Pediatric Symptom Checklist

The Pediatric Symptom Checklist (PSC) is a 35-item parent-report questionnaire designed to identify children with difficulties in psychosocial functioning. Its primary purpose is to alert pediatricians at an early point about which children would benefit from further assessment. A positive result on the overall scale indicates that the child in question would benefit from further evaluation. It is not a diagnostic tool. The PSC has subscales which measure inner distress and mood, interpersonal relations and behavior, and attention. The PSC is also used in pediatrics and other settings to measure changes in psychosocial functioning over time. Michael Jellinek, MD, created the PSC and has researched it over more than thirty years in collaboration with J. Michael Murphy, Ed.D. and other investigators. The PSC has been used in more than 200 studies in the US and other countries and has been endorsed by the American Academy of Pediatrics, the state of Massachusetts, the government of Chile and many other organizations. The Pediatric Symptom Checklist (PSC) is a 35-item parent-report questionnaire designed to identify children with difficulties in psychosocial functioning. Its primary purpose is to alert pediatricians at an early point about which children would benefit from further assessment. A positive result on the overall scale indicates that the child in question would benefit from further evaluation. It is not a diagnostic tool. The PSC has subscales which measure inner distress and mood, interpersonal relations and behavior, and attention. The PSC is also used in pediatrics and other settings to measure changes in psychosocial functioning over time. Michael Jellinek, MD, created the PSC and has researched it over more than thirty years in collaboration with J. Michael Murphy, Ed.D. and other investigators. The PSC has been used in more than 200 studies in the US and other countries and has been endorsed by the American Academy of Pediatrics, the state of Massachusetts, the government of Chile and many other organizations. The PSC was designed because none of the available instruments offered the 'optimal combination of efficiency, ease of administration, and screening accuracy' (p. 451). The first draft was a shortened and revised form of the Washington Symptom Checklist (WSCL) designed by Weinberger and Gregory. The researchers shortened the WSCL from 67 to 27 questions and removed open-ended questions. They also revised questions to address the five major areas they wanted to examine: mood, play, school, friends, and family relations. The PSC was further revised based on 'the symptoms of the major diagnoses for children listed in the American Psychiatric Association DSM-III, the clinical impressions of several pediatricians, psychologists, and child psychiatrists, and a review of items from other questionnaires reported to be the most useful in identifying children with emotional problems' (p. 372). The current PSC contains 35 statements focused on the child’s day-to-day behavior and mood. Parents are asked to indicate how frequently each of the statements, referred to as symptoms, describes the child; response options include 'never', 'sometimes', and 'often'. Examples of statements include 'feels he or she is bad', 'teases others', and 'is distracted easily'. The questionnaire takes 3–5 minutes to complete. The original study of the PSC focused on children between 6 and 12 years old, but the checklist has been studied and validated in all age groups between 4 and 16 years. The PSC is scored by assigning point values to the ratings: 2 = “often”, 1 = “sometimes”, and 0 = “never”. The points are summed for a total score, with possible scores ranging from 0 to 70. An overall score above the cutoff point, sometimes referred to as a positive score, indicates need for further assessment. The cutoff score for children older than 6 years old is 28. For children younger than 6 years old, four items that pertain to school are excluded. As a result, the range of scores is lower and the cutoff score is lowered to 24. If a child obtains a score above the cutoff, the pediatrician would review the questionnaire, explore any apparent problem areas, determine the severity of dysfunction, and then decide on what type of follow-up is appropriate: no follow-up needed, treatment already being received, follow-up by pediatrician, or referral to a mental health professional.