Use of the Strengths and Difficulties Questionnaire in child and school health services among children aged 4 and 6 years in Southern Norway: clinical considerations

• Published in: BMC pediatrics 2023-01, Vol.23 (1), p.30-30, Article 30
• Main Authors: Mølland, Eirin, Haraldstad, Kristin, Abildsnes, Eirik, Håland, Åshild Tellefsen, Köpp, Unni Mette Stamnes, Fegran, Liv, Westergren, Thomas
• Format: Article
• Language: English
• Subjects: Child; Child health; Children; Children & youth; Childrens health; Cutoff; Education; Evaluation; Evidence-based nursing; Families & family life; Female; Health aspects; Health services; Humans; Income distribution; Male; Maternal-child health centers; Mental Health; Mothers; Parents & parenting; Parents - psychology; Primary healthcare; Psychometrics; Public health; Quality of life; Questionnaires; School Health Services; Sex Factors; Socioeconomic factors; Student health services; Surveys and Questionnaires
• ISSN: 1471-2431; 1471-2431
• DOI: 10.1186/s12887-023-03837-1

Parent reported mental health can be assessed by the Strengths and Difficulties Questionnaire (SDQ). Currently, Norwegian norms for parent-reported SDQ do not exist, whereas Swedish, Danish, and United Kingdom (UK) norms have been published. We aimed to (1) describe parent-reported SDQ among children aged 4 and 6 years in Southern Norway, (2) evaluate empirical cutoff values within the context of the Starting Right project in relation to the Swedish, Danish, and UK cutoffs, and (3) evaluate the representativeness of the study sample with regard to parental socioeconomic status. This study included parent-reported observations for 665 children (63% consent rate). Means and standard deviations were calculated for the domains of SDQ, and gender differences were assessed. Based on the Swedish, Danish, and UK cutoffs and the 80 and 90 percentile cutoff values within the study, we calculated the total number of children with borderline and abnormal scores. Boys had higher mean total difficulties (7.3 vs 5.6) and impact scores (0.3 vs 0.1) and lower prosocial scores (8.3 vs 8.8) than girls. The differences in means were largest in the case of externalizing symptoms (5.0 vs 3.6) and hyperactivity subscore (3.2 vs 2.3). Using the UK cutoff values, 28 and 25 children had borderline and abnormal total difficulties scores, respectively. The corresponding numbers using the within study or Scandinavian cutoff values were 84-99 and 54-79, respectively. Overall, our study sample was well representative of the target population. Our findings consistently indicated that girls had better SDQ scores than boys among children aged 4 and 6 years. Fewer children would be identified as having mental health difficulties using the UK cutoff values than using the Scandinavian age- and gender-relevant cutoff values.