Spence Children’s Anxiety Scale – Child (SCAS- Child)

Abstract

The Spence Children’s Anxiety Scale – Child Version (SCAS-Child) is an internationally recognized, standardized psychometric instrument developed to assess the frequency and severity of anxiety disorder symptoms in children and adolescents aged 8 to 15 years. Conceptualized and validated by Australian clinical psychologist Susan H. Spence, the instrument operationalizes the diagnostic taxonomy of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and retains robust diagnostic correspondence with contemporary DSM-5 criteria. Comprising 45 to 46 items—including 38 core anxiety items, 6 positive filler items intended to mitigate acquiescence and negative response bias, and an optional open-ended phobic inquiry—the scale evaluates six distinct anxiety domains: separation anxiety, social phobia, obsessive-compulsive problems, panic disorder/agoraphobia, generalized anxiety disorder, and fears of physical injury (specific phobias). Respondents rate item frequency along a four-point Likert scale (0 = Never, 1 = Sometimes, 2 = Often, 3 = Always), yielding a total anxiety score ranging from 0 to 114 alongside discrete subscale totals. Extensive cross-cultural validation studies have established that the SCAS-Child exhibits exceptional internal consistency (Cronbach’s α typically exceeding .90 for the total scale), solid test-retest reliability over clinical intervals, robust convergent validity with established legacy measures (such as the Revised Children’s Manifest Anxiety Scale), and discriminant validity differentiating anxious youths from healthy controls and depressive cohorts. Confirmatory factor analytic investigations routinely support a hierarchical model featuring six first-order factors loading onto a single overarching higher-order anxiety construct, reinforcing the scale’s empirical and theoretical utility in epidemiological screening, clinical assessment, and cognitive-behavioral treatment outcome monitoring.

Keywords

Spence Children’s Anxiety Scale, SCAS-Child, child psychometrics, pediatric anxiety assessment, DSM-5 anxiety disorders, separation anxiety, social phobia, generalized anxiety, panic disorder, obsessive-compulsive symptoms, internalizing disorders, confirmatory factor analysis.

Authors

The SCAS-Child was authored and developed by Susan H. Spence, AO, PhD, DipClinPsych, a distinguished clinical psychologist and academic researcher based in Australia. Professor Spence has held prestigious professorial and leadership appointments across multiple tertiary institutions, including the University of Queensland, the Australian National University, and Griffith University, where she serves as Emeritus Professor at the School of Applied Psychology and the Australian Institute for Suicide Research and Prevention (AISRAP). Her empirical scholarship focuses predominantly on the developmental trajectories, etiology, classification, assessment, and cognitive-behavioral prevention and treatment of emotional and behavioral disorders in children and adolescents.

In her programmatic validation work throughout the late 1990s and early 2000s, Professor Spence collaborated with prominent developmental psychopathology researchers, including Paula M. Barrett and Cynthia M. Turner, executing large-scale epidemiological and clinical validation studies that established normative profiles across diverse youth cohorts. In recognition of her transformative contributions to clinical child psychology and mental health service design, Professor Spence was appointed an Officer of the Order of Australia (AO). Up-to-date documentation, normative score conversions, and psychometric profiles are curated collaboratively through the official SCAS online clearinghouse (www.scaswebsite.com).

Purpose

Childhood and adolescent anxiety disorders represent some of the most prevalent psychiatric conditions encountered in developmental psychopathology, with worldwide epidemiological estimates suggesting point prevalence rates between 6.5% and 10% among youth. Left undetected and untreated, early internalizing distress exerts substantial secondary morbidity, precipitating academic underachievement, peer alienation, school refusal, chronic somatic complaints, and heightened risk for major depressive episodes, substance abuse, and suicidality during emergent adulthood. Historically, clinical assessment tools relied predominantly on unidimensional instruments—such as the Revised Children’s Manifest Anxiety Scale (RCMAS) or the State-Trait Anxiety Inventory for Children (STAIC)—which, although sensitive to diffuse physiological arousal and subjective worry, lacked explicit structural alignment with established diagnostic taxonomies, impeding nuanced differential diagnosis across specific anxiety subtypes.

The SCAS-Child was explicitly engineered to address this conceptual and psychometric void. Developed against the operational criteria of the DSM-IV (and preserving direct congruency with DSM-5 criteria), the primary purpose of the SCAS-Child is to afford a reliable, valid, and time-efficient self-report metric capable of delineating both the global severity of internalizing distress and the granular multidimensional presentation of six distinct anxiety domains. Specifically, the instrument aims to:

• Facilitate Population-Level Screening: Identify youth within primary care, community, and educational environments who exhibit subclinical or syndromal elevations in anxiety symptoms, enabling targeted early intervention initiatives before severe functional impairment crystallizes.
• Aid Multitrait-Multimethod Clinical Evaluation: Serve as an indispensable self-report component within comprehensive psychological assessment batteries, complementing parent-report versions (SCAS-Parent), structured clinical interviews (e.g., the Anxiety Disorders Interview Schedule for Children [ADIS-C]), and behavioral observations.
• Delineate Distinct Symptom Profiles: Discriminate between phenomenologically distinct clinical expressions—such as distinguishing autonomic panic reactivity from social evaluation fears or separation distress—thereby informing tailored psychotherapeutic conceptualization.
• Monitor Longitudinal Treatment Trajectories: Function as a sensitive, standardized outcome measurement tool throughout evidence-based psychological treatments, such as Cognitive Behavioral Therapy (CBT), pharmacotherapy, or school-based resilience curricula (e.g., the Cool Kids or FRIENDS protocols), tracking symptom change across active treatment and follow-up intervals.

Importantly, while the SCAS-Child is not designed to function in isolation as a deterministic diagnostic algorithm, its standardized normative cutoff scores—benchmarked against demographic percentiles and standard deviations above clinical thresholds—equip practitioners with empirical indicators of symptom significance that guide triage, intervention planning, and clinical decision-making.

Psychological Construct

The SCAS-Child measures the overarching psychological construct of pediatric anxiety, conceptualized as a multi-component response system characterized by subjective cognitive apprehension, heightened physiological/autonomic arousal, and behavioral avoidance or reassurance-seeking. Rather than treating anxiety as an undifferentiated, unitary state of generalized tension, the scale adopts a multifaceted architecture reflecting specific developmental vulnerabilities and diagnostic symptom clusters. The instrument encompasses six primary clinical subscales alongside a structured set of control items:

1. Separation Anxiety (6 items)

This subscale captures developmentally inappropriate and excessive apprehension concerning separation from primary attachment figures or from home. Items capture behavioral and subjective symptoms such as anticipatory dread when contemplating time away from parents, acute distress regarding solo sleeping, school morning reluctance driven by anticipatory separation panic, and pervasive rumination that catastrophic harm, illness, or death will befall family members while separated. Exemplary items include “I worry about being away from my parents” and “I feel scared if I have to sleep on my own.”

2. Social Phobia / Social Anxiety (6 items)

This dimension operationalizes marked, persistent fear of social or performance situations where the child is exposed to scrutiny, evaluation, or potential negative judgment by peers or adults. Cognitive themes center on fears of embarrassment, humiliation, looking foolish, or performing inadequately during evaluative tasks. Items also assess situational avoidance or distress within social environments, such as speaking aloud before peers, participating in class, or using communal restrooms. Exemplary items include “I feel afraid that I will make a fool of myself in front of people” and “I feel afraid if I have to talk in front of my class.”

3. Obsessive-Compulsive Symptoms (6 items)

Reflecting the clinical architecture of childhood OCD (classified within anxiety disorders under DSM-IV and maintained as a vital transdiagnostic internalizing presentation), this domain assesses recurrent, intrusive, distress-provoking ego-dystonic thoughts or mental imagery (obsessions), alongside repetitive overt or covert behaviors performed to neutralize distress or avert perceived catastrophe (compulsions). Symptoms encompass compulsive checking (doors, switches), repetitious motor rituals (handwashing, ordering), neutralizing cognitions (magical counting or special words), and distress arising from intrusive “bad or silly” mental imagery. Exemplary items include “I have to keep checking that I have done things right” and “I have to do some things over and over again.”

4. Panic Disorder and Agoraphobia (9 items)

This construct assesses acute, unexpected surges of intense fear or somatic discomfort peaking within minutes, occurring in the absence of genuine objective threat. The items capture hallmark autonomic symptoms—including sudden dyspnea, palpitations, tremors, lightheadedness, and trembling—alongside cognitive panic appraisals, such as fear of losing control or anticipating spontaneous terror. Agoraphobic components measure situational avoidance and anticipatory dread regarding public or enclosed venues where egress might be arduous or embarrassing, such as crowded shopping plazas, public transportation, or cinema theaters. Exemplary items include “All of a sudden I feel really scared for no reason at all” and “My heart suddenly starts to beat too quickly for no reason.”

5. Fears of Physical Injury / Specific Phobia (5 items)

This domain taps circumscribed, developmentally common phobic stimuli involving imminent threats of physical harm, pain, or bodily damage. The items reflect prepotent evolutionary fears that frequently emerge across middle childhood, including fear of darkness, predatory animals (e.g., dogs), medical/dental interventions, precipitous heights or elevators, and small invertebrates (insects or spiders). Exemplary items include “I am scared of the dark” and “I am scared of going to the doctor or dentist.”

6. Generalized Anxiety Disorder / Overanxious Symptoms (6 items)

Reflecting the cognitive phenotype of chronic, uncontrollable, diffuse worry across multiple life domains, this dimension evaluates ongoing apprehension concerning future events, personal competence, academic performance, and personal safety. The construct includes both cognitive rumination and pervasive somatic tension manifestations, such as epigastric distress (“funny feeling in the stomach”), autonomic jitteriness, and accelerated heart rate in response to daily challenges. Exemplary items include “I worry about things” and “When I have a problem, I get a funny feeling in my stomach.”

Positive Filler Items (6 items)

Distributed systematically throughout the scale are six non-scored filler items evaluating perceived competence and positive affect (e.g., “I am good at sports,” “I feel happy,” “I like myself”). These items are strategically embedded to break automatic negative response sets, attenuate acquiescence bias, and ensure that young respondents do not feel pathologized or overwhelmed by a continuous series of symptom-focused queries.

Theoretical Framework

The construction and validation of the SCAS-Child are grounded in the convergence of modern developmental psychopathology, evolutionary preparedness, and contemporary cognitive-behavioral theories of emotional disorders.

Cognitive-Behavioral Models of Child Anxiety

The theoretical framework predominantly reflects the cognitive models articulated by Aaron T. Beck, alongside specialized developmental models formulated by Kendall, Rapee, and Barlow. According to Beck’s cognitive specificity hypothesis, psychological distress is mediated by idiosyncratic cognitive schemata that bias information processing. In anxious youths, these schemata are characterized by hypervigilance toward environmental threat cues, selective attention toward potential hazards, catastrophic overestimation of threat probability and severity, and systematic underestimation of personal coping resources.

Within this framework, the SCAS-Child items evaluate both the cognitive appraisals characteristic of specific disorders (e.g., social evaluation anxiety, anticipatory catastrophizing over parental safety) and the concomitant somatic manifestations resulting from autonomic nervous system activation (the “fight-or-flight” cascade). The feedback loop between physiological sensation (e.g., tachycardia, hyperventilation) and catastrophic misinterpretation (e.g., “I am dying” or “I am going crazy”) is directly indexed within the panic/agoraphobia and generalized anxiety subscales.

Developmental and Evolutionary Perspectives

The SCAS-Child reflects a developmentally sensitive ethos recognizing that anxiety manifestations undergo systematic ontogenetic shifts throughout childhood and adolescence. As posited by developmental psychopathology models:

• Early to Middle Childhood: Fears are heavily dominated by physical threat, darkness, animal phobias, and separation vulnerabilities, reflecting attachment disruptions and evolutionary survival mechanisms (e.g., Seligman’s evolutionary preparedness theory).
• Late Childhood to Adolescence: As formal operational thinking and social-cognitive perspective-taking abilities mature, fears shift toward abstract evaluation, social scrutiny, peer status, academic competence, and generalized, multidimensional worries about the future.

By capturing both evolutionarily primed, concrete fears (fears of physical injury) and sophisticated socio-cognitive anxieties (social phobia, generalized worry), the SCAS-Child accommodates this developmental continuum across the 8-to-15 age bracket.

Barlow’s Triple Vulnerability Etiological Model

David H. Barlow’s triple vulnerability model offers a compelling etiological foundation for the hierarchical factor structure exhibited by the SCAS-Child. Barlow posits that anxiety disorders emerge from the interaction of:

1. A Generalized Biological Vulnerability: Heritable neurobiological traits conferring emotional reactivity, trait neuroticism, and behavioral inhibition.
2. A Generalized Psychological Vulnerability: Early developmental learning experiences fostering a diminished sense of perceived control over internal and external events.
3. A Specific Psychological Vulnerability: Conditioned cognitive associations wherein particular situations, physical sensations, or interpersonal contexts are appraised as exceptionally hazardous (e.g., evaluating social scrutiny as humiliating or autonomic surges as catastrophic).

In structural equation modeling of the SCAS-Child, the overarching higher-order anxiety factor captures the generalized biological and psychological vulnerabilities (shared negative affectivity and broad neurotic distress), whereas the six distinct first-order subscales represent specific psychological vulnerabilities unique to each disorder cluster.

Validity

Extensive psychometric investigations conducted across clinical, community, and transcultural samples have established robust psychometric validity for the SCAS-Child.

Construct and Factorial Validity

In the foundational validation paper by Spence (1998), confirmatory factor analysis (CFA) evaluated whether the hypothesized six-factor model conformed to empirical data obtained from a normative sample of 2,052 Australian children aged 8 to 12 years. The anticipated six-factor structure demonstrated superior statistical fit relative to alternative unidimensional or orthogonal configurations. Subsequent investigations across diverse international jurisdictions—including European, Asian, North American, and Latin American cohorts—have systematically confirmed that a hierarchical model featuring six first-order factors loading onto a single higher-order anxiety construct yields exceptional fit indices, affirming strong construct validity across varying cultural backgrounds.

Convergent Validity

The SCAS-Child exhibits strong, statistically significant convergent validity when evaluated against established, validated legacy measures of pediatric internalizing distress:

• Revised Children’s Manifest Anxiety Scale (RCMAS): Correlations between the SCAS-Child Total Score and the RCMAS Total Anxiety score typically range between r = .71 and r = .78 (p < .001), indicating substantial convergence in assessing internalizing distress.
• State-Trait Anxiety Inventory for Children (STAIC): Correlations between the SCAS Total Anxiety score and the STAIC Trait Anxiety subscale routinely fall within the r = .65 to .75 range.
• Structured Diagnostic Interviews: Subscale scores correlate substantially with dimensional severity ratings derived from the Anxiety Disorders Interview Schedule for Children (ADIS-C), demonstrating that children meeting formal DSM criteria for a specific anxiety disorder score significantly higher on the corresponding SCAS subscale.

Discriminant and Divergent Validity

Discriminant validity has been rigorously demonstrated against both non-anxiety psychopathology and externalizing behavioral syndromes:

• Depressive Symptomatology: While anxiety and depression naturally correlate due to underlying negative affectivity, correlations between SCAS-Child subscales and child depression metrics (such as the Children’s Depression Inventory [CDI]) are consistently moderate (r ≈ .50 to .60), significantly lower than the correlations observed between the SCAS and other validated anxiety instruments.
• Externalizing Syndromes: Correlations between the SCAS-Child and measures of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or conduct disorder are low to negligible (r < .25), confirming that the instrument specifically taps internalizing distress rather than diffuse childhood maladjustment.

Criterion and Clinical Discriminative Validity

Spence (1998) established that the SCAS-Child exhibits exceptional discriminative utility in separating clinically diagnosed anxious cohorts from non-clinical community controls. In clinical validation samples (N = 218), children diagnosed with DSM-IV anxiety disorders exhibited statistically significantly higher raw scores across every individual subscale and the total composite scale compared to matched healthy peers. Receiver operating characteristic (ROC) analyses routinely demonstrate areas under the curve (AUC) exceeding .85 for the total score, with normative cutoff scores set at approximately 1 to 1.5 standard deviations above the community mean (equivalent to the 84th percentile) maximizing diagnostic sensitivity (approx. 75–80%) and specificity (approx. 80–85%).

Reliability

The SCAS-Child exhibits outstanding internal consistency and temporal stability across clinical and epidemiological research.

Internal Consistency

In large-scale psychometric studies, internal consistency estimates (calculated via Cronbach’s alpha and McDonald’s omega) confirm the cohesive reliability of the instrument:

• Total Anxiety Score: The 38-item composite routinely yields Cronbach’s α coefficients between .92 and .94, reflecting exceptional global reliability in both clinical and community cohorts.
• Subscale Consistency: Individual subscales demonstrate acceptable to strong internal reliability, despite some scales containing as few as five or six items:
  • Separation Anxiety: α = .70 to .82
  • Social Phobia: α = .70 to .80
  • Obsessive-Compulsive: α = .73 to .83
  • Panic Disorder / Agoraphobia: α = .79 to .85
  • Generalized Anxiety: α = .73 to .81
  • Fears of Physical Injury: α = .60 to .72 (the comparatively lower coefficient reflects the heterogeneity of phobic stimuli such as heights, darkness, and medical procedures within a brief 5-item scale).

Test-Retest Reliability

Temporal stability has been established across diverse test-retest intervals:

• Short-Term Stability (2 to 4 weeks): Pearson correlation coefficients for the SCAS Total Score range from r = .75 to r = .86, demonstrating robust consistency when evaluated prior to therapeutic interventions.
• Medium-Term Stability (12 weeks to 6 months): Spence (1998) reported a 12-week test-retest correlation coefficient of r = .60 for the total anxiety score in non-clinical community samples, a figure consistent with expected developmental fluctuations in internalizing states among developing children. Subscale stability estimates across this window ranged from .45 to .62.

Cross-informant reliability between the SCAS-Child self-report and the SCAS-Parent version generally yields correlations in the moderate range (r = .40 to .55), aligning closely with meta-analytic benchmarks for parent-child internalizing concordance and underscoring the critical necessity of multi-informant assessment in child psychology.

Factor Analysis

The internal structural validity of the SCAS-Child has been scrutinized extensively using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

Initial Structural Derivation

In her seminal investigation, Spence (1997) conducted CFA on item responses from a broad normative community cohort of 2,052 children. To rigorously evaluate the underlying structure of childhood anxiety symptoms, several competing structural models were systematically contrasted:

1. A Unidimensional Model: All anxiety items loading onto a single general distress factor.
2. An Uncorrelated Orthogonal Multi-Factor Model: Independent, non-overlapping symptom domains.
3. A Correlated First-Order Six-Factor Model: Six intercorrelated first-order dimensions corresponding to DSM categories.
4. A Hierarchical (Higher-Order) Factor Model: Six first-order factors loading onto a single higher-order, overarching anxiety construct.

The statistical analyses demonstrated that the single-factor and orthogonal models exhibited exceptionally poor fit to the empirical data. Conversely, both the correlated six-factor model and the hierarchical higher-order factor model provided superior, statistically robust fit indices.

Model Fit Parameters and Invariance

In subsequent large-scale multi-site investigations (e.g., Spence, Barrett, & Turner, 2003) and cross-national replications across diverse sociocultural contexts, structural equation modeling has confirmed robust fit criteria for the hierarchical six-factor framework:

• Root Mean Square Error of Approximation (RMSEA): Values consistently range between .035 and .048, falling well below the conventional .06 threshold for superior model fit.
• Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI): Coefficients routinely range from .92 to .96, indicating strong structural fidelity.
• Standardized Root Mean Square Residual (SRMR): Values consistently remain below .05.
• First-Order Factor Loadings: Individual items load strongly onto their designated first-order factors (standardized loadings typically between .45 and .78), with minimal cross-loadings.
• Higher-Order Factor Loadings: The six first-order factors exhibit substantial loadings onto the overarching internalizing anxiety dimension (ranging from .65 to .90), demonstrating that while the clinical subtypes maintain discriminant validity, they remain anchored to a unified higher-order trait of pediatric anxiety.

Furthermore, multigroup CFA has affirmed metric and scalar measurement invariance across biological sex and age cohorts (children aged 8–11 vs. adolescents aged 12–15). This invariance confirms that the underlying latent constructs are measured equivalently across demographic subgroups, allowing valid comparisons of observed mean scores across genders and developmental stages.

Instrument / Measurement Tool

• Instrument Name: Spence Children’s Anxiety Scale – Child Version (SCAS-Child)
• Author: Susan H. Spence, AO, PhD
• Publication Date: 1997 (Structural Factor Validation); 1998 (Standardized Psychometric Clinical Metric)
• Target Demographic: Children and adolescents aged 8 through 15 years (suitable for youth with an approximate reading age of 8+ years)
• Administration Format: Self-report questionnaire; available in paper-and-pencil format or interactive web-based computerized administration via www.scaswebsite.com
• Administration Time: Approximately 10 to 15 minutes
• Total Number of Items: 45 items (comprising 38 scored clinical anxiety items, 6 unscored positive filler items, and 1 unscored open-ended phobic inquiry)
• Authentic Response Scale: 4-point Likert frequency scale:
  • 0 = Never
  • 1 = Sometimes
  • 2 = Often
  • 3 = Always
• Scoring and Computational Procedures:
  • The Total Anxiety Score is computed by summing the 38 scored clinical anxiety items, yielding a raw score range from 0 to 114. Higher scores correspond to greater symptom frequency and severity.
  • The 6 positive filler items (Items 11, 17, 26, 31, 38, 43) are omitted from all subscale and total anxiety calculations; they exist exclusively to disrupt negative response styles.
  • Item 45 is a qualitative inquiry enabling respondents to document idiosyncratic phobias not captured by the standardized items, serving descriptive clinical utility rather than quantitative scaling.
• Subscale Item Composition:
  • Separation Anxiety: Sum of Items 5, 8, 12, 15, 16, 44 (6 items; Range: 0–18)
  • Social Phobia: Sum of Items 6, 7, 9, 10, 29, 35 (6 items; Range: 0–18)
  • Obsessive-Compulsive: Sum of Items 14, 19, 27, 40, 41, 42 (6 items; Range: 0–18)
  • Panic Disorder / Agoraphobia: Sum of Items 13, 21, 28, 30, 32, 34, 36, 37, 39 (9 items; Range: 0–27)
  • Fears of Physical Injury: Sum of Items 2, 18, 23, 25, 33 (5 items; Range: 0–15)
  • Generalized Anxiety: Sum of Items 1, 3, 4, 20, 22, 24 (6 items; Range: 0–18)
  • Unscored Positive Filler Items: Items 11, 17, 26, 31, 38, 43
• Clinical Interpretation and Normative Benchmarks: Raw scores are converted into age- and gender-stratified T-scores and percentile ranks derived from large normative community cohorts. A raw or percentile score equal to or exceeding 1 standard deviation above the community mean (specifically a percentile score > 84 or T-score ≥ 60) denotes elevated internalizing distress warranting formal clinical evaluation. Scores exceeding 2 standard deviations above the mean (percentile > 98 or T-score ≥ 70) indicate severe clinical anxiety.

Permissions & Fee and Test Year

The Spence Children’s Anxiety Scale (SCAS) was formulated between 1997 and 1998. In a commitment to advancing global child mental health and empirical psychometrics, the copyright holder, Professor Susan H. Spence, has made the scale freely accessible for non-commercial clinical practice, academic research, and educational applications without royalty or licensing fees.

Clinicians, researchers, and educators may download, administer, and reproduce the paper versions or utilize automated scoring software hosted on the instrument’s official website (www.scaswebsite.com) without requesting individual written authorization, provided that Professor Spence’s copyright notices and formal academic citations remain intact. Any commercial distribution, incorporation into proprietary digital platforms, or fee-generating software requires explicit prior contractual agreement with the developer. Translation into foreign languages is actively facilitated through formal translation protocols detailed on the clearinghouse portal, which has yielded more than 30 validated language translations globally.

References

Spence, S. H. (1997). Structure of anxiety symptoms among children: A confirmatory factor-analytic study. Journal of Abnormal Psychology, 106(2), 280–297. https://doi.org/10.1037/0021-843X.106.2.280

Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36(5), 545–566. https://doi.org/10.1016/S0005-7967(98)00034-5

Spence, S. H., Barrett, P. M., & Turner, C. M. (2003). Psychometric properties of the Spence Children’s Anxiety Scale with young adolescents. Journal of Anxiety Disorders, 17(6), 605–625. https://doi.org/10.1016/S0887-6185(02)00236-0

Muris, P., Schmidt, H., & Merckelbach, H. (2000). Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: The Screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale. Personality and Individual Differences, 28(2), 333–346. https://doi.org/10.1016/S0191-8869(99)00102-6

Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent-report measure of children’s anxiety: Psychometric properties and comparison with children’s self-ratings. Behaviour Research and Therapy, 42(7), 813–839. https://doi.org/10.1016/S0005-7967(03)00200-6

Orgilés, M., Méndez, X., Spence, S. H., Carrobles, J. A., & Inglés, C. J. (2012). Spanish validation of the Spence Children’s Anxiety Scale. Child Psychiatry & Human Development, 43(2), 271–281. https://doi.org/10.1007/s10578-011-0265-y

Items of the Scale