Strengths and Difficulties Questionnaire (SDQ)

Overview

The Strengths and Difficulties Questionnaire (SDQ) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people, their parents and teachers.

There are currently three versions of the SDQ: a short form, a longer form with an impact supplement (which assesses the impact of difficulties on the child’s life) and a follow-up form. The 25 items in the SDQ comprise 5 scales of 5 items each. The scales include:

1) Emotional symptoms subscale

2) Conduct problems subscale

3) Hyperactivity/inattention subscale

4) Peer relationships problem subscale

5) Prosocial behaviour subscale

The SDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening.

Terms of use

If you are planning to use this measure for the delivery and improvement of health and/or social care, a license to incorporate it into electronic systems can be obtained from NHS Digital. Please note that licenses obtained via this route may be restricted to particular territory (e.g. England, UK). If planning to use the measure outside of England, you may wish to contact NHS Digital to clarify the geographical scope of the licence.

Scales/Subscales

The questionnaire can be completed on paper or online and can all be found on the Youth In Mind website.

Suitability

The SDQ can be completed by children and young people aged 11-17 years old, and a separate version can be completed by those aged 18 and over. The parent and teacher SDQ can be completed by the parent or teacher of CYP aged between 2 and 17 years old.

Clinical experience indicates that the SDQ may be appropriate to use with CYP with mild learning difficulties, but not with more severe learning difficulties (Law & Wolpert, 2014).

Administration

The questionnaire takes between five and ten minutes to complete. All versions of the questionnaire can be given to the appropriate respondent to complete themselves.

Alternatively, in order to ensure that each item is understood by the respondent, or to gain additional information about each response, the questionnaires can be administered directly by the clinician who can ask follow-up questions.

Working remotely with SDQ

Paper versions may be downloaded and subsequently photocopied without charge by individuals or non-profit organisations provided they are not making any charge to families. Users are not permitted to create or distribute electronic versions for any purpose without prior authorisation from youthinmind. If you are interested in making translations or creating electronic versions you MUST first contact youthinmind@gmail.com.

SDQplus assessments (https://sdqscore.org/sdqplus/) can reduce physical contact and allow those working remotely to continue providing mental health assessment, monitoring and analysis. The closely related web browser application SDQblockchain allows using SDQplus for cohorts of individuals (e.g., groups, class of students, client or patient list). The new self-entered assessments of SDQplus each cost US$1.00. They are email-able and provide reports (PDF included) and software tools in the fee.

Find out more here

Scoring

Assisted Scoring: If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces a technical and readable report with a description of the scores for a small cost.
Manual Scoring: Paper versions of the SDQ can be scored by following the instructions found on the SDQ website.

Interpretation

Assisted: After entering paper versions of the SDQ on the SDQ website, a report designed for professionals will then be generated.
If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces instant feedback reports including a technical report designed for professionals as well as a readable report with a description of the scores, the level of concern, an overall impression as well as suggestions about what to do if the child or young person, their parent/teacher still has concerns.
Manual: Instructions for scoring the SDQ manually can be found on the SDQ scoring website and instructions for interpreting the SDQ when scored by hand can be found here. Instructions in other languages are also available here.

Psychometric properties

Property	Definition	SDQ
Internal consistency	The degree to which similar items within a scale correlate with each other.	Research on the reliability of the SDQ has produced mixed results. Some articles say the SDQ exhibits strong internal consistency (Yao et al., 2009), some say the SDQ shows satisfactory internal consistency (Goodman, 2001) and others say there are concerns regarding the reliability of the subscales, with most subscales showing low internal consistency. It has been suggested that the SDQ total difficulties score should just be used for screening purposes (Mieloo et al., 2012).
Test-retest reliability	Degree to which the same respondents have the same score after period of time when trait shouldn't have changed.	SDQ showed moderate test-retest reliability (Yao et al., 2009).
Concurrent validity	Correlation of the measure with others measuring same concept.	SDQ shows good concurrent validity (Muris, Meesters & van den Berg, 2003).
Discriminant validity	Lack of correlation with opposite concepts.	SDQ showed good discriminant validity (Lundh, Wangby-Lundh & Bjarehed, 2008).

Translation

The SDQ is one of the most widely and internationally used measure of child mental health and has been translated into more than 80 languages. The English and translated versions are available here. Information on normative SDQ data from the United Kingdom, Australia, Denmark, Finland, Italy, Germany, Japan, Spain, Sweden and the United States can be found here.

Useful resources

More information on the SDQ can be found online, together with downloadable questionnaires and scoring instructions.

References

Goodman. R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40 (11), 1337-1345.

Law, D., & Wolpert, M. (2014). Guide to using outcomes and feedback tools with children, young people and families. UK: Press CAMHS.

Lundh, L.G., Wangby-Lundh, M., & Bjarehed, J. (2008). Self reported emotional and behavioral problems in Swedish 14 to 15-year-old adolescents: A study with the self-report version of the Strengths and Difficulties Questionnaire. Scandinavian Journal of Psychology, 49, 523–532.

Mieloo, C., Raat, H., van Oort, F., Bevaart, F., Vogel, I., Donker, M., & Jansen, W. (2012). Validity and reliability of the strengths and difficulties questionnaire in 5-6 year olds: Differences by gender or parental education. PLoS One, 7 (5), 1-8.

Muris, P., Meesters, C., & van den Berg, F. (2003). The Strengths and Difficulties Questionnaire (SDQ): Further evidence for its reliability and validity in a community sample of Dutch children and adolescents. European Child and Adolescent Psychiatry, 12 (1), 1–8.

Yao, S., Zhang, C., Zhu, X., Jing, X., McWhinnie, C. M., & Abela, J. R. Z. (2009). Measuring Adolescent Psychopathology: Psychometric Properties of the Self-Report Strengths and Difficulties Questionnaire in a sample of Chinese adolescents. Journal of Adolescent Health, 45, 55–62.

Hall, C., Guo, B., Valentine, A., Groom, M., Daley, D., Sayal, K., Hollis, C. (2019). The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms. US National Library of MedicineNational Institutes of Health