items), Separation Anxiety (8 items), Social Anxiety (7 items), and School Avoidance (4 items).
Bill this assessment
In the US, the SCARED (Child Anxiety Screen) is usually billed under these CPT codes. Payer rules vary.
Using this assessment in practice
For clinicians
Send it as a gentle check-in before the session. The score is waiting when you open the chart, and the trend builds itself.
For individuals
This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
References
- 1.Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, Neer SM. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-53.View source
- 2.Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry. 1999;38(10):1230-6.View source
- 3.Monga S, Birmaher B, Chiappetta L, Brent D, Kaufman J, Bridge J, Cully M. Screen for Child Anxiety-Related Emotional Disorders (SCARED): convergent and divergent validity. Depress Anxiety. 2000;12(2):85-91.View source
- 4.Trafalis S, Giannini C, Joves J, Portera S, Toyama H, Mehta A, Basile K, Friedberg RD. A pediatrician-friendly review of three common behavioral health screeners in pediatric practice: Findings and recommendations. Pediatr Investig. 2021;5(1):58-64.View source
Last reviewed: Jun 3, 2026
Related Assessments
Explore complementary clinical tools and screeners