Finnish norms for young children on the Strengths and Difficulties Questionnaire.
BACKGROUND
Early recognition of children's mental health problems is crucial. Although the Strengths and Difficulties Questionnaire (SDQ) is a commonly used screening method, further research is needed on its validity and norms for young children.


OBJECTIVE
The aims of the study were to confirm the adjusted lower (normal/borderline) and upper (borderline/abnormal) cut-offs for the SDQ in a Finnish community sample of 4-9-year-old children, and to explore the SDQ's ability to identify the children with mental health problems.


METHODS
Parents and teachers completed the SDQs (n = 2666). The Development and Well-Being Assessment (DAWBA) was administered to parents and teachers of 646 children.


RESULTS
The overall participation rate was 57%. The suggested cut-offs for the SDQ total difficulties scale rated by parents and teachers were 2-5 points lower than the corresponding published British norms. The sensitivity for the total score normal/borderline cut-off (9/10) was 76% in the parent and 66% in the teacher reports and for the borderline/abnormal cut-off (11/12) 90% and 70% respectively. The respective specificity values were 69%, 63%, 74% and 66%. The area under curve (AUC) values of the higher cut-offs were good for parent (0.87) and satisfactory for teacher rated (0.76) total scores. The presence of a DAWBA-rater assigned diagnosis in the abnormal group compared with the normal group was sixfold in the parent and threefold in the teacher reported SDQs.


CONCLUSIONS
The suggested cut-offs were clearly lower than the British norms. Yet the properties of the method's discriminative validity were acceptable. Population specific norms, taking into account both the culture and children's age, seem necessary for screening and for international comparisons of the method's validity properties.
Anne-Mari Borg, M.D., Department of Child Psychiatry, School of Medicine, University of Tampere , 33014 Tampere , and Department of Child Psychiatry, Tampere University Hospital , 33521 Tampere , Finland.
Anne-Mari
AM
Borg
Pälvi
P
Kaukonen
Matti
M
Joukamaa
Tuula
T
Tamminen
D002648:Child; D002675:Child, Preschool; D003469:Culture; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000175:diagnosis*; D010290:Parents; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
Child psychiatry; Cut-off points; Finnish; Screening questionnaire; Strengths and Difficulties Questionnaire; Validity