4-60 months

Available within CHADIS in both English and Spanish, the Ages & Stages Questionnaires® are parent-report tools designed to screen for developmental problems among infants, toddlers, and young children. Nineteen separate questionnaires are available for children of different ages (at two-month intervals between 4 and 24 months, at 3 month intervals between 24 and 36 months, and at 6 month intervals between 36 and 60 months). Each questionnaire includes 6 "yes/no" questions in each of 5 domains: Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social. The ASQ is among those measures endorsed for general developmental screening by the American Academy of Pediatrics (2006) and the American Academy of Neurology (Filipek et al., 2000) as well as First Signs (www.firstsigns.org). The Ages & Stages Questionnaires® User's Guide is available online.

Bricker, Squires, Mounts, Potter, Nickel, Twombly, & Farrell

Paul H. Brookes Publishing Co.

American Academy of Pediatrics (2006). Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics 118(1) 405-420.

Bricker, D., Squires, J., Mounts, L., Potter, L., Nickel, R., Twombly, E., & Farrell, J. (1999). Ages & Stages Questionnaires®. Ages & Stages Questionnaires®, Second Edition. Baltimore, MD: Paul H. Brookes Publishing Co.

Filipek, P.A., Accardo, P.J., Ashwal, S., Baranek, G.T., Cook, E.H., Dawson, G., et al. (2000). Practice parameter: Screening and diagnosis of autism. Neurology 55: 468-479.

4-60 months

The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) are parent-report tools designed to screen for developmental problems among infants, toddlers, and young children. Twenty separate questionnaires are available in both English and Spanish for children of different ages (at two-month intervals between 2 and 24 months, at 3 month intervals between 24 and 39 months, and at 6 month intervals between 36 and 60 months). Each questionnaire includes 6 "yes/sometimes/not yet" questions in each of 5 domains: Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social. The ASQ is among those measures endorsed for general developmental screening by the American Academy of Pediatrics (2006) and the American Academy of Neurology (Filipek et al., 2000), as well as First Signs (www.firstsigns.org).

Jane Squires & Diane Bricker

2009 Paul H. Brookes Publishing Co.

Squires & Bricker. Ages & Stages Questionnaires®: A Parent-Completed Child Monitoring System, Third Edition (ASQ-3). Baltimore: Paul H. Brookes Publishing Co., Inc. Copyright © 2009 by Paul H. Brookes Publishing Co., Inc. All rights reserved.

Ages & Stages Questionnaires® in Spanish, Third Edition (ASQ-3 Spanish), Squires & Bricker. © 2009 Brookes Publishing Co.

American Academy of Pediatrics (2006). Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics 118(1) 405-420.

Filipek, P.A., Accardo, P.J., Ashwal, S., Baranek, G.T., Cook, E.H., Dawson, G., et al. (2000). Practice parameter: Screening and diagnosis of autism. Neurology 55: 468-479.

0-18 months

Screener assessing developmental delay across five domains: social, gross motor, fine motor, self help and language.

Harold Ireton

Behavioral Science Systems

Harold Ireton

Ireton, H. (2005). Child Development Inventory. Minneapolis: Behavioral Science Systems.

18-36 months

Available within CHADIS in both English and Spanish, the M-CHAT is included in CHADIS as a tool for ASD screening. The 23-item M-CHAT is a parent-report checklist derived from the Checklist for Autism in Toddlers (CHAT; Baron-Cohen, Allen, & Gillberg, 1992). A "risk" score is obtained when a parent endorses any 2 items considered "critical" (items 2, 7, 9, 13, 14, and 15), or any 3 items overall. The M-CHAT is the most widely used and best validated of the ASD screening tools that do not require observation by a professional. A clinician-administered follow-up interview has been adapted in CHADIS for immediate office administration through prompts for the clinician to ask child specific items (see MCHAT Follow-Up).

Robins, Fein, & Barton

1999

Robins, D., Fein, D., Barton, M., & Green, J. (2001). The Modified-Checklist for Autism in Toddlers (M-CHAT): An initial investigation in the early detection of autism and Pervasive Developmental Disorders. Journal of Autism and Developmental Disorders, 31 (2), 131-144.

0-48 months

A series of questionnaires developed at our Center based on the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; Zero to Three, 2005). Questionnaires assess five major functional domains: sleep; feeding; regulation; life events, and mood/anxiety.

Adapted from Zero to Three by the Center for Promotion of Child Development through Primary Care

Zero to Three (2005). Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. Washington, DC: Author.

Sturner, R. A., Albus, K., Thomas, J., & Howard, B. (2007). A Proposed Adaptation of DC: 0-3 for Primary Care, Developmental Research and Prevention of Mental Disorders. Infant Mental Health Journal 28 (1) 1-11.

0-8 years

The PEDS is a brief questionnaire assessing parents' appraisals of their children's development.

Frances Page Glascoe, Ellsworth and Vandermeer Press

1997

Glascoe, F.P. (1997). Parents’ Evaluation of Developmental Status. Nashville, TN: Ellsworth and Vandermeer Press.

18-60 months

Screener for emotional/behavioral problems in young children, with additional items assessing parent emotional functioning.

M. Gleason

Gleason, M.M., Dickstein S., & Zeanah, C.H. (in press). Recognizing young children in need of mental health assessment: Development and preliminary validity of the Early Childhood Screening Assessment. Infant Mental Health Journal.

Infancy through adolescence

A brief questionnaire assessing difficulties with children's emotions, concentration, behavior, and social skills that may affect the child and family. Initial and follow-up parent-report versions are available for children ages 0-3 and for children 4 and up. Initial and follow-up child self-report versions are available for children age 11 and up.

Robert Goodman

None available.

0-8 years

The PEDS is a brief questionnaire assessing parents' appraisals of their children's development.

Frances Page Glascoe, Ellsworth and Vandermeer Press

1997

Glascoe, F.P. (1997). Parents' Evaluation of Developmental Status. Nashville, TN: Ellsworth and Vandermeer Press.

 3-12 years

A series of algorithmic questionnaires triggered by parent concerns, based on the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and Diagnostic and Statistical Manual for Primary Care (DSM-PC), Child and Adolescent Version. These questionnaires cover all major mental health domains and result in provisional diagnoses of disorder, problem or variation.

Adapted from the American Academy of Pediatrics by the Center for Promotion of Child Development through Primary Care

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: Author.

American Academy of Pediatrics (1996). Diagnostic and Statistical Manual for Primary Care (DSM-PC), Child and Adolescent Version.  Elk Grove Village, IL: Author.

6-12 years

The Vanderbilt Assessment Scales were designed to diagnose and track ADHD symptoms over time as well as screen for comorbid problems, including conduct disorder, oppositional defiant disorder, and anxiety and depression.

The follow-up scales include the 18 core ADHD symptoms from the initial Vanderbilt, as well as the same Performance items.

Note: new versions coming soon.

American Academy of Pediatrics and National Initiative for Children's Healthcare Quality

2002

Wolraich, M.L., Hannah, J.N., Pinnock, T.Y., et al. (1996). Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. Journal of the American Academy of Child Adolescent Psychiatry 35:319-324.

6 years and up

Brief questionnaire intended for completion by parents (not teachers) assessing child/adolescent use of medications for attention, behavior, and emotions. Assesses medications used, doses, and medication compliance for each.

Center for Promotion of Child Development through Primary Care

6 years and up

Adapted from the NICHQ Vanderbilt Assessment by our Center, this brief screen assesses possible side effects of medications for attention, behavior, and emotions. Both parent- and teacher-report versions are available.

Adapted from the Vanderbilt Assessment Scales by the Center for Promotion of Child Development through Primary Care

0-8 years

The PEDS is a brief questionnaire assessing parents' appraisals of their children's development.

Frances Page Glascoe, Ellsworth and Vandermeer Press

1997

Glascoe, F.P. (1997). Parents’ Evaluation of Developmental Status. Nashville, TN: Ellsworth and Vandermeer Press.

18-60 months

Screener for emotional/behavioral problems in young children, with additional items assessing parent emotional functioning.

M. Gleason

Gleason, M.M., Dickstein S., & Zeanah, C.H. (in press). Recognizing young children in need of mental health assessment: Development and preliminary validity of the Early Childhood Screening Assessment. Infant Mental Health Journal.

Infancy through adolescence

A brief questionnaire assessing difficulties with children's emotions, concentration, behavior, and social skills that may affect the child and family. Initial and follow-up parent-report versions are available for children ages 0-3 and for children 4 and up. Initial and follow-up child self-report versions are available for children age 11 and up.

Robert Goodman

None available.

8-17 years

A 41-item questionnaire assessing anxiety in children and adolescents. Both parent-report and child self-report versions are available.

Boris Birmaher, M.D., Suneeta Khetarpal, M.D., Marlane Cully, M.Ed., David Brent M.D., and Sandra McKenzie, Ph.D.

Monga, S., Birmaher, B., Chiappetta, L., Brent, D., Kaufman, J., Bridge, J., & Cully, M. (2000). Screen for child anxiety-related emotional disorders (SCARED): Convergent and divergent validity. Depression and Anxiety 12(2): 85-91.

13-18 years

Adolescent self-report measure which covers depression, anxiety, eating disorders, and substance abuse.

Jeffrey Johnson, PhD Robert Spitzer, MD, Kurt Kroenke, M.D., Janet B. W. Williams, D.S.W

2002

Johnson et al. (2002). Patient Health Questionnaire for Adolescents (PHQ-A). Journal of Adolescent Health.

11-16 years

35-item adolescent self-report screen assessing internalizing and externalizing symptomatology (note typo: ‘symptomology’)

Pagano, Cassidy, Murphy, Little, & Jellinek

1999

Pagano, M.E., Cassidy, L.J., Murphy, J.M., Little, M., Jellinek, M.S. (1999). Identifying school-age children at risk: The Pediatric Symptom Checklist as a self-report measure. Psychology in the Schools.

 11-17 years

This questionnaire was developed based on the CHAMPS version of the American Medical Association’s Guidelines for Adolescent Preventive Services (GAPS). Designed for youth self-report, the questionnaire assesses youth risk behavior including diet, exercise, violence exposure, and sexual behavior.

Black, Santelli, Kruse & Gordon

Black, M.M., Santelli, J.S., Kruse, L., & Gordon, J.L. (1998). CHAMPS: A Computerized Health Assessment for Adolescents.

13-19

The Kutcher Adolescent Depression Scale (KADS) is a 6-item self-report scale that was designed specifically to diagnose and assess the severity of adolescent depression.

Sarah Brooks, MD

LeBlanc JC, Almudevar A, Brooks SJ, Kutcher S: Screening for Adolescent Depression: Comparison of the Kutcher Adolescent Depression Scale with the Beck Depression Inventory, Journal of Child and Adolescent Psychopharmacology, 2002 Summer; 12(2):113-26.

13-19 years

The PHQ-9 is an adolescent self-report depression screener, including the nine depression items from the PHQ.

Kroenke, Spitzer, & Williams

 

Kroenke K, Spitzer R L, Williams J B. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 2001; 16(9): 606-613

Adolescent

The CRAFFT is a brief substance use risk assessment for completion by adolescents.

Children’s Hospital Boston; Reproduced with permission from the Center for Adolescent Substance Abuse Research, CeASAR, Children’s Hospital Boston

2001

Knight, J.R., Sherritt, L., Shrier, L.A., Harris, S.K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine 156(6) 607-614.

Infancy through adolescence

A brief questionnaire assessing difficulties with children's emotions, concentration, behavior, and social skills that may affect the child and family. Initial and follow-up parent-report versions are available for children ages 0-3 and for children 4 and up. Initial and follow-up child self-report versions are available for children age 11 and up.

Robert Goodman

None available.

8-17 years

A 41-item questionnaire assessing anxiety in children and adolescents. Both parent-report and child self-report versions are available.

Boris Birmaher, M.D., Suneeta Khetarpal, M.D., Marlane Cully, M.Ed., David Brent M.D., and Sandra McKenzie, Ph.D.

Monga, S., Birmaher, B., Chiappetta, L., Brent, D., Kaufman, J., Bridge, J., & Cully, M. (2000). Screen for child anxiety-related emotional disorders (SCARED): Convergent and divergent validity. Depression and Anxiety 12(2): 85-91.

Adult (postpartum)

The EPDS is a widely-used brief (10 item) assessment of postpartum depression in adults.

Cox, Holden, & Sagovsky

Cox, J.L., Holden, J.M., & Sagovsky, R. (1987).  Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry  150:782-786.

Adult

Screener for assessment of an adult's social support from family, friends, and significant other

Zimet, Dahlem, Zimet, & Farley

Zimet, G.D, Dahlem, N.W., Zimet, S.G., & Farley, G.K. (1988) The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment 52 (1): 30-41.

All

Available with CHADIS in both English and Spanish, the McMaster Family Assessment Device, General Functioning Subscale, provides a general assessment of family functioning. The measure includes 12 statements about family communication and support.

Epstein, Baldwin, & Bishop

Epstein, N.B., Baldwin, L.M., & Bishop, D.S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy 9(2): 171-180.3

Adult

Checklist of potential stressors and risk factors (financial problems, marital problems, etc.) developed at our Center based on the DSM-PC's "environmental situations" list

Adapted from the American Academy of Pediatrics by the Center for Promotion of Child Development through Primary Care

American Academy of Pediatrics (1996). Diagnostic and Statistical Manual for Primary Care (DSM-PC), Child and Adolescent Version.  Elk Grove Village, IL: Wolraich, M., Ed.

Adult

Three-item screen for domestic violence.

Feldhaus, Koziol-McLean, Amsbury, Norton, Lowenstein, & Abbott

Feldhaus, K.M., Koziol-McLain, J., Amsbury, H.L., Norton, I.M., Lowenstein, S.R., Abbott, J.T. (1997). Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. Journal of the American Medical Association, 277 (17):1357-1361

Prior to age 18

Questionnaire refers to adverse events in parents' lives prior to age 18

Felitti et al.

Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14 (4): 245-258.

All

Checklist of medical conditions (allergies, diabetes, depression, etc.) for which there is a history in the child's family

Center for Promotion of Child Development through Primary Care

0-5 years

Covers EPSDT health risks, including exposure to HIV, TB, lead, low fluoride, smoker, substance abuser, person with low immunity/chemotherapy, and live vaccine.

Center for Promotion of Child Development through Primary Care-based on EPSDT questions

Adapted from the Center for Communicable Diseases by The Center for Promotion of Child Development through Primary Care

0-17 years

These three distinct but overlapping assessments allow clinicians to assess visit priorities among parents of children of all ages, while choosing the length and complexity of the assessment desired.

• Topics I Want to Discuss at this Visit (Short Form): Asks parents a single question: “What do you most want to discuss at the upcoming visit?” Parents are asked to endorse one or two items. Response options cover the range of potential topics parents most often wish to discuss, and age-appropriate responses are offered to parents with children of differing ages.
• Topics I Want to Discuss at this Visit: Includes the visit prioritization item described above, plus a few agenda-broadening items assessing child strengths and parents’ perceptions as to the best and hardest parts of parenting. This version is favored by our CHADIS team as more likely to improve the parents overall experience with the visit and is the approach endorsed by the Mental Health Task Force of the AAP for check-up visits.
• Review of Systems and Visit Priorities: This questionnaire includes the visit prioritization, strengths, and best/hardest part items described above but also the opportunity to endorse additional items parents wish to discuss during their visit. Items endorsed as a priority for the visit result in follow-up items detailing the specifics of the parent’s concern, yielding a comprehensive review of systems.

We recommend that you review these tools and determine which one best suits the needs of your practice. Because of the significant overlap between items in these questionnaires, the use of more than one of the above for a single patient would result in redundancy.  

Center for Promotion of Child Development through Primary Care

0-11 years

Questions assessing general guidance topics to be covered in the context of the visit, as recommended by the AAP's Bright Futures Guidelines. Topics include dental care, media usage, use of interim medical services, and family practices around reading to the child.

Adapted from Hagan & Duncan by the Center for Promotion of Child Development through Primary Care

Hagan, J.F., & Duncan, P.M., Eds. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents; Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

0-11 years

Brief questionnaire assessing safety concerns (e.g. safety in the home, gun safety, water safety) as recommended by AAP's Bright Futures Guidelines.

Adapted from Hagan & Duncan by the Center for Promotion of Child Development through Primary Caree

Hagan, J.F., & Duncan, P.M., Eds. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents; Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

All

Questions assessing history of cardiac problems in child's family.

Center for Promotion of Child Development through Primary Care

6-12 years

The Vanderbilt Assessment Scales were designed to diagnose and track ADHD symptoms over time as well as screen for comorbid problems, including conduct disorder, oppositional defiant disorder, and anxiety and depression.

The follow-up scales include the 18 core ADHD symptoms from the initial Vanderbilt, as well as the same Performance items.

Note: new versions coming soon..

American Academy of Pediatrics and National Initiative for Children's Healthcare Quality

2002

Wolraich, M.L., Hannah, J.N., Pinnock, T.Y., et al. (1996). Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. Journal of the American Academy of Child Adolescent Psychiatry 35:319-324.

6 years and up

Brief questionnaire intended for completion by teachers, assessing both special services received by the student (IEP, preferential seating, aide, etc.) and disciplinary actions received (suspensions, office referrals, etc.)

Center for Promotion of Child Development through Primary Care

Three versions, for ages 3-9, 10-18 and 19-48 months

This parent questionnaire assesses the quality of preventive and developmental care received, including anticipatory guidance, family-centered care, and degree of follow-up for risk of developmental and behavioral problems. Individual respondents' results are not made available to clinicians, but can be included in group reports, facilitating quality improvement efforts.

Adapted from CAHMI by the Center for Child Development Through Primary Care

2002

Bethell, C., Peck, C., & Schor, E. (2001). Assessing Health System Provision of Well-Child Care: The Promoting Healthy Development Survey. Pediatrics 107 (5): 1084-1094.

Two versions, for ages 0-4 and 5-20 years

Tool designed to facilitate case evaluation and planning within systems.

1999, The Praed Foundation