The Spence Children's Anxiety Scale was developed to assess the severity of anxiety symptoms broadly in line with the dimensions of anxiety disorder proposed by the DSM-IV.
The scale assesses six domains of anxiety including generalized anxiety, panic/agoraphobia, social phobia, separation anxiety, obsessive compulsive disorder and physical injury fears. It is designed to be relatively easy and quick for children to complete, normally taking only around 10 minutes to answer the questions. Young people are asked to rate the degree to which they experience each symptom on a 4-point frequency scale.
This measure consists of 44 items, of which 38 reflect specific symptoms of anxiety and 6 relate to positive, filler items to reduce negative response bias. Of the 38 anxiety items, 6 reflect separation anxiety, 6 social phobia, 6 obsessive compulsive problems, 6 panic/3 agoraphobia, 6 generalized anxiety/overanxious symptoms and 5 items concern fears of physical injury. Items are randomly allocated within the questionnaire. Children are asked to rate on a 4 point scale involving never (0), sometimes (1), often (2), and always (3), the frequency with which they experience each symptom. The instructions state "Please put a circle around the word that shows how often each of these things happen to you. There are no right and wrong answers". There are six positively worded filler items.
Development of the Scale
The items were selected from an initial pool of 80 items generated to reflect a broad spectrum of anxiety symptoms. The items were selected from a review of existing literature, clinical experience of 4 clinical psychologists who specialized in anxiety disorders, existing child anxiety assessment measures, structured clinical interviews, and the DSM diagnostic criteria. Items were deleted if they clearly pertained to a specific trauma event or medical condition. The final 38 items were selected following extensive pilot testing. Greater detail regarding development of the scale is provided in two published papers ( Spence, 1997; Spence, 1998 - see articles page).
Uses of the Scale
Clinical purposes: The scale has been widely used in clinical contexts for both assessment and therapy evaluation purposes. The SCAS is not intended as a diagnostic instrument when used in isolation. Rather it is designed to provide an indication of the nature and extent of anxiety symptoms to assist in the diagnostic process. It is recommended that clinicians use the scale in partnership with a structured clinical interview. In addition to normative data, T-Scores have been developed to assist the clinician in determining whether anxiety symptoms are elevated above what would be regarded as normal levels within the community. The scale is sensitive to treatment outcome and may be used to evaluate the impact of therapy on anxiety symptoms in children and adolescents.
Community screening and prevention: The scale has also been used for identification of children at risk of developing anxiety problems and for monitoring the outcome of interventions to prevent the development of anxiety.
Research: The SCAS has now been used in a significant number of research studies to examine the structure of anxiety symptoms and as an indicator of anxiety in young people.