Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families

Abstract

BackgroundScreening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3–5) as perceived by families in New Zealand.MethodsA qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed.ResultsMany parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool.ConclusionsIn summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.

Concurrent Validity of the Strengths and Difficulties Questionnaire in an Indigenous Pre-School Population

“…However, in New Zealand the SDQ is only used as part of the B4SC, the last routine Tamariki Ora (the New Zealand Well Child Programme) assessment carried out by nurses. A recent qualitative study indicated that for Māori parents, cultural values and perspectives might impact on people's willingness or ability to be open when answering the questions, and that this may lead to the possibility that people do not complete the questionnaire honestly (Kersten et al, 2016b). This could be one reason for the low threshold values.…”

“…Our previous qualitative work suggested that Māori parents considered the process of administering the SDQ and the tool itself as a Pākehā (New Zealander of European descent) approach to labelling their children, that they preferred a non-deficit approach, and that they were concerned about providing affirmative responses to negative questions (Kersten et al, 2016b). This may impact on the cultural and face validity of the SDQ for Māori and inadvertently lead to them reporting fewer difficulties on the tool.…”

“…Māori tamariki (children), similar to indigenous children from around the world, are recognised as facing health disparities that frequently begin in pre-school years (Bramley, Hebert, Tuzzio, & Chassin, 2005;King, Smith, & Gracey, 2009;Robson & Harris, 2007). We, and others, have shown previously that Māori generally prefer face to face interactions rather than questionnaires, a non-deficit approach in assessment, and the consideration of the historical context of colonisation (Elder & Kersten, 2015;Kersten et al, 2016b;Smith, 1999). It is therefore important to evaluate if the SDQ is valid for use with Māori.…”

Strengths and Difficulties Questionnaires strengths and limitations as an evaluation and practice tool in Social Work

“…Differences in ethnicity, context, age, gender, sexuality, ability and class feed in to how different people experience the world, identify their place in it and engage with others (Gibson-Graham, 2016). Kersten, Dudley et al's (2016) findings suggest that some individuals or families, although guided through the SDQ question by question, faced challenges about:…”

“…4-5). As no interviews were conducted in this body of research, a direct correlation to Kersten, Dudley et al's (2016) findings is not possible but is analysed to provide an example of why SDQ scores may have been so variable between scorers or no response was given. SDQ, although seen as easy to use in psychology circles (Vostanis, 2006), thus remains largely untested in social work practice for its potential strengths and weaknesses as an information gathering and evaluation tool.…”