The Pediatric Symptom Checklist (PSC) is a 35-item parent-report questionnaire designed to identify children with difficulties in psychosocial functioning.
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).
[3] The first draft was a shortened and revised form of the Washington Symptom Checklist (WSCL) designed by Weinberger and Gregory.
They also revised questions to address the five major areas they wanted to examine: mood, play, school, friends, and family relations.
[1] 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).
[2] 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".
As a self-report measure, it is useful for identifying symptoms of internalizing disorders, such as anxiety or depression, which are often missed by parents.
It also includes three sub-scales which were designed to screen for distinct domains of psychosocial problems — internalizing, externalizing, and attention — and provide physicians with more information about directions for further evaluation.
The subscales were also intended to increase the sensitivity of the screen because only using a total score might miss children with dysfunction in only one domain.
[4] One of the original studies of the PSC-17 measured internal consistency of the full scale and each of its subscales and found alpha values for each between 0.79 and 0.89.
[1] An early study of the PSC compared it with the Child Behavior Checklist (CBCL) developed by Achenbach and found kappa = 0.76 indicating a high level of agreement.
[4] The original study of the PSC-17 compared its subscales to other validated parent report instruments and found good agreement.
Routine use of screening instruments, like the PSC, in primary care is a means of improving recognition and management of dysfunction.
[19] Studies have shown that referral to mental health services can lead to improved academic performance and that recognizing and managing psychosocial problems is “one of the best ways to prevent delinquency, violence, and other high-risk behaviors.” [18][19] The PSC can also be used to track outcomes of treatment as successful interventions have been found to reduce scores over time.
[24] The PSC and PSC-17, as parent-report measures, have some limitations: parents may not recognize or acknowledge their children's problems, especially if they have weak parent-child connections, and may under- or over-report their symptoms.