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

Abstract

Background Parent reported mental health can be assessed by the Strengths and Difculties 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 cutof values within the context of the Starting RightTM project in relation to the Swedish, Danish, and UK cutofs, and (3) evaluate the representativeness of the study sample with regard to parental socioeconomic status. Methods 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 diferences were assessed. Based on the Swedish, Danish, and UK cutofs and the 80th and 90th percentile cutof values within the study, we calculated the total number of children with borderline and abnormal scores. Results Boys had higher mean total difculties (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 diferences 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 cutof values, 28 and 25 children had borderline and abnormal total difculties scores, respectively. The corresponding numbers using the within study or Scandinavian cutof values were 84–99 and 54–79, respectively. Overall, our study sample was well representative of the target population. Conclusions Our fndings consistently indicated that girls had better SDQ scores than boys among children aged 4 and 6 years. Fewer children would be identifed as having mental health difculties using the UK cutof values than using the Scandinavian age- and gender-relevant cutof values.