Pediatric Screening (Ages 6-16)

The following PSC screening is for educational purposes only.  Your answers to the following questions will be compared to those given by subjects with and without anxiety concerns.

Emotional and physical health go together in children. Because parents are often the first to notice a problem with their child’s behavior, emotions, or learning, you may help your child get the best care possible by answering these questions.

Directions: Please indicate which statement best describes your child.

Cognitive, Emotional and Behavioral Screening (Ages 6-16)


1. Complains of aches and pains

2. Spends more time alone

3. Tires easily, has little energy

4. Fidgety, unable to sit still

5. Has trouble with teacher

6. Less interested in school

7. Acts as if driven by a motor

8. Daydreams too much

9. Distracted easily

10. Is afraid of new situations

11. Feels sad, unhappy

12. Is irritable, angry

13. Feels hopeless

14. Has trouble concentrating

15. Less interested in friends

16. Fights with other children

17. Absent from school

18. School grades dropping

19. Is down on him or herself

20. Visits the doctor with doctor finding nothing wrong

21. Has trouble sleeping

22. Worries a lot

23. Wants to be with you more than before

24. Feels he or she is bad

25. Takes unnecessary risks

26. Gets hurt frequently

27. Seems to be having less fun

28. Acts younger than children his or her age

29. Does not listen to rules

30. Does not show feelings

31. Does not understand other people’s feelings

32. Teases others

33. Blames others for his or her troubles

34. Takes things that do not belong to him or her

35. Refuses to share

Please complete and receive your results by email:

The above PSC screening is to be used for educational purposes only.  It is not intended to replace advise given by a qualified medical professional.  Emotional, behavioral and learning isues have profound effects on health and well being and therefore should be evaluated by a qualified medical professional.

The Pediatric Screening is adapted from the PSC.. All rights reserved.