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  • Ca Pediatric Symptom Checklist (psc-35) Scoring Sheet - San Francisco 2021

Get Ca Pediatric Symptom Checklist (psc-35) Scoring Sheet - San Francisco 2021-2025

Date of Birth: Assessment Date (mm/dd/yyyy): Item No. 4 7 8 9 14 PSC-35 Filled out by: Name of Care Provider/Clinician/ Case Manager: Attention subscale items Fidgety, unable to sit still Acts as if driven by a motor Daydreams too much Distracted easily Has trouble concentrating Never (0), Sometimes (1), or Often (2) Enter score Enter score Enter score Enter score Enter score 0 Attention subscale score: Item No. 11 13 19 22 27 Internalizing subscale items Feels sad, unhappy Feels hopeless.

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The youth self-report version of the Pediatric Symptom Checklist (PSC-Y) can be used with patients between the ages of 11 and 18 and takes less than five minutes to complete and score. The PSC-Y can be administered and scored by a nurse, medical technician, physician assistant, physician or other office staff.

The total score is calculat- ed by adding together the score for each of the 35 items. For children and adolescents ages 6 through 16, a cutoff score of 28 or higher indicates psycho- logical impairment. For children ages 4 and 5, the PSC cutoff score is 24 or higher (Little et al., 1994; Pagano et al., 1996).

Total Score: is determined by adding the value of the 35 items. “Never” has a value of (0), “Sometimes” has a value of (1), and “Often” has a value of (2). Cutoffs: Clinical cutoffs vary by the age of the child. For children ages 3 to 5, scores of 24 and above are clinically significant.

The BPSC is an emotional/behavioral screening instrument for children under 18 months of age. The BPSC was created as part of a comprehensive screening instrument designed for pediatric primary care and is modeled after the Pediatric Symptom Checklist.

Total score* *Clinical cutoffs are determined by the age of the child. For children ages 3 to 5, scores of 24 and above are clinically significant. For children/adolescents aged 6 to 18, scores of 28 and above are clinically significant.

Parents/caregivers will complete the PSC-35 (parent-completed version) for their children ages 3 and youth up to age 18.

What is the PSC–17? The Pediatric Symptom Checklist (PSC) is brief screening questionnaire that is used to improve the recognition and treatment of psychosocial problems in children ages 4 to 17 years. It is used in place of the PHQ-9 for Health Home beneficiaries within this age group.

The total score is calculat- ed by adding together the score for each of the 35 items. For children and adolescents ages 6 through 16, a cutoff score of 28 or higher indicates psycho- logical impairment. For children ages 4 and 5, the PSC cutoff score is 24 or higher (Little et al., 1994; Pagano et al., 1996).

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232