1. Does your child worry excessively about certain situations, people, or the world at large?
A. They often get apprehensive, and it seems almost impossible to comfort them.
B. They sometimes get worried about something bad happening, yet we can calm them down relatively quickly.
C. They get worried rarely and mostly in an unknown situation; they quickly become calmer when they feel our support.
2. How does your child eat and sleep?
A. They eat regularly and mostly have a good night's sleep.
B. They seem to eat a bit more or less than usual or sometimes have difficulty falling or staying asleep.
C. They eat very much or very little or have nightmares, wake up often, or can't fall asleep at night.
3. Is your child restless or tired most of the time?
A. They sometimes appear more hyperactive or tired, slightly affecting their everyday activities.
B. They are often restless or exhausted; they seem too distracted or tired to participate in everyday activities, even play.
C. They are normally calm and have enough energy throughout the day.
4. Does your child experience any of the following � muscle tension, headaches, stomachaches, nausea, shaking, and sweating?
A. It happens rarely, and these conditions disappear with the prescribed medication.
B. It happens from time to time, and medication appears to be somewhat effective.
C. It happens often, and medication doesn't seem to affect them in the long run.
5. Does your child want to avoid everyday social activities, such as playing with friends, going out, meeting new people, or going to school/kindergarten?
A. They get very upset and refuse to participate in such activities.
B. They seem a bit worried whenever the time comes for these activities.
C. They enjoy these activities and go out with great enthusiasm.
6. How does your child react when you go out without them or leave them with others?
A. They may cry and not let us go outside, yet they get calmer after a while.
B. They are relatively calm when they are in a familiar place.
C. They get upset and clingy, and it's tough to comfort them.
7. How does your child react when speaking or performing in front of others, like in school presentations or social events?
A. They feel a bit nervous but can manage to speak or perform with some encouragement
B. They are comfortable speaking or performing in front of others without much hesitation.
C. They become extremely anxious, avoid such situations, or have a hard time even if they do it.
8. How often does your child express physical symptoms like shortness of breath, racing heart, or dizziness without any apparent physical cause?
A. Rarely, and these symptoms usually go away on their own.
B. Sometimes, the symptoms may linger for a bit.
C. Quite often, these symptoms might cause discomfort or distress.
9. Does your child frequently seek reassurance or ask repetitive questions about their safety or the safety of others?
A. Occasionally, they might ask a few questions, but not excessively.
B. They ask repetitive questions or seek reassurance more often than usual.
C. They constantly seek reassurance and ask repetitive questions that are hard to satisfy.
10. How does your child react to changes in their routine or unexpected events?
A. They adapt well and might feel a little curious about the change.
B. They are somewhat resistant to changes but can manage with some support.
C. They become visibly distressed, anxious, or upset when things don't go as planned.
11. Is your child irritable or reacts angrily towards you without apparent reason?
A. They may get angry when they're not allowed something.
B. They often appear irritable and uneasy and react with opposition to almost everything.
C. They seem more nervous and angry without apparent reason from time to time.
12. Does your child often feel the need to avoid situations that remind them of a past negative experience?
A. Occasionally, they might express discomfort but can still manage these situations.
B. They tend to avoid certain situations or places due to past negative experiences.
C. They consistently avoid situations that remind them of past negative experiences.
13. How does your child behave when in a new situation or presented with a new task?
A. They are curious about the new environment and openly engage in the activities.
B. They appear a bit cautious, have difficulty loosening up, and engage in activities with a little push.
C. They seem very cautious and fear making mistakes so much that we have to push them a lot to participate in any task.
14. Does your child cry or seem overly sensitive in everyday life?
A. They become very upset even in non-provoking situations, and it's hard to comfort them.
B. They are more sensitive and get upset more quickly, yet they calm down after a while.
C. They may cry and become sensitive only when the situation has evoked it.
15. Does your child have irrational fears, such as the fear of a certain object, animal, person, or place?
A. They have a fear of the dark or become uneasy whenever there is a storm outside.
B. They get very upset and refuse to look at certain animals or objects or go to specific people or places.
C. They may fear places or people who are not yet familiar with them, yet they are willing to engage with our support.
