Validity of the Strengths and Difficulties Questionnaire in Preschool-Aged Children

Abstract

BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen for child mental health problems and measure common forms of psychopathology in 4-to 16-year-olds. Using longitudinal data, we examined the validity of a version adapted for 3-to 4-year-olds. METHODS:We used SDQ data from 16 659 families collected by the Millennium Cohort Study, which charts the development of children born throughout the United Kingdom during [2000][2001]. Parents completed the preschool SDQ when children were aged 3 and the standard SDQ at ages 5 and 7. The SDQ's internal factor structure was assessed by using confirmatory factor analysis, with a series of competing models and extensions used to determine construct, convergent, and discriminant validity and measurement invariance over time. Predictive validity was evaluated by examining the relationships of age 3 SDQ scores with age 5 diagnostic measures of attention-deficit/hyperactivity disorder, autism spectrum disorder/Asperger syndrome, and teacher-reported measures of personal, social, and emotional development. RESULTS:Confirmatory factor analysis supported a 5-factor measurement model. Internal reliability of subscales ranged from v = 0.66 (peer problems) to v = 0.83 (hyperactivity). Itemfactor structures revealed measurement invariance over time. Strong positive correlations between ages 3 and 5 SDQ scores were not significantly different from correlations between age 5 and 7 scores. Conduct problems and hyperactivity subscales independently predicted developmental and clinical outcomes 2 years later.CONCLUSIONS: Satisfactory psychometric properties of the adapted preschool version affirm its utility as a screening tool to identify 3-to 4-year-olds with emotional and behavioral difficulties. WHAT'S KNOWN ON THIS SUBJECT:Although the psychometric properties of the school-age Strengths and Difficulties Questionnaire (SDQ) have been extensively examined by using longitudinal data, the preschool version of the SDQ has only been explored in a limited number of cross-sectional studies. WHAT THIS STUDY ADDS:This is the first psychometric study of the preschool SDQ using longitudinal data. We report measurement invariance over time, satisfactory reliability, construct and criterion validity, and predictive utility for subsequent behavioral problems (4 years) and clinical disorders (2 years). Ms Croft contributed to the choice of analysis, carried out the analyses, and drafted the manuscript; Dr Stride conceptualized and designed the analyses and reviewed and revised the manuscript; Dr Maughan conceptualized the study and critically reviewed the manuscript; Dr Rowe coordinated the research team, contributed to the choice of analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

The Strengths and Difficulties Questionnaire (SDQ) for preschool children—a Swedish validation

“…Recently, SDQ was used in a normative sample of parents of children aged 2-5 (15) . The SDQ preschool version has been confirmed to identify 3-4 years old children with emotional and behavioural difficulties (16) . The self-report has also been validated in Sweden (17) .…”

The psychometric properties of the Strengths and Difficulties Questionnaire in a multi-ethnic sample of young children

“…Similarly, CFAs conducted using data from three-year old Spanish children found only marginal baseline fit for either the teacher or parent rated version in five-factor first order and second order configurations (Ezpeleta et al, 2013). Croft et al (2015) found a less than adequate fit (CFI = 0.905) for a five-subscale structure but did not test solutions not involving the prosocial scale. It is difficult to unpick the reasons for the variation in fit between samples for solutions involving the prosocial scale as our study is unusual in that we tested different configurations with it included and excluded.…”

“…At least superficially, some broad comparisons can be drawn, but these are tentative and sample sizes, population heterogeneity, and methods may have altered size and pattern of any or all loadings. Theunissen et al (2013) using CFA in a parent-rated Dutch sample of 3-4 year olds found that Q03 (complains) and Q19 (bullied) low-loaded (<0.3) in a five-subscale configuration, while Croft, et al (2015) reported a loading of 0.39 for Q21 (thinks) in their 3 year old sample. In their CFA study of Spanish 3 year olds Ezpeleta, et al (2013) found that Q22 (steals/spiteful) low-loaded (<0.4) on the parent-rated version in both five-subscale and second-order models whereas Q19 (bullied) low-loaded (<0.4) on the teacher-rated version in both models.…”

“…a screening instrument, and fewer modelling studies have been conducted in samples within this younger age range. A recently reported CFA of the parent administered SDQ at age 3 in a UK-representative sample found more support for a five than a three or one subscale structure (Croft et al, 2015). In contrast, CFA studies in Spanish and Dutch samples reported less than satisfactory baseline fit for the five subscales, a unidimensional structure of all 25-items, and a second order structure of the five subscales within the two broad subscales (Ezpeleta et al, 2013;Theunissen et al, 2013).…”

“…As with analyses of the SDQ 4-17 , the tested structures included items from the prosocial subscale even though this subscale is not typically included when scoring the instrument. Croft et al (2015) studied invariance over time (age 3, 5 and 7), finding support for strong invariance for the conduct and hyperactivity subscales and metric invariance for the peer and emotional subscales. Presently -in this age range -there are few other correlation and descriptive studies, (e.g.…”