C-FOCI: Children's Florida Obsessive Compulsive Inventory

About the C-FOCI

The Children's Florida Obsessive Compulsive Inventory (C-FOCI) was developed by Eric Storch and colleagues as a brief, self-report screening and monitoring tool for obsessive-compulsive disorder (OCD) in youth. It was designed to be practical for both clinical settings and research, requiring minimal administration time while providing meaningful information about symptom presence and severity.

The C-FOCI is the child-adapted version of the Florida Obsessive Compulsive Inventory (FOCI) and is appropriate for youth from approximately age 7 through 17, depending on reading level and cognitive ability. For younger children or those with limited literacy, clinician-administered or parent-assisted administration is recommended.

What the Assessment Measures

The C-FOCI consists of two components:

Part 1, Symptom Checklist A list of common OCD symptoms that the child marks as present or absent. Items span:

• Contamination obsessions and cleaning/washing compulsions
• Checking and ordering behaviors
• Intrusive thoughts (harm, religion, sexuality)
• Hoarding and collecting behaviors
• Repeating and counting rituals

Part 2, Severity Scale (5 items) Rated on a 0–4 scale, assessing:

1. Time occupied by obsessions and compulsions
2. Distress caused by symptoms
3. Interference with daily functioning
4. Difficulty resisting symptoms
5. Degree of control over symptoms

Scoring

Severity Scale total score: 0–20

A positive screen requires both the presence of at least one symptom on the checklist AND a severity scale score ≥8.

Psychometric Properties

The C-FOCI has demonstrated strong psychometric properties across clinical and community samples:

• Good internal consistency (Cronbach's α ≈ 0.80–0.87)
• Adequate test-retest reliability
• Significant correlation with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), supporting convergent validity
• Sensitivity and specificity for OCD diagnosis comparable to lengthier measures

(Storch et al., 2009; Piqueras et al., 2017)

Clinical Considerations

• The C-FOCI is a screening and monitoring tool, not a diagnostic instrument. A positive screen should prompt further clinical evaluation.
• The severity scale is particularly useful for tracking treatment response over time.
• Children with limited self-awareness about their symptoms may underreport; parental report and direct observation should supplement self-report data.

Who the C-FOCI Is For

Appropriate when:

• The client is a child or adolescent (approximately ages 7–17)
• You are screening for OCD symptom presence or monitoring treatment response
• A brief, self-administered measure is needed in a clinical or research context

References

• Storch EA, Khanna M, Merlo LJ, et al. (2009). Children's Florida Obsessive Compulsive Inventory: psychometric properties and feasibility of a self-report measure of obsessive-compulsive symptoms in youth. Child Psychiatry and Human Development, 40(3), 467–483. PMID: 19326209
• Piqueras JA, Rodríguez-Jiménez T, Ortiz AG, et al. (2017). Factor Structure, Reliability, and Validity of the Spanish Version of the Children's Florida Obsessive Compulsive Inventory (C-FOCI). Child Psychiatry and Human Development, 48(1), 116–127. PMID: 27283942