RCADS Scoring · Revised Children's Anxiety and Depression Scale

The RCADS is a 47-item self-report measure of anxiety and depression symptoms in youth ages 8 to 18, organised into six DSM-aligned subscales.

About the RCADS

The Revised Children's Anxiety and Depression Scale was developed by Bruce Chorpita and colleagues, who revised the Spence Children's Anxiety Scale so that its items would map onto dimensions of several DSM anxiety disorders and major depression. The result is a single self-report measure that screens across the most common internalizing concerns in childhood and adolescence.

It is designed for young people roughly ages 8 to 18, with a matching parent-report version (RCADS-P) and shorter forms (such as the 25-item RCADS-25) for briefer screening or repeated monitoring. The RCADS, its norms, and its scoring spreadsheets are distributed by UCLA Child FIRST under a limited licence (free for individual clinical and educational use) and are widely used in schools, paediatric clinics, and measurement-based care.

What does the RCADS measure?

The RCADS covers six symptom domains:

• Separation Anxiety Disorder
• Social Phobia
• Generalized Anxiety Disorder
• Panic Disorder
• Obsessive-Compulsive Disorder
• Major Depressive Disorder

The five anxiety subscales combine into a Total Anxiety score, and all six combine into a Total Anxiety and Depression score, giving both a broad internalizing picture and a symptom-specific profile.

The RCADS-25 short form

The RCADS-25 has 25 items in two scales ^[3]:

• Total Anxiety (15 items). Ebesutani and colleagues found that all the anxiety items mainly reflected one broad anxiety dimension, so they built a 15-item anxiety scale with items drawn evenly from the five anxiety domains.
• Total Depression (10 items). The depression scale is kept whole from the full RCADS.

What it gives up is the profile: the short form has no separate separation anxiety, social phobia, generalized anxiety, panic or obsessive-compulsive subscales ^[3]. It was developed in a school sample of 1,060 and a clinic-referred sample of 303 young people, for repeated measurement in clinical settings and for wide-scale screening.

How do you give the RCADS?

The RCADS takes about 10–15 minutes to complete and is self-administered, with the parent-report RCADS-P collected in parallel when possible. Non-clinical staff can administer the form, but scoring requires the norm-based spreadsheet and a licensed clinician interprets the T-score profile alongside history and functional impact.

The RCADS-25 was built to reduce the burden and time of completing the scale, which suits repeated session-to-session monitoring ^[3]; it has youth self-report and caregiver versions.

How do you score and interpret the RCADS?

How to score the RCADS

Each of the 47 items is rated 0 (Never), 1 (Sometimes), 2 (Often), or 3 (Always).

• T-scores. Raw subscale sums are converted to age- and gender-standardized T-scores using the RCADS norms, because the symptom level expected of, say, a 9-year-old differs from that of a 16-year-old.
• Spreadsheet. Scoring is normally done with the official RCADS scoring spreadsheet, which applies the correct norm table.
• Direction. Higher T-scores indicate more symptoms relative to same-age, same-gender peers.

How to score the RCADS-25

1. Rate each of the 25 items 0 (Never), 1 (Sometimes), 2 (Often) or 3 (Always) ^[4].
2. Add the depression items (1, 4, 8, 10, 13, 15, 16, 19, 21 and 24) for Total Depression, raw 0 to 30 ^[4].
3. Add the other 15 items for Total Anxiety, raw 0 to 45, and all 25 for Total Anxiety and Depression ^[4].
4. Prorate missing items within a scale: divide the sum of the completed items by the number completed, multiply by the number of items in the scale, and round. Do not score Total Depression with more than 2 items missing, or Total Anxiety with more than 3 ^[4].
5. Convert each raw score to a T-score using the RCADS-25 tables for the young person's grade level and gender; grade is age in years minus 6 ^[4]. A raw score is not read against fixed cutoffs, because the same raw score means different things at different grades.

RCADS T-score bands

These T-score thresholds follow the RCADS scoring guidance (Chorpita). They are applied per subscale, so a young person can fall in the clinical range on one subscale while staying within the normal range on others. A clinical-range T-score is a positive screen that warrants a full clinical evaluation; it is a screening result, not a clinical conclusion.

Psychometric properties

• Original study. The factor structure was tested in a school sample of 1,641 children and adolescents and matched dimensions of DSM-IV anxiety disorders and depression; reliability and validity analyses in a second sample of 246 young people supported it ^[1].
• Short form. The RCADS-25's 15-item Total Anxiety scale corresponded with anxiety diagnoses from structured clinical interviews. Its 10-item Depression scale had acceptable reliability (Cronbach's α .80 in the clinic sample and .79 in the school sample), unlike an earlier 5-item short depression scale (α .63) ^[3].
• German community norms. In 1,562 schoolchildren aged 8 to 17, Cronbach's α ranged from 0.73 to 0.96 across the total and six subscales, the six-factor model fit better than one- and two-factor models, and scores correlated with quality of life and functional impairment. The study also provides normative data ^[2].

Limitations

• Screening, not a clinical conclusion. A clinical-range T-score indicates symptoms consistent with an anxiety or depressive disorder and warrants full evaluation.
• Norm-dependent scoring. T-scores rely on the reference norms; using local or version-matched norms matters for accuracy.
• Length and informant. At 47 items it is longer than single-domain screens; pair self- and parent-report and interpret divergence, especially in younger children.
• Short form trades detail for speed. The RCADS-25 gives anxiety and depression totals only, so it cannot show which anxiety domain is driving a high score ^[3]; use the full RCADS when that profile matters.

For a briefer youth anxiety screen, consider the SCARED; for depression alone, the MFQ; for adults, the GAD-7 and PHQ-9.

Billing the RCADS (CPT 96127)

RCADS administration qualifies for reimbursement under CPT code 96127 (brief emotional/behavioural assessment) when it is scored and documented with clinical interpretation. Medicare's Medically Unlikely Edit caps 96127 at 4 units per date of service; commercial payer limits vary, so confirm your contract. Self-report and parent-report forms completed in the same encounter may each be billed as a separate unit.