Developmental, Behavioral, Psychosocial, Screening, and Assessment Forms

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The following Bright Futures Tool and Resource Kit materials are available for download for review and reference purposes only. For any other use, to make multiple copies of specific items, or to incorporate forms into an Electronic Medical Record System, please contact institutions@aap.org.

NOTE: No tool is perfect, and the inclusion of these tools does not imply American Academy of Pediatrics endorsement, they were chosen because of their accessibility and reliability based on current research.

Maternal Depression Screening
Patient Health Questionnaire-2 (PHQ-2) | Instructions
Patient Health Questionnaire-9 (PHQ-9) | Instructions (translated versions available here​​​​)
Edinburgh Postnatal Depression Scale: Permission required for use*
Contact the Royal College of Psychiatrists at permissions@rcpsych.ac.uk to request permission to use. Rights and Permissions Manager: Lucy Alexander.
Also see Detection of Postnatal Depression: Development of the 10-Item Edinburgh Postnatal Depression Scale, by J. L. Cox, J. M. Holden, and R. Sagovsky, in the British Journal of Psychiatry. 

Parent and Family Assessment

Safe Environment for Every Kid (SEEK) Parent Questionnaire (PQ)​​​
This brief evidence-based questionnaire screens for prevalent ​psychosocial problems:
parental depression, major stress, substance abuse, partner violence, harsh punishment and food insecurity. For information on the SEEK PQ and model, go to SEEKwellbeing.com, then Implementation/Core Materials.​ 
  (translated versions available 
her​e​​​​​​)

Developmental Screening​
Developmental Screening Tools -Table

Psychological and Behavioral Assessment
Pediatric Symptom Checklist (PSC-17) | Instructions (translated versions available here)
Pediatric Symptom Checklist (PSC-35) | Youth Report (Y-PSC) | Instructions
Strengths and Difficulties Questionnaires (SDQ sample) | Follow-up | Instructions
  (translated versions available here​)
For permission to use the SDQ, contact Helena Hamilton​​ at:
E-mail: youthinmind@gmail.com
Web site: www.sdqinfo.org

Autism-Specific Screening
Checklist for Autism in Toddlers (CHAT) | Instructions
Modified Checklist for Autism in Toddlers (M-CHAT) | Instructions
  (translated versions available here​)

Oral Health Screening
AAP Oral Health Risk Assessment Tool​ (in both English and Spanish)

Substance Use Screening
CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) Screening Questionnaires 
  (translated versions available here​​​​)
Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide​​ (NIH resource)

*Note: The Bright Futures Tool and Resource Kit contains additional forms and materials.

To obtain these materials, order your CD today.