RCADS-Child

Initials and Date of Birth(Required)
MM slash DD slash YYYY

Instructions:

Select the word that shows how often each of these things happens to you. There are no right or wrong answers.
Never= 0, Sometimes=1, Often=2, Always=3
1. I worry about things(Required)
2. I feel sad or empty(Required)
3. When I have a problem, I get a funny feeling in my stomach(Required)
4. I worry when I think I have done poorly at something(Required)
5. I would feel afraid of being on my own at home(Required)
6. Nothing is much fun anymore(Required)
7. I feel scared when I have to take a test(Required)
8. I feel worried when I think someone is angry with me(Required)
9. I worry about being away from my parents(Required)
10. I get bothered by bad or silly thoughts or pictures in my mind(Required)
11. I have trouble sleeping(Required)
12. I worry that I will do badly at my school work(Required)
13. I worry that something awful will happen to someone in my family(Required)
14. I suddenly feel as if I can't breathe when there is no reason for this(Required)
15. I have problems with my appetite(Required)
16. I have to keep checking that I have done things right (like the switch is off, or the door is locked)(Required)
17. I feel scared if I have to sleep on my own(Required)
18. I have trouble going to school in the mornings because I feel nervous or afraid(Required)
19. I have no energy for things(Required)
20. I worry I might look foolish(Required)
21. I am tired a lot(Required)
22. I worry that bad things will happen to me(Required)
23. I can't seem to get bad or silly thoughts out of my head(Required)
24. When I have a problem, my heart beats really fast(Required)
25. I cannot think clearly(Required)
26. I suddenly start to tremble or shake when there is no reason for this(Required)
27. I worry that something bad will happen to me(Required)
28. When I have a problem, I feel shaky(Required)
29. I feel worthless(Required)
30. I worry about making mistakes(Required)
31. I have to think of special thoughts (like numbers or words) to stop bad things from happening(Required)
32. I worry what other people think of me(Required)
33. I am afraid of being in crowded places (like shopping centers, the movies, buses, busy playgrounds)(Required)
34. All of a sudden I feel really scared for no reason at all(Required)
35. I worry about what is going to happen(Required)
36. I suddenly become dizzy or faint when there is no reason for this(Required)
37. I think about death(Required)
38. I feel afraid if I have to talk in front of my class(Required)
39. My heart suddenly starts to beat too quickly for no reason(Required)
40. I feel like I don’t want to move(Required)
41. I worry that I will suddenly get a scared feeling when there is nothing to be afraid of(Required)
42. I have to do some things over and over again (like washing my hands, cleaning or putting things in a certain order)(Required)
43. I feel afraid that I will make a fool of myself in front of people(Required)
44. I have to do some things in just the right way to stop bad things from happening(Required)
45. I worry when I go to bed at night(Required)
46. I would feel scared if I had to stay away from home overnight(Required)
47. I feel restless(Required)
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Developer Reference:

Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of
DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour research
and therapy, 38(8), 835-855.