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Acute Stress Checklist for Children (ASC-Kids)

The Acute Stress Checklist for Children (ASC-Kids) is a brief self-report measure of acute traumatic stress reactions (including ASD diagnostic criteria) in children and adolescents aged 8 to 17. It has 29 items relating to the ASD diagnostic criteria and associated features. The measure is available in English and Spanish.

Completing the full-length measure takes about 5-10 minutes.

Brief (3- or 6-item) screener versions are also available, in English and Spanish.

It is designed as self-report but can be read to children ages 8 to 10 or if reading comprehension is a concern.

Available Only to ISTSS Members

This resource should be used in an ethical and responsible manner and should be used only for the purpose(s) for which it has demonstrable validity. Please observe copyright where indicated and reference it appropriately.

ASC-Kids all versions. 

Key Features and Uses

Brief child self-report, practical for administration in community settings within first month of exposure to acute event

Author/Publisher Details

Nancy Kassam-Adams
Center for Injury Research & Prevention
Children's Hospital of Philadelphia
2716 South Street, 13th floor
Philadelphia, PA 19146

Date   

2006 (29-item version in English)
2013 (29-item version in Spanish)
2016 (3- and 6- item screener versions)

Description   

The Acute Stress Checklist for Children (ASC-Kids) is a 29-item questionnaire designed to assess child acute stress reactions within the first month after exposure to a potentially traumatic event. Most items are rated on a three-point Likert scale (Never/Not at all; Sometimes/Somewhat; Often/Very much).

The ASC-Kids is a stand-alone self-report measure suitable for use by children ages 8 and older. For children 10 and younger, it may be helpful to read the items aloud while the child completes the answer on his/her own form.
25 ASC-Kids items assess DSM-IV criteria for acute stress disorder (Criterion A2, symptom criteria, and impairment). Four additional items ask about associated features that may be useful clinically (subjective life threat, family context, and coping). Scoring for DSM-5 ASD criteria has been described but not yet validated.

The brief screener versions are suitable for inclusion in clinical or research protocols in which time is very limited, or where traumatic stress symptoms are of interest but not the main focus.

Language   

Versions are available in English and Spanish.

Scoring and Psychometrics   

All items are scored as 0-1-2 (with 2 items reverse-scored). An item rated as "2" (very or often true) is considered to be a positive item when assessing presence of diagnostic criteria.

The ASC-Kids Symptom Scale is a continuous severity score (sum of 19 symptom items). The measure can also be scored for the presence of each DSM-IV diagnostic criterion for ASD.

  • Test retest reliability within 1 week = .76 for symptom scale (.83 for sum of all 29 items).
  • Internal consistency (Cronbach's alpha) = .85 for symptom scale (.86 for sum of all 29 items).
  • Convergent validity with PTSD symptom scale (r = .77)
  • Predictive validity to PTSD symptoms 4 months later (r = .61)
  • Moderate correlation with parent rating of child acute stress symptoms (r=.37)

Cut-off scores of 3 or greater (for the 3-item screener) or 6 or greater (for the 6-item screener) suggest the need for additional assessment of acute traumatic stress symptoms.

Key/Core References   

Kassam-Adams, N. (2006). The acute stress checklist for children (ASC-Kids): Development of a child self-report measure. Journal of Traumatic Stress, 19(1), 129-139.

Kassam-Adams, N, Gold, J, Montaño, Z, Kohser, K, Cuadra, A, Muñoz, C, Armstrong, FD. (2013). Development and psychometric evaluation of child acute stress measures in Spanish and English. Journal of Traumatic Stress, 26(1):19-27.  doi: 10.1002/jts.21782

Kassam-Adams, N & Marsac, ML. (2016). Brief practical screeners in English and Spanish for acute posttraumatic stress symptoms in children.  Journal of Traumatic Stress, 29 (6):483-490. doi: 10.1002/jts.22141  PMID: 27923266

Manual   

There is no manual for the ASC-Kids it is used in the same way as other self report scales and is self explanatory. For advice on interpretation, see above and refer to key references.