How To Interpret Your Child’s Pediatric Symptom Checklist

When you are concerned that your child may have a problem with his or her behavior, emotions, or learning, the pediatric symptom checklist can help you decide if there is a problem.

Yesterday on the blog, I printed a copy of the pediatric symptom checklist which is used for determining possible problems in children’s psychosocial functioning. You can see the questionnaire by going to yesterday’s post Childhood Problem with Behavior, Learning, or Emotion? Pediatric Symptom Checklist. You can instead print out a pdf of the questionnaire here if you prefer a pdf.*

How you score the pediatric symptom checklist**

There are 35 questions on the pediatric symptom checklist (PSC). Each question is answered by “never” which is scored a zero, “sometimes” which is scored as one, or “often” and scored as two. Add up all the points from the 35 questions. So the score can be anywhere from 0 to 70. If you missed from 1 to 3 questions (that is you, you left them blank) simply score those questions as zero. However, if you left for or more of the questions unanswered you can’t use that questionnaire as it is considered invalid.

If the child is between age 6 years and 18 years, then the cutoff score is 28. This means that if the total score is 28 or more than the child is impaired (this means that the child may have a significant problem). If the total score is 27 or less than the child is considered not impaired.

For children who are aged three years to five years, ignore (meaning don’t score these questions) question 5, 6, 17, and 18. These questions don’t apply to preschoolers because they are about elementary school items. So for preschoolers there’s only 31 questions to be answered.

For preschool children aged three years to five years, the cutoff score is 24 or greater.

If your child has a score of 28 or more (for children aged six years to 18 years) or a score of 24 or greater for preschoolers (children from three years old to five years old), then you should take the form with you to your doctor for further evaluation.

What a positive pediatric symptom checklist score means

Studies of the PSC suggest that for every three children who has a score of 28 or more for school-aged children or 24 or more for preschoolers two of those three children will have moderate to serious impairment in some aspect of psychosocial functioning. The third child will usually have at least mild impairment. A small number of children with a positive score won’t have any serious or even mild psychosocial impairment (these are normally functioning children whose parents are perhaps very anxious for them).

In the past, the PSC has proved to be very accurate. Nineteen out of twenty children who have a normal PSC screen will be functioning normally. However, no test is perfect and there is a slight chance that a child rated as normal functioning on the test has a significant impairment.

All tests have false positives (children identified as having a problem who really don’t) and false negatives (children identified as not having any problems who actually do). That’s why you want to talk to your doctor if you have a concern about your child even if the test is normal.

*The PSC is availableas a pdf for download at http://www.massgeneral.org/psychiatry/assets/PSC-35.pdf

**How to score the PSC at http://www.massgeneral.org/psychiatry/services/psc_scoring.aspx

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