PSC-17: Pediatric Symptom Checklist

This checklist is designed for parents or caregivers to reflect on a child's emotional and behavioral well-being. It is not a diagnostic tool, but can help guide awareness and support-seeking decisions.

⏱️ Time to complete: ~3 minutes👥 For ages: 4-16 years👤 Completed by: Parent/Caregiver

1. My child feels sad, unhappy

Never

Sometimes

Often

2. My child complains about feeling sick when nothing is wrong

Never

Sometimes

Often

3. My child seems to be having less fun

Never

Sometimes

Often

4. My child fidgety, unable to sit still

Never

Sometimes

Often

5. My child has trouble with teacher

Never

Sometimes

Often

6. My child less interested in school

Never

Sometimes

Often

7. My child acts as if driven by a motor

Never

Sometimes

Often

8. My child daydreams too much

Never

Sometimes

Often

9. My child distracted easily

Never

Sometimes

Often

10. My child is afraid of new situations

Never

Sometimes

Often

11. My child feels hopeless

Never

Sometimes

Often

12. My child has trouble concentrating

Never

Sometimes

Often

13. My child worries a lot

Never

Sometimes

Often

14. My child refuses to share

Never

Sometimes

Often

15. My child does not listen to rules

Never

Sometimes

Often

16. My child does not understand other people's feelings

Never

Sometimes

Often

17. My child teases others

Never

Sometimes

Often

Important Information

About This Tool: The PSC-17 was developed by Dr. Michael Jellinek and Dr. J. Michael Murphy and is in the public domain. It is widely used in pediatric settings.

Disclaimer: This tool is meant to support reflection and is not a substitute for professional care. Z Psychology did not create or modify this tool.

When to Seek Help: If you have concerns about your child's behavior or emotional wellbeing, we encourage you to consult with a licensed provider.

PSC-17: Pediatric Symptom Checklist

Please indicate how often each statement describes your child:

1. My child feels sad, unhappy

2. My child complains about feeling sick when nothing is wrong

3. My child seems to be having less fun

4. My child fidgety, unable to sit still

5. My child has trouble with teacher

6. My child less interested in school

7. My child acts as if driven by a motor

8. My child daydreams too much

9. My child distracted easily

10. My child is afraid of new situations

11. My child feels hopeless

12. My child has trouble concentrating

13. My child worries a lot

14. My child refuses to share

15. My child does not listen to rules

16. My child does not understand other people's feelings

17. My child teases others

Important Information