Now that you’ve had a chance to review some examples, think about your child’s fears. Then fill out this Fears and Worries Checklist. You can either print it and fill it out, or you can fill it out electronically. Don’t worry about getting everything right now, you will come back to this checklist later on!
Print out this PDF version for your own use.
Specific Fears
- Dark
- Insects
- Animal(s)
- Medical providers or situations
- Water
- Weather changes
- Loud noises
- Items that make loud noises
- Monsters, aliens, the supernatural, etc.
- Heights
- Escalators/elevators
- Germs
- Throwing up or getting sick
- OTHER:
Generalized Worries
- Worries about making mistakes
- Worries about getting in trouble
- Worries about performance
- Anxious about assignments or tests
- Gets upset and/or starts over when something they are doing is not perfect
- Asks a lot of questions
- Complains of physical symptoms (e.g., headaches, stomachaches, sleep problems)
- OTHER:
Social Fears
- Thinks others will think badly of them
- Scared of answering or asking questions in class
- Avoids standing out or being the center of attention
- Worries that others will laugh at them
- Avoids interacting with peers
- Avoids speaking to others
- OTHER:
Separation
- Scared of being separated from caregivers
- Worries about something bad happening to caregivers
- Worries about getting lost
- Scared of sleeping away from caregivers or home
- Follows caregivers around
- Complains of physical symptoms when required to separate from caregivers
- Gets upset/tantrums when required to separate from caregivers
- OTHER:
