Pediatric Symptom Checklist (PSC-35) - Los Angeles County 2026

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The document is a Pediatric Symptom Checklist (PSC-35) designed for use by caregivers in Los Angeles County to assess children's emotional and physical health. It includes a series of questions aimed at identifying behavioral, emotional, and learning issues in children, with responses indicating the frequency of various symptoms. The checklist is intended to help parents and guardians provide accurate information to facilitate appropriate care for their child.

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Click ‘Get Form’ to open the Pediatric Symptom Checklist (PSC-35) in the editor.
Begin by entering the date and your child's name at the top of the form. This information is essential for identifying the assessment.
Next, indicate your relationship to the child by selecting from the provided options such as Mother, Father, or Agency Staff.
In the main section, you will see a series of statements regarding your child's behavior. For each statement, mark under the heading that best describes how often it applies to your child: NEVER, SOMETIMES, or OFTEN.
Once all statements are completed, review your responses for accuracy. Ensure that you have answered all required questions.
If applicable, agency staff should complete their section at the bottom of the form, including practitioner details and total score.

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When do you use a Pediatric Symptom Checklist?

The Pediatric Symptom Checklist (PSC) helps mental health clinicians understand the types and severity of problems reported by the parents of patients or adolescent patient themselves. When administered at successive time points, the PSC can also be used to assess improvement or deterioration in functioning.

What is the cut off for pediatric symptom checklist?

Interpreting PSC Scores The recommended cutoff to indicate a possible problem is based on a large national sample in the U.S., where a score of 28+ identifies about 12% of children as being at risk (Jellinek et al., 1999; Murphy et al., 2016).

What is the age range for pediatric symptom checklist PSC?

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.

What is the age criteria for pediatric patients?

The Child Symptom Inventory-4 (CSI-4) is a behavior rating scale for evaluating the symptoms of DSM-IV and DSM-5 emotional and behavioral disorders among children between 5 and 12 years old who are attending elementary school (kindergarten thru 6th grade). There are both parent- and teacher-completed versions.

Who can administer a pediatric symptom checklist?

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.

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How to calculate pediatric symptom checklist?

The PSC consists of 35 items that are rated as Never, Sometimes, or Often present and scored 0, 1, and 2, respectively. The total score is calculat- ed by adding together the score for each of the 35 items.

What is the age range for the PSC checklist?

The Pediatric Symptom Checklist, or PSC or PSC-35, is required for youth mental health clients ages 0-18.