Perinatal Screening
Screening Frequency
| Timeline | Screening Tool |
| Pre-Conception | PHQ-9 GAD-7 Review safety of psych meds |
| Intake | EPDS + GAD-7 ANRQ |
| 26-28 weeks gestation | EPDS + GAD-7 |
| Six weeks postpartum | EPDS + GAD-7 ANRQ (post partum) |
If your patient is high-risk, we recommend additional screening with the EPDS at 2 weeks postpartum.
We recommend asking "How is your bond with your baby?" at any postpartum visit.
Screening Tools
Interactive Screening Tool
A quick and easy way to screen your patients for depression and/or anxiety with an option to print or email the results.
Depression
Edinburgh Postnatal Depression Scale (EPDS) (Form-fillable; Printable; English)
The EPDS has been translated into many other languages, including French, and these versions can be found here.
Anxiety
GAD-7 Patient Screening Tool (Form fillable; Printable; English)
GAD-7 (French)
Depression and Anxiety Combined Screening
Combined EPDS and GAD-7 Screening Tool (Form fillable; Printable; English)
ANRQ (Psychosocial) Risk Questionnaire
ANRQ with Family Violence & Drug/Alcohol Questions - Client
ANRQ Postnatal Version with FV & D+A Questions - Client
Additional Screening
| If your patient scores... | Consider screening for... |
| Positive on the EPDS | Bipolar Disorder with the MDQ |
| Positive for Q10 on the EPDS | Suicide Risk with the C-SSRS |
| Positive on the GAD-7 | PTSD with the PCL-5 |
Why screen for bipolar disorder?
- It is important to screen for bipolar disorder because 1 in 5 patients who screen positive for perinatal depression may have bipolar disorder.
- Treating with an unopposed antidepressant can induce mania, mixed states, and rapid cycling, all of which carry significant risks.
- Bipolar disorder is associated with increased risk of postpartum psychosis and postpartum psychosis is associated with suicide and infanticide.
Bipolar Disorder
Suicide Risk Assessment Tool
Columbia-Suicide Severity Rating Scale (C-SSRS) - PDF
PTSD
Early Childhood Screening
Screening can happen at any point you deem it relevant for an assessment. Examples may include:
- During routine well-baby and well-child visits through developmental surveillance,
- Whenever parents express concerns about behaviour, emotions, regulation, attachment, sleep, feeding, or social-emotional development,
- When there are risk factors such as caregiver mental illness, family stress, adverse childhood experiences, developmental concerns, or disrupted parent-child relationships.
Early Childhood Screening Guidance
Screening Tools
Mental Health and Level of Need
HEADS-ED Under 6 (clinician-administered tool):
- Screens for mental health and developmental concerns and level of need across seven domains for children under age 6
Trauma:
The Pediatric Aces and Related Life-events Screener (child tool) PEARLS child tool:
- Caregiver report questionnaire that screens for Adverse Childhood Experiences and socio-determinants of health.
- CATS is based on DSM-5 criteria for 3-6-year-old PTSD symptom criteria. CATS includes a caregiver self-report as well as an interview.
Autism Spectrum Disorder:
Childhood Asperger Syndrome Test (CAST):
- Brief caregiver report questionnaire to screen for behaviours linked to core features of autism spectrum conditions including social impairment, repetitive behaviours, and communication difficulties.
Attention-Deficit Hyperactivity Disorder and Oppositional Defiance Disorder
Swanson, Nolan and Pelham Rating Scale (SNAP-IV):
- Caregiver, or teacher report rating scale used to assess difficulties in behaviour regulation or attention. The items and sub-scales for Inattention, Hyperactivity and Oppositional Defiance Disorder are based on DSM-V criteria.
Anxiety
- Parent/guardian report scale to assess anxiety in the child. In addition to providing an overall measure of anxiety, PAS scores on fiver subscales: (1) Generalized anxiety, (2) Social anxiety, (3) Obsessive compulsive disorder, (4) Physical injury fears, and (5) Separation anxiety.
Parenting Stress
- Parents or caregivers of children of any age can complete the PSS questionnaire to assess feelings about the positive and negative aspects of parenthood.
Me as a Parent Scale (MaaPS-16)
- The MaaPS-16 is completed by parents to screen for perceived parenting efficacy and self-regulation.