If you think your child may have an anxiety disorder, please answer the questions below, print out the page, and show the results to your child's health care professional.
|Yes No||Does the child have a distinct and ongoing fear of social situations involving unfamiliar people?|
|Yes No||Does the child worry excessively about a number of events or activities?|
|Yes No||Does the child experience shortness of breath or a racing heart for no apparent reason?|
|Yes No||Does the child experience age-appropriate social relationships with family members and other familiar people?|
|Yes No||Does the child often appear anxious when interacting with peers, or try to avoid them?|
|Yes No||Does the child have a persistent and unreasonable fear of an object or situation, such as flying, heights, or animals?|
|Yes No||When the child encounters the feared object or situation, does he react by freezing, clinging, or having a tantrum?|
|Yes No||Does the child worry excessively about her competence and quality of performance?|
|Yes No||Does the child cry, have tantrums, or refuse to leave a family member or other familiar person when she must?|
|Yes No||Has the child experienced a decline in classroom performance, refused to go to school, or avoided age-appropriate social activities?|
|Yes No||Does the child spend at least one hour each day repeating things over again, such as hand washing, checking, arranging, or counting?|
|Yes No||Does the child have exaggerated fears of people or events ( burglars, kidnappers, car accidents) that might be difficult, such as in a crowd or on an elevator?|
|Yes No||Does the child experience a great number of nightmares, headaches, or stomachaches?|
|Yes No||Does the child repetitively use toys to re-enact scenes from a disturbing event?|
|Yes No||Does the child redo tasks because of excessive dissatisfaction with less-than-perfect performance?|
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994.
Reprinted with the permission of the Anxiety Disorders Association of America.