Preschool Anxiety Scale

The Preschool Anxiety Scale (PAS), developed by Spence and colleagues, is a validated parent-report measure specifically calibrated for the developmental…

Questions: 28
Duration: 6 min
Original title: Preschool Anxiety Scale
Adaptation: Preschool Anxiety Scale
Authors: Spence, S.H., Rapee, R., McDonald, C., & Ingram, M.
Created: 2001

The Preschool Anxiety Scale (PAS), developed by Spence and colleagues, is a validated parent-report measure specifically calibrated for the developmental presentation of anxiety in children and adolescents. Recognizing that early anxiety often manifests before children possess the cognitive and verbal skills for self-report, the instrument leverages parent observations across a spectrum of daily contexts to capture a comprehensive clinical picture.

Clinically, the instrument provides a structured method to distinguish transient, age-appropriate fears from persistent anxiety patterns. It systematically profiles five key domains: generalized anxiety, social anxiety, obsessive-compulsive symptoms, specific fears, and separation anxiety.

By offering normative data and clinical thresholds, the PAS allows clinicians to establish an objective baseline, monitor symptom trajectories, and tailor early family-based support. Relying on a standardized assessment ensures that early internalizing distress is accurately mapped and appropriately addressed in therapeutic planning.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

53/ 112

The Preschool Anxiety Scale (PAS) is a 28-item parent-report questionnaire designed to assess anxiety symptoms in children aged 2.5 to 6.5 years. It measures five domains: separation anxiety, physical injury fears, social anxiety, obsessive-compulsive disorder, and generalized anxiety. It is a screening and tracking tool, not a diagnostic instrument.

0–33

Within normal limits

34–47

Elevated

48–112

Very elevated

Raw score ≥ 48 = T ≥ 70, ≥ 98th percentile (official 2019 table).

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1368 · 2019

0112

M = 19.76 ± 13.7

Scoring

Subscale sum, total score ranging from 0 to 112, each item is scored on a 5-point scale (from 0 to 4).

Obsessive-compulsive disorder

8/ 20

Obsessive compulsive disorder subscale, computed by summing specific items of the PAS.

items 3, 9, 18, 21, 27

0–3

Within normal limits

4–20

Elevated

Obsessive Compulsive column: 4 = T 62 (87–89th percentile; 3 = T 57).

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1370 · 2019

020

M = 1.39 ± 2.06

Social anxiety

14/ 24

Social anxiety subscale, computed by summing specific items of the PAS.

items 2, 5, 11, 15, 19, 23

0–10

Within normal limits

11–24

Elevated

Social Anxiety column: 11 = T 61 (85th–86th percentile) — first raw score reaching T ≥ 60 (10 = T 59).

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1370 · 2019

024

M = 5.66 ± 4.74

Separation anxiety

6/ 20

Separation anxiety subscale, computed by summing specific items of the PAS.

items 6, 12, 16, 22, 25

0–6

Within normal limits

7–20

Elevated

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1370 · 2019

020

M = 3.24 ± 3.14

Generalized anxiety

10/ 20

Generalised anxiety subscale, computed by summing specific items of the PAS.

items 1, 4, 8, 14, 28

0–5

Within normal limits

6–20

Elevated

Generalised Anxiety column: 6 = T 60 (84th percentile).

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1371 · 2019

020

M = 2.88 ± 3.07

Fears of physical injury

15/ 28

Physical injury fears subscale, computed by summing specific items of the PAS.

items 7, 10, 13, 17, 20, 24, 26

0–11

Within normal limits

12–28

Elevated

Physical Injury Fears column: 12 = T 61 (11 = T 59).

généralemixed · community sample · combined Australian community sample (official website norms) · 3–6 years · Australia · n = 1369 · 2019

028

M = 6.61 ± 4.64

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What the test measures

The PAS systematically maps the severity of early childhood anxiety by capturing behavioral, emotional, and somatic manifestations as observed by parents. The 28 items group into five distinct clinical facets:

Generalized Anxiety: Captures pervasive worrying, difficulty self-soothing, and tension rooted in the autonomic nervous system.
Social Anxiety: Evaluates fear of negative evaluation, excessive shyness, and distress in group settings or when interacting with unfamiliar adults and peers.
Obsessive-Compulsive Symptoms: Identifies early indicators of rigidity, such as repetitive automatic behaviors, compulsive checking, or intrusive distressing thoughts.
Physical Injury Fears: Screens for specific phobic responses to common developmental triggers, including heights, the dark, loud noises, and animals.
Separation Anxiety: Assesses disproportionate distress upon separation from primary caregivers, reluctance to sleep alone, and fears of abandonment or loss.

This multidimensional structure is specifically designed for preschool-aged children (3 to 6 years old), capturing symptoms before formal diagnostic criteria may be fully met.

When and why to use it

Clinicians use the PAS when evaluating early childhood behavioral concerns to transition from general parental worry to an objective, structured assessment. The tool is particularly useful for:

Baseline Intake: Establishing a comprehensive symptom profile during an initial evaluation of a young child presenting with behavioral dysregulation or severe anticipatory fear.
Screening and Triage: Comparing the child's distress to normative thresholds to determine if the reported fears exceed age-appropriate developmental stages.
Differential Support: Identifying specific anxiety profiles to target parent-led interventions or select appropriate coping strategies for children and adolescents.
Treatment Monitoring: Tracking symptom shifts over time using anxiety self-monitoring frameworks to evaluate the efficacy of chosen clinical strategies.

Relying on a validated score adds objective clarity to the clinical impression, ensuring that subtle internalizing symptoms are neither overlooked nor prematurely pathologized.

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The questions

Below is a list of items that describe children. For each item, please circle the response that best describes your child. Please circle 4 if the item is very often true, 3 if the item is quite often true, 2 if the item is sometimes true, 1 if the item is seldom true or 0 if the item is not at all true. Please answer all the items as well as you can, even if some do not seem to apply to your child.
1. My child has a hard time stopping worrying.
Evaluates the child's capacity for emotional regulation and their ability to independently break a cycle of chronic worry.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
2. My child worries about looking silly in front of people.
Probes early manifestations of fear of negative evaluation and self-consciousness in social contexts.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
3. My child has to constantly check if they have done things correctly (e.g., if a door or faucet is closed).
Assesses rigid checking behaviors that suggest the emergence of compulsive safety routines.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
4. My child is tense, restless, or irritable when they worry.
Identifies physical and behavioral dysregulation occurring as a direct somatic consequence of worrying.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
5. My child is afraid to ask an adult for help (e.g., a daycare educator or a school teacher).
Examines the child's level of social inhibition when requiring assistance from a familiar but non-parental authority figure.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
6. My child is reluctant to go to sleep without me or to sleep away from home.
Screens for nighttime separation anxiety and the inability to self-soothe without the primary caregiver's physical presence.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
7. My child is afraid of heights (high places).
Captures specific phobic responses to heights, reflecting a concrete physical injury fear.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
8. My child has difficulty sleeping when they worry.
Highlights how internalizing distress actively disrupts the child's sleep architecture and resting routines.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
9. My child repeatedly washes their hands several times a day.
Identifies repetitive hygiene behaviors indicative of early compulsive or contamination-related distress.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
10. My child is afraid of being in crowds or enclosed spaces.
Assesses specific fears related to spatial confinement or overwhelming sensory environments.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
11. My child is afraid of meeting or talking to people they don't know well.
Evaluates social withdrawal and acute apprehension when encountering unfamiliar individuals.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
12. My child worries that something bad will happen to their parents.
Probes catastrophic worries regarding caregiver safety, a hallmark cognitive component of separation anxiety.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
13. My child is afraid of thunderstorms.
Screens for a common specific phobia involving loud or unpredictable natural events.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
14. My child spends a large part of the day worrying about different things.
Measures the pervasiveness of the child's anxiety, indicating how much of their daily life is consumed by worry.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
15. My child is afraid to speak in front of their class (or daycare group), for example during a presentation.
Assesses performance anxiety and distress when forced into the center of attention within a peer group.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
16. My child worries that something bad will happen to them (e.g., getting lost or being kidnapped) and that they will never see you again.
Captures catastrophic fears of abandonment or personal harm, driving intense attachment behaviors.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
17. My child is nervous when they go to the swimming pool.
Identifies situational specific fears tied to aquatic environments or swimming activities.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
18. My child needs things to be placed in exactly the right order or the right place to prevent bad things from happening.
Evaluates the child's reliance on rigid ordering or magical thinking to ward off perceived threats.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
19. My child worries about doing something embarrassing in front of other people.
Highlights early social anxiety driven by the anticipation of public embarrassment or humiliation.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
20. My child is afraid of insects or spiders.
Screens for common specific animal or insect phobias.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
21. My child has bad or strange thoughts or images that keep coming back.
Probes the presence of distressing, repetitive intrusive thoughts or imagery.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
22. My child feels distressed when I leave them at daycare/school or with a babysitter.
Assesses the severity of acute distress triggered during routine separation transitions.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
23. My child is afraid to approach a group of children and join their activities.
Evaluates behavioral avoidance and social fear when integrating into peer-led group activities.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
24. My child is afraid of dogs.
Captures a specific phobia of animals, particularly dogs, which can limit outdoor functioning.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
25. My child has nightmares in which they are separated from me.
Identifies nighttime manifestations of separation anxiety intruding into dream content.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
26. My child is afraid of the dark.
Screens for a pervasive specific fear of the dark that complicates bedtime and nighttime routines.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
27. My child has to think of special things (like numbers or letters) to prevent bad things from happening.
Assesses cognitive rituals and magical thinking deployed as a neutralizing strategy against harm.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true
28. My child asks for reassurance when it doesn't seem necessary.
Highlights the behavioral loop of reassurance-seeking driven by intolerance of uncertainty.
- Never true
- Rarely true
- Sometimes true
- Often true
- Very often true