Get the free Pediatric Symptom Checklist (PSC) - Pediatric Associates of Wellesley

DATE COMPLETED BY NAME RECORD # D.O.B. USE IMPRINTER HERE Pediatric Symptom Checklist (PSC) Emotional and physical health go together in children. Because parents are often the first to notice a problem

How to fill out pediatric symptom checklist psc

How to fill out the Pediatric Symptom Checklist (PSC):

1. Gather the necessary materials: You will need a copy of the PSC form, a pen or pencil, and a quiet and comfortable space to complete the checklist.
2. Read the instructions: Familiarize yourself with the instructions provided at the beginning of the PSC form. These instructions will guide you on how to accurately complete the checklist.
3. Review the checklist items: The PSC includes a list of different symptoms that are commonly seen in children. Carefully read through each item and consider whether your child has experienced any of these symptoms in the past six months.
4. Rate the severity: For each symptom, there will be a scale ranging from 0 to 2. Rate the severity of each symptom based on how often your child has experienced it in the past six months. A score of 0 indicates "never," 1 indicates "sometimes," and 2 indicates "often."
5. Be honest and reflective: Provide honest and accurate responses based on your observations of your child's behavior and symptoms. Take time to reflect on instances when your child has exhibited these symptoms and use that information to inform your rating.
6. Consider consulting a healthcare professional: If you are unsure about any of the symptoms or need assistance in interpreting the checklist, consider reaching out to a healthcare professional. They can provide guidance and help you better understand the results.

Who needs the Pediatric Symptom Checklist (PSC):

1. Parents and caregivers: The PSC is primarily designed for parents and caregivers to assess and monitor their child's behavioral and emotional well-being. It can provide valuable insights into potential areas of concern that may need further attention or support.
2. Healthcare professionals: The PSC is also commonly used by healthcare professionals, including pediatricians, psychologists, and school counselors. It can aid in the screening and identification of behavioral and emotional problems in children and inform appropriate interventions and support services.
3. Researchers and educators: The PSC is a widely recognized and validated tool that is frequently used in research studies and educational settings. It helps gather data on the prevalence of various symptoms and provides insights into the overall mental health of children.

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