Scale of Food Allergy Anxiety (SOFAA)

All four versions of the Scale of Food Allergy Anxiety (SOFAA) are downloadable here and free to use for non-commercial research and clinical purposes. Any other use requires written permission of the authors. Please click on the links below to download PDFs of each SOFAA.

The SOFAA-C is a self-rated questionnaire intended for use with children and adolescents ages 8–18 to assess food allergy-related anxiety and related anxious avoidance behaviors over the past week.

The SOFAA-P was developed as the corresponding parent-rated version; parents rate their perceptions of their child’s food allergy-related anxiety and anxious avoidance over the past week.

Full versions of both the SOFAA-C and SOFAA-P consist of 21 items, presented in the same order and with similar wording. Condensed versions of the measures are also available here as the SOFAA-C-brief and SOFAA-P-brief.

The 21-item SOFAA-C and 21-item SOFAA-P showed good-to-excellent validity – evaluated for construct, convergent, and divergent effects – and excellent reliability – both for internal consistency and under test-retest conditions. As shorter screening measures, the 14-item SOFAA-C-brief and 7-item SOFAA-P-brief were also shown to be valid and reliable (see Dahlsgaard et al., 2021).

Items for the SOFAAs were developed by a cognitive-behavioral therapist specializing in pediatric anxiety (KKD), in consultation with food allergy medical professionals (MOL, JMS) and parents of children with food allergies.

The SOFAAs may be used to screen children at risk for excessive food allergy-related anxiety, guide behavioral health interventions in this population, aid mental health providers in the efficient construction of exposure hierarchies, and establish a severity threshold for eligibility and evaluated outcome in a clinical trial.

Frequently asked questions

How do I score the SOFAA measures?

Answer: For all 4 versions of the SOFAA, responses are scored on a 5-point rating scale (4 = Almost Always; 3 = Often; 2 = Sometimes; 1 = Almost Never; and 0 = Never). Ratings from all items are summed to create a Total Score; higher scores indicate greater anxiety. Add up the scores and report this raw total as “SOFAA-P Total Score was…” or “SOFAA-C Total Score was…”

Do I have to convert/recode the 0-4 Likert scale to 1-5 prior to scoring?

Answer: No. Use 0-4 with no conversion.

What are the possible ranges of scores on the SOFAAs?

Answer: Total Scores on the full, 21-item versions of the SOFAA-C and SOFAA-P range from a possible 0-84. In the original validation sample (Dahlsgaard et al., 2021), the SOFAA-C Total Score mean was 29.1 (SD=18.3) and the SOFAA-P Total Score mean was 33.9 (SD=16.1).

Total Scores on the 14-item SOFAA-C-brief range from a possible 0-56; Total Scores on the 7-item SOFAA-P-brief range from 0-28. In the original validation sample (Dahlsgaard et al., 2021), the SOFAA-C-brief Total Score mean was 22.5 (SD=13.3) and the SOFAA-P-brief Total Score mean was 10.1 (SD=6.8). 

How do I handle missing items?

Answer: Calculate the Mean item score from the completed items on an individual’s SOFAA and then impute that mean item score for any items that were not completed. Then, sum all items for a raw total score as described above.

How do I reference the original validation of the SOFAAs for a journal article?

Answer: The current reference for the SOFAA in Vancouver style is as follows:

Dahlsgaard KK, Wilkey LK, Stites SD, Lewis MO, Spergel JM. Development of the Child- and Parent-Rated Scales of Food Allergy Anxiety (SOFAA). The Journal of Allergy and Clinical Immunology: In Practice. 2022 Jan 1;10(1):161-169.e6.

The current reference for the SOFAA in APA style is as follows:

Dahlsgaard, K. K., Wilkey, L. K., Stites, S. D., Lewis, M. O., & Spergel, J. M. (2022). Development of the Child- and Parent-Rated Scales of Food Allergy Anxiety (SOFAA). The Journal of Allergy and Clinical Immunology: In Practice, 10(1), 161-169.e6.

Here is the direct link to the online version of the article at JACI: In Practice:

Is there an electronic version of the SOFAAs with automatic scoring available?

Answer: At present, there is not – please print out measures and check back to this page for updates.

Are there any subscales or established cut points for the SOFAAs?

Answer: Not yet; please report Total Scores. And please check back to this page for ongoing updates on further validation efforts.

I have more questions on the use of the SOFAA OR I would like to collaborate on research on further validation of the SOFAA – whom should I contact?


Megan O. Lewis, MSN CRNP

  • Co-Director, The Food Allergy Bravery Clinic
  • Food Allergy Center
  • Children’s Hospital of Philadelphia
  • 3401 Civic Center Boulevard
  • Philadelphia, PA  19104
  • Email:

The SOFAAs may not be altered, sold, translated into another language or adapted for another medium (e.g., electronic, internet) without written permission of the developers of the SOFAAs.

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