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The Review Course in Family Medicine

Anxiety-focused Assessment for Children and Youth

The Canadian Pediatric Society has new guidance to help assess children and adolescents with anxiety disorders.


Remember: these can remit and relapse, presenting differently at different developmental stages.


Here are the FIVE essential components of the anxiety-focused assessment: 1. Self/ parent reported symptoms and functioning

a. Assess for hyperarousal, avoidance, and excessive worry

b. Allow verbal children to describe their thoughts and feelings 2. Medical, developmental, social, and mental health history a. Understand location (e.g. learning disorders and school-based anxiety) and social context (e.g. poverty, racism) 3. Structured history taking tools and standardized rating scales* a. SSHADESS- screening and counseling topics for adolescents b. SCARED: self/parent reported screening tool for severity 4. Review other assessments a. Incorporate school, early child care and other HCP assessments 5. Observation of child and child-parent interaction a. Overprotective or clingy behavior in child- parent interactions

b. Features of anxiety in the parent


*More tools available at:


Fear is a normal part of development. So, when do you call it ‘anxiety’?









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