The ECSA is a screening tool for early childhood mental health concerns and parental depression for children 18–60 months. The screen also identifies parental concerns.

There is one form for all age groups. The parent version includes items focused on parental depression and parental distress. The child care version is available without caregiver items.

Parents complete the 40-item form, identifying frequency of specific behavioral problems as well as those items about which they have concerns. The last four items include the PHQ-2 validated screen for adult depression as well as two items that reflect parental distress. The measure also includes a question about "how worried" parents are about the child's behavior, emotions, and relationships.

Measure Completion: The content is written at the fifth-grade reading level and can be completed in 5–10 minutes. It is available in English, Spanish, and Romanian.


Scoring Overview

Please complete all items for most accurate scoring. If more than 2 items (items 1–36) are missing, the score is not interpretable.

Items 1–36: The response categories are: "Rarely/not true", " Sometimes/Sort-of", and "Almost always/very true", and are scored 0, 1, and 2 respectively. A score of 18 or higher on items 1–36 represents a positive screen with a higher risk of meeting criteria for a mental health disorder.

Items 37–38: A score of at least 2 on items 37 and 38 indicates a positive PHQ-2 screen reflecting likelihood of parental depression.

Items 39–40: Items 38 and 39 reflect maternal distress. No cut-off has been identified.

Concern: Parents are also asked to circle a “+” if they are “concerned about a behavior and want help with it”.

Please consult the ECSA manual for scoring instructions.



This information is provided by MassHealth.