a teen patient conversing with a doctor

Checking IN

An electronic distress screening tool for clinical use in pediatric chronic illness

Why Screen for Pediatric Distress?

Having a medical condition can significantly impact a child’s mental health. Children with certain medical conditions can face a 50% to 60% higher risk of developing mental health disorders. The National Comprehensive Cancer Network (NCCN) designated emotional distress as the sixth vital sign for providers to recognize, document, and treat at each patient visit.


Objectives of distress screening:

  1. Improve patients’ quality of life through a tailored, personalized plan.
  2. Improve treatment adherence and identify barriers based in real time, with patient & parent feedback included.
  3. Fulfill Standards for the Psychosocial Care of Children with cancer and Their Families.

Pediatric Distress Screening:


Is endorsed by professional organizations

Pediatric distress screening is endorsed by National Comprehensive Cancer Network (NCCN), International Psycho-Oncology Society (IPOS), and International Society of Pediatric Oncology (SIOP).


Meets accreditation standards

Cancer programs seeking accreditation from the American College of Surgeons Commission on Cancer are monitored for adherence to patient-centered care standards, including distress screening.


Follows industry best practice

It’s considered a clinical best practice standard of care, supported by 149 studies.

checking in with a tablet

What Is Checking IN?

Checking IN is an evidence-informed and web-based dyad distress screening measure for patients aged 8-21.1 Key features of the tool include:

  • Self-reporting from the pediatric patient
  • Parent perceptions of the child's distress
  • Real-time feedback for providers

Program Highlights

  • Quick completion time (5-10 minutes) 
  • Accessible by phone, computer, and tablet, and can be delivered prior to patient visit or in an outpatient setting 
  • Provides clinically important and otherwise unknown data that may help inform the course of treatment 
  • Helpful in detecting suicidal ideation/self-harm in patients aged 10-21
  • Automations help streamline information received by clinics
  • Digital platform can support other assessments
  • Platform is flexible and can be used in multiple departments
  • Can be integrated with Electronic Medical Records


Domains Assessed

We offer 2-survey types: one for the patient and one for parents. They are broken out by 3 age groups with a further option to include Checking IN Light. Checking IN Light was developed for the email/SMS version for at home completion and does not including screening for suicidal ideation.









Access to Support


Why Checking IN Was Created

Pediatric patients are under-screened for distress due to operational barriers, particularly in the outpatient setting. Challenges in pediatrics within an outpatient setting include:

  • Lack of a real-time solution – Identification of psychosocial problems is often delayed during busy clinic days 
  • Staffing & resource bandwidth – With fewer resources, not every child can be seen by mental health professionals 
  • No easy way to identify highest psychosocial acuity – A brief measure is needed to identify those who need help

The NIH research showed current screening measures have limitations for children. These include: 

  • Lack of assessment for symptom interference or suicidal ideation
  • Kids don’t like the word “distress”
  • Not available digitally
  • No way to provide immediate feedback to provider

I love how the Checking IN screener can stratify areas of emotional concern. For example, are there concerns about sleep? How about family relationships or school? This allows us to determine if we need to have a conversation with the parents outside the patient's room.

Dr. Mark Vanderwel Medical Director of Endocrinology at Levine Children’s Hospital in Charlotte, NC
a girl in a hospital bed

How Checking IN Was Created

The questionnaire was developed by researchers in the Pediatric Oncology Branch of the National Cancer Institute (NCI NIH) and the National Institute of Mental Health (NIMH). 

Through the NIH's Tech Transfer program, the NCI and NIMH gave the Cancer Support Community (CSC) permission to commercialize Checking IN to increase its use in clinical settings and improve medically ill children's psychosocial health. 

Often, medical teams are not aware of a child's emotional distress until it becomes severe. This screening allows for early assessment and intervention with a vulnerable population of children. This tool has been useful in helping medical providers understand their patients more comprehensively.

Dr. Amii Steele Chief of Levine Children’s Psychology & Neuropsychology
a smiling girl in a hospital bed with a teddy bear
Man's hands typing on laptop keypad

Schedule a Demo Today

Contact us to learn more and schedule a demo for Checking IN

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  1. Wiener, L., Bedoya, S. Z., Gordon, M., Fry, A., Casey, R., Steele, A., Ruble, K., Ciampa, D., & Pao, M. (2023). Checking IN: Development, acceptability, and feasibility of a pediatric electronic distress screener. Clin Pract Pediatr Psychol, 11(1), 94–107.