Spence Preschool Anxiety Scale

Abstract

The Spence preschool Anxiety Scale (SCAS-P) is a specialized psychometric instrument designed for the early detection and quantitative assessment of anxiety symptoms in very young children, typically those in the preschool age range (3 to 6 years). Adapted from the widely used Spence Children’s Anxiety Scale (SCAS), the SCAS-P focuses on parent-reported behaviors and emotional states relevant to common pediatric Anxiety Disorder diagnoses. It provides a multi-dimensional measure covering specific symptom clusters, allowing clinicians and researchers to identify patterns of distress corresponding to different clinical presentations.

The scale is structured to measure five distinct anxiety subscales: Separation Anxiety, Physical Injury Fears, Social Anxiety, Obsessive Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD). This detailed assessment tool is crucial for early intervention, as anxiety symptoms often manifest differently in preschoolers compared to older children. The total score is derived from the first 28 items, utilizing a 5-point Likert scale response format.

Keywords

Spence preschool Anxiety Scale, SCAS-P, child anxiety, preschool assessment, separation anxiety, generalized anxiety, social anxiety, obsessive compulsive disorder, parent report.

Authors

Spence, S.H., Rapee, R., McDonald, C., Ingram, M., Barrett, P.M., Turner, C.M.

Purpose

The primary purpose of the Spence preschool Anxiety Scale is to provide a reliable and valid screening tool for assessing the frequency and severity of anxiety-related symptoms in children aged 3 to 6 years. Early identification of clinically significant anxiety is vital, as untreated childhood anxiety can lead to long-term impairment and persistence into adolescence and adulthood.

The scale is used in clinical settings to aid in diagnostic formulation by comparing a child’s symptom profile against normative data. In research, it serves as a standardized outcome measure for evaluating the efficacy of early intervention programs targeting specific anxiety disorders such as Social Anxiety and Separation Anxiety.

Construct

The SCAS-P is designed to measure the presence and severity of symptoms aligned with the diagnostic criteria for five specific anxiety constructs recognized in classification systems like the DSM (Diagnostic and Statistical Manual of Mental Disorders). The constructs measured are:

• Generalized Anxiety Disorder (GAD): Items related to excessive worry, tension, and difficulty controlling worry.
• Social Anxiety: Items concerning fear of negative evaluation, speaking in front of others, or interacting with unfamiliar people.
• Obsessive Compulsive Disorder (OCD): Items assessing repetitive behaviors (compulsions) and recurrent intrusive thoughts or images (obsessions).
• Physical Injury Fears: Items related to specific phobias concerning physical dangers, injury, or environmental threats (e.g., storms, heights, animals).
• Separation Anxiety: Items measuring distress regarding separation from primary caregivers, worry about harm befalling parents, and nightmares related to separation.

The scale also includes supplementary items (29-34) related to traumatic experiences and associated symptoms, suggesting a potential supplementary assessment of trauma-related distress, although these are typically scored separately from the core anxiety subscales.

Validity

The validity of the SCAS-P, as supported by research into the structure of anxiety in preschoolers (Spence et al., 2001), demonstrates strong structural validity. Confirmatory factor analysis supports the five-factor model relevant to this age group, confirming that the items reliably group into the intended diagnostic categories.

Furthermore, studies have shown good convergent validity, where SCAS-P scores correlate highly with other established measures of child anxiety, such as the Child Behavior Checklist (CBCL) Internalizing scale. Discriminant validity is also evident, as the scale successfully distinguishes between anxious and non-anxious clinical samples, confirming its utility as a diagnostic screening tool.

Reliability

The reliability of the SCAS-P is typically high across both the total score and the individual subscales. Internal consistency, measured by Cronbach’s alpha, generally falls within the acceptable to excellent range (e.g., above 0.80 for the total score and often above 0.70 for subscales), indicating that the items within each factor consistently measure the same underlying construct.

Test-retest reliability, assessing the stability of the scores over time, has been demonstrated to be adequate in non-clinical samples, suggesting that the scale provides consistent measurement of anxiety symptoms when reapplied after a reasonable interval. This stability is crucial for monitoring treatment progress in clinical practice.

Factor Analysis

The factor structure of the SCAS-P was established through extensive research, notably the work published by Spence, Rapee, McDonald, and Ingram (2001). Unlike the original SCAS for older children, which often yields a six-factor solution (including Panic/Agoraphobia), the preschool version typically supports a robust five-factor structure specific to younger children’s symptom presentation.

Confirmatory Factor Analysis (CFA) is the primary statistical methodology used to validate this structure, ensuring that the five subscales—Separation Anxiety, Physical Injury Fears, Social Anxiety, Obsessive Compulsive Disorder, and Generalized Anxiety Disorder—are distinct yet related dimensions of child anxiety. This structure confirms that the scale accurately captures the multi-faceted nature of anxiety in the preschool population.

Instrument

Test Type: Parent-Report Questionnaire

Format: 34 items (28 scored items plus 6 supplementary trauma-related items). Responses are measured on a 5-point Likert scale.

Language Available: English (original, Australian context) and numerous translations (e.g., Dutch, Spanish, Chinese, Turkish).

Population Group: Clinical and Non-Clinical pediatric populations.

Age Group: Preschool children (typically 3 to 6 years).

Population Details: The scale is administered to a parent or primary caregiver who reports on the child’s behavior over a specified period.

Test Methodology: Quantitative assessment based on frequency ratings. Scoring involves summing item scores for each subscale and calculating a total anxiety score (Items 1-28).

Keywords

SCAS-P, child development, psychometric assessment, early childhood, clinical psychology, parent-report scale, GAD, OCD.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

The Spence Children’s Anxiety Scale family of instruments, including the preschool version, is generally available for non-commercial research and clinical use free of charge, subject to obtaining permission from the primary author, Susan H. Spence. The core structural validation work for the preschool version was published in 2001, making this the reference year for the instrument’s definitive structure. Further information and permissions can often be sought via the official website provided in the source material: http://www.scaswebsite.com/1_1_.html.

Reference’s

• Spence, S.H., Rapee, R., McDonald, C., & Ingram, M. (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy, 39, 1293 – 1316.

• Spence. S.H., (1997). Structure of Anxiety Symptoms Among Children: A Confirmatory Factor-Analytic Study. J Abnorm Psych 106(2): 280-297.

• Spence. S.H, Barrett. P.M, Turner. C.M. (2003). Psychometric Properties of the Spence Children’s Anxiety Scale with Young Adolescents. J Anxiety Disord 17(6): 605-625.

Items of the Spence preschool Anxiety Scale

Scoring Key: 0= Not True at All, 1=Seldom True, 2= Sometimes True, 3= Quite Often True, 4=Very Often True

Subscale Scoring:

• Generalized Anxiety: Items 1 + 4 + 8 + 14 + 28
• Social Anxiety: Items 2 + 5 + 11 + 15 + 19 + 23
• Obsessive Compulsive disorder: Items 3 + 9 + 18 + 21 + 27
• Physical Injury Fears: Items 7 + 10 + 13 + 17 + 20 + 24 + 26
• Separation Anxiety: Items 6 + 12 + 16 + 22 + 25
• Total Score: Sum of Scores for Items 1 to 28

Core Items (1-28):

1. Has difficulty stopping him/herself from worrying
2. Worries that he/she will do something to look stupid in front of other people
3. Keeps checking that he/she has done things right (e.g., that he/she closed a door, turned off a tap)
4. Is tense, restless or irritable due to worrying
5. Is scared to ask an adult for help (e.g., a preschool or school teacher)
6. Is reluctant to go to sleep without you or to sleep away from home
7. Is scared of heights (high places)
8. Has trouble sleeping due to worrying
9. Washes his/her hands over and over many times each day
10. Is afraid of crowded or closed-in places
11. Is afraid of meeting or talking to unfamiliar people
12. Worries that something bad will happen to his/her parents
13. Is scared of thunder storms
14. Spends a large part of each day worrying about various things
15. Is afraid of talking in front of the class (preschool group) e.g., show and tell
16. Worries that something bad might happen to him/her (e.g., getting lost or kidnapped), so he/she won’t be able to see you again
17. Is nervous of going swimming
18. Has to have things in exactly the right order or position to stop bad things from happening
19. Worries that he/she will do something embarrassing in front of other people
20. Is afraid of insects and/or spiders
21. Has bad or silly thoughts or images that keep coming back over and over
22. Becomes distressed about your leaving him/her at preschool/school or with a babysitter
23. Is afraid to go up to group of children and join their activities
24. Is frightened of dogs
25. Has nightmares about being apart from you
26. Is afraid of the dark
27. Has to keep thinking special thoughts (e.g., numbers or words) to stop bad things from happening
28. Asks for reassurance when it doesn’t seem necessary

Supplementary Trauma Items (29-34):

29. Has your child ever experienced anything really bad or traumatic (e.g., severe accident, death of a family member/friend, assault, robbery, disaster) YES NO

Please briefly describe the event that your child experienced ……..

If you answered NO to question 29, please do not answer questions 30-34. If you answered YES, please DO answer the following questions.

Do the following statements describe your child’s behavior since the event?

30. Has bad dreams or nightmares about the event
31. Remembers the event and becomes distressed
32. Becomes distressed when reminded of the event
33. Suddenly behaves as if he/she is reliving the bad experience
34. Shows bodily signs of fear (e.g., sweating, shaking or racing heart) when reminded of the event