Tools Every NP/PA Should Know for Detecting Anxiety in Children

Anxiety disorders are among the most common mental health conditions in children and adolescents—affecting nearly one in ten young patients. Yet, they often go unnoticed in busy primary care settings. For Nurse Practitioners (NPs) and Physician Assistants (PAs), being equipped with the right tools for early detection is essential not only for accurate diagnosis, but also for connecting children and families with timely treatment.At PsyPhyCare, we know that supporting clinicians with practical resources can make all the difference. Below are the must-know screening toolsevery NP and PA should have in their toolkit when evaluating pediatric patients for anxiety.

1. PSC-17 (Pediatric Symptom Checklist – 17)

• Who it’s for: Ages 5–17
• Completed by: Parents
• What it screens: Anxiety, depression, ADHD, and externalizing behaviors.
• Why it matters: This quick, free, and validated screener can be integrated into your EMR or used in paper form. A positive result doesn’t confirm a diagnosis but signals the need for further assessment.

💡 Tip: Billing code 96127 can be applied when documenting PSC-17 screenings during well-child visits.

2. SCARED (Screen for Child Anxiety Related Disorders)

• Who it’s for: Ages 8–18
• Completed by: Child and/or parent
• What it does: Differentiates types of anxiety—such as separation anxiety, social anxiety, generalized anxiety, and panic disorder.
• Why it matters: Understanding the type of anxiety helps tailor treatment plans, whether that’s CBT, parental coaching, or medication.

3. PHQ-9 Modified for Adolescents

• Who it’s for: Adolescents
• What it measures: Depression symptoms, which often overlap with or complicate anxiety.
• Why it matters: Identifying co-occurring depression ensures that treatment is comprehensive, not just focused on anxiety.

4. GAD-2

• Who it’s for: Teens and young adults
• What it screens: Core symptoms of generalized anxiety disorder.
• Why it matters: As a brief two-question screener, it’s easy to implement universally, especially in busy practices.

5. ASQ-SI (Ask Suicide-Screening Questions – Suicide Ideation)

• Who it’s for: Adolescents
• Why it matters: Anxiety can increase risk for suicidal thoughts, and screening ensures safety concerns are addressed early.

Integrating Screening Into Practice

• Make it universal: Offer screeners at all well-child and adolescent visits.
• Use EMR integration: Many tools can auto-score, saving time.
• Have a plan for positives: Establish referral pathways to behavioral health, and know when CBT, SSRIs, or both may be indicated.
• Educate families: Normalize anxiety, reduce stigma, and provide resources to support parents at home.

Why This Matters

Early detection changes lives. Children with untreated anxiety often struggle with school avoidance, sleep problems, and physical complaints that impact their development. By using these tools, NPs and PAs can catch symptoms earlier, guide families toward effective treatment, and ultimately improve long-term outcomes.At PsyPhyCare, we believe that empowering practitioners with evidence-based resources doesn’t just enhance clinical care—it strengthens communities.

✨ Looking for more practitioner resources? Visit RAMP at Lurie Children’s Hospital for CME opportunities, training, and patient handouts you can use in practice.Resources Advancing Mental Health in PediatricsRAMP is an online training hub for pediatric clinicians offering a full mental health curriculum as well as brief modules that cover frequently asked questions and targeted clinic guidance. Read more. 

This article was informed by insights from Dr. Preethi Raghupatruni, MD, Medical Director at Lurie Children’s Pediatrics at Uptown and Clinical Educator at Northwestern University Feinberg School of Medicine, presented at Pri-Med Midwest 2024.