Spence Preschool Anxiety Scale

Abstract

The Spence Preschool Anxiety Scale (SPAS) is a specialized psychometrics instrument developed to screen for and comprehensively assess symptoms related to various anxiety disorders in very young children, typically those aged 2.5 to 6 years. Serving as a crucial downward extension of the established Spence Children’s Anxiety Scale (SCAS), the SPAS is meticulously tailored to capture the unique phenomenology and developmental expression of anxiety in the preschool age range.

Administered primarily as a parent-report measure, the SPAS provides essential data for early identification, clinical diagnosis, and etiological research into childhood anxiety. The scale comprises 28 core items distributed across five distinct anxiety subscales, which yield a detailed profile of a child’s internalizing symptoms, including generalized worry, specific phobias, and separation distress. An optional additional set of six items is included to address potential symptoms related to trauma or post-traumatic stress.

Keywords

Spence Preschool Anxiety Scale, SPAS, Separation anxiety disorder, Generalized anxiety disorder, Social Anxiety, Obsessive Compulsive Disorder (OCD), Preschool, Childhood anxiety, Parent-report measure, Early identification, Psychometrics, Internalizing behaviors, Specific phobia, SCAS.

Authors

Susan H. Spence, Ronald Rapee, C. McDonald, M. Ingram.

Purpose

The fundamental purpose of the SPAS is the timely detection and accurate quantification of anxiety symptoms within the preschool population. Recognizing that early onset anxiety often persists and exacerbates into later childhood and adolescence, the instrument is vital for facilitating early intervention strategies. The scale delivers scores across key diagnostic domains, enabling clinicians and researchers to generate a precise profile of a child’s specific anxiety presentation, rather than just a global measure of distress.

The SPAS is utilized extensively in both research and clinical settings. Clinically, it serves as an effective screening tool for identifying high-risk children who require further diagnostic evaluation. In research, it is crucial for examining the prevalence, underlying causes (etiology), and effectiveness of various treatment outcomes for early childhood anxiety. The optional inclusion of items addressing traumatic events (Items 29–34) offers a preliminary assessment of post-traumatic stress symptoms, though the primary focus remains on specific and generalized anxiety presentations.

Construct

The SPAS is designed to measure the frequency and severity of symptoms across five established domains of anxiety, closely adhering to the diagnostic categories outlined in major classification systems like the DSM. These domains have been carefully adapted to reflect developmentally appropriate manifestations of distress and worry in young children.

The five core constructs assessed by the scale include: Generalized anxiety disorder (GAD), which reflects excessive worry; Social Anxiety, concerning fear of social evaluation; Physical Injury Fears (representing specific phobias); Separation anxiety disorder, involving distress related to parental absence; and Obsessive Compulsive Disorder (OCD) symptoms. By segmenting these constructs into subscales, the SPAS provides a nuanced and actionable understanding of the child’s specific internalizing behavioral patterns, moving beyond a single total anxiety score.

Validity

The validity of the SPAS is robustly supported by evidence demonstrating its congruence with established diagnostic criteria for anxiety disorders observed in early childhood. Studies examining concurrent validity consistently show that SPAS scores significantly correlate with clinical diagnoses derived from comprehensive, structured diagnostic interviews, such as the Anxiety Disorders Interview Schedule for Children (ADIS-C).

Furthermore, strong discriminant validity has been established, as the scale effectively differentiates between children presenting with primary anxiety conditions and age-matched non-anxious control groups. The underlying structure of the SPAS is designed to mirror the highly robust factor structure of its precursor, the SCAS, thereby providing strong theoretical and construct validity for the assessment of anxiety symptoms in the crucial early childhood period.

Reliability

The SPAS consistently demonstrates good internal consistency, a measure of how well items within the scale correlate with each other. This is particularly evident for the Total Anxiety score and its major subscales, such as GAD and Separation anxiety disorder. Empirical research frequently reports Cronbach’s alpha coefficients that fall well within acceptable ranges for screening instruments used in developmental psychology and clinical assessment.

In addition to internal consistency, test-retest reliability—which measures the stability of scores over time—has also been established across short intervals. This consistency confirms that the scale provides dependable and stable measurements of anxiety symptoms within typical preschool populations, supporting its utility for monitoring symptom severity and evaluating treatment progress across intervention periods.

Factor Analysis

The scale’s factor structure was rigorously investigated to ensure that the anxiety symptoms clustered into dimensions that were both meaningful and clinically relevant, aligning with the foundational SCAS model. Confirmatory Factor Analysis (CFA) studies have largely supported a five-factor model.

This five-factor structure corresponds precisely to the five distinct clinical subscales: Generalized anxiety disorder, Social Anxiety, Separation anxiety disorder, Physical Injury Fears, and Obsessive Compulsive Disorder. The confirmation of this robust factor structure validates the SPAS instrument for use in differential diagnosis, ensuring that the subscale scores accurately reflect distinct yet related components of anxiety in young children within both research and clinical practice.

Instrument

Test Type: Parent-Report Questionnaire / Screening Tool

Format: 28 core items scored on a 5-point Likert scale (0 to 4), plus 6 optional items (Items 29-34) related to trauma.

Language Available: English (and numerous translations are available globally through the SCAS distribution network).

Population Group: Children and Youth

Age Group: Preschoolers (typically 2.5 to 6 years old)

Population Details: Used with both clinical populations (children referred for anxiety or behavior problems) and non-clinical community samples for prevalence studies.

Test Methodology: Parents or primary caregivers rate how often each statement is true for the child over a specified period. The 5-point scale ranges from 0= Not True at All to 4= Very Often True. Subscale scores are derived by summing the scores of the relevant items, and a Total Score is calculated based on Items 1 through 28.

Keywords

Childhood psychopathology, Early identification, Clinical assessment, SCAS, SPAS, Developmental psychology, Internalizing behaviors, Specific phobia, Parent-report measure, Anxiety disorder.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: N/A

Correspondence Address: N/A

Permissions & Fee and Test Year

The Spence Preschool Anxiety Scale is often made available for non-commercial research and clinical use without charge, though users are typically required to obtain permission directly from the primary author, Susan H. Spence. The foundational research that detailed the structure of anxiety symptoms among preschoolers and established the SPAS framework was published in 2001, marking the approximate foundational test year.

The instrument is officially hosted online and can be accessed via the primary website for the SCAS family of scales. The instrument can be found at: 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:

• 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

Scale Items (0= Not True at All, 1=Seldom True, 2= Sometimes True, 3= Quite Often True, 4=Very Often True):

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

Trauma Items (Optional):

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