In this large prospective study of UK two - parent families, two measures of father involvement (positive parenting beliefs at age 9 months and frequency of creative play at age 5 years) were associated with lower risk of subsequent behaviour problems, assessed using
the SDQ total difficulties scale, in both boys and girls.
Using
the SDQ total difficulties scale, nearly all these involvement measures were associated with lower risks of behaviour problems in boys and / or girls before adjustment for confounders (Table 6).
In adjusted models of father involvement, using
the SDQ total difficulties score, we found no statistically significant association of behavioural outcomes with frequency or share of routine care at 9 months, 3 years or 5 years.
Using
the SDQ total difficulties scale, before adjustment for confounders, bedtime / reading / play at 3 years and bedtime / reading at 5 years were associated with lower risks of behaviour problems in girls (Table 5); after adjustment, there were no statistically significant associations for either boys or girls (Fig 3).
Where equivalent measures of mother involvement were available, we found associations with risk of behaviour problems using the SDQ prosocial scale (but not
the SDQ total difficulties scale) for mothers, and using the total difficulties (but not prosocial) scale for fathers.
SDQ total difficulties scores (summed hyperactivity, conduct, emotional, and peer problem scores) were significantly associated with «treatment status» and «presence of any disorder» criteria, supporting concurrent criterion validity of the measure.15, 16 However, each preschool SDQ study was limited to a cross-sectional design, prohibiting examination of factor structure stability over time and validity in predicting future psychopathology.
The SDQ total difficulties score has been shown to be a psychometrically sound measure of child mental health problems [27, 30].
Abbreviations: SDQ, Strengths and Difficulties Questionnaire; SDQ - T, Teacher version Strengths and Difficulties Questionnaire; SDQ TDS,
SDQ Total Difficulties Score; TRF, Teacher's Report Form; TRF TPS, TRF Total Problem Scale
The SDQ Total Difficulties Score (TDS) was calculated by aggregating the scores for the emotional symptoms, conduct problems, hyperactivity - inattention, and peer problems subscales (range 0 — 40).
Parents with lower education reported significantly higher scores on the subscale Hyperactivity - Inattention (mean difference = 0.34) as well as higher
SDQ Total Difficulties score (mean difference = 0.79).
*
SDQ total difficulties scores of 17 or more indicate high risk of emotional or behavioural problems.
We calculated
a SDQ total difficulties score by summing individual subscale scores (excluding the prosocial subscale).
Due to the ordinal and categorical nature of the response options, reliability was assessed using polychoric correlation - based version of the reliability coefficients.45 These analyses suggested satisfactory internal consistency for
the SDQ total difficulties scale (α = 0.86) and for all subscales (α emotional problems = 0.82, conduct problems = 0.71, hyperactivity — inattention = 0.76, peer problems = 0.75 and prosocial behaviours = 0.77).
Not exact matches
The mean
SDQ score was 12.3 (SD = 7.3)(see online supplementary additional file 1 for a graph of the distribution of
total difficulties scores).
For the parent report version of the
SDQ used in the current study, the new four - band classification system for
total difficulties scores is as follows: 0 — 13 «close to average», 14 — 16 «slightly raised», 17 — 19 «high» and above 19 «very high».17 For the purposes of analysis, we considered that all children with a
total difficulties score below the threshold for high risk of emotional or behavioural problems (< 17) had «good» mental health.18 — 20 The
SDQ has previously been found to be acceptable, 21 reliable and valid22 among the SEARCH cohort.
Results: As reported by the surveyed children, the
SDQ mean
total difficulties score of those having migrant parents was 12.55 (SD = 5.96) and 18.9 % of these children had scores higher than the cut - off score.
The compared
total difficulties score reported by children having parents working away from home in our study is higher than that of children in a study of Dang Hoang Minh et al. who also used a
SDQ scale for 591 adolescents (18.9 % vs. 10.73 %).
When teachers scored the children's behavior as problematic (
SDQ -
total difficulties score), the mother's YSQ of these children showed higher EMS scores in all domains, in domain 1 (disconnection and rejection), domain 4 (otherdirectedness), and domain 5 (see above) even significantly.
Emotional and behavioural
difficulties were measured using the Total Problems Scale from the Strengths and Difficulties Questionnaire (SDQ; MCS) and the Problem Scale of the Brief Infant Toddler Social Emotional Assessment Scale (BI
difficulties were measured using the
Total Problems Scale from the Strengths and
Difficulties Questionnaire (SDQ; MCS) and the Problem Scale of the Brief Infant Toddler Social Emotional Assessment Scale (BI
Difficulties Questionnaire (
SDQ; MCS) and the Problem Scale of the Brief Infant Toddler Social Emotional Assessment Scale (BITSEA; LSAC).
Table 3.1 Socio - demographic and socio - economic characteristics of children who score in the borderline or abnormal ranges for each
SDQ sub-scale and the
total difficulties scale at school entry
This report uses the
total difficulties SDQ score, summarising information from 20 questions administered to mothers covering four domains of their children's mental health 3.
Figure 3.2 presents the abnormal and borderline scores across deprivation categories for each of the
SDQ's domains, as well as the
total difficulties score (derived from all the domains apart from pro-social behaviour).
Cut off scores have been established in the UK (although not among ethnic minority groups) and other populations, for each scale and the
total number of
difficulties.28, 29 The P3 — 4 (age 3 — 4 years) and P4 — 16 (age 4 — 16 years) versions of the
SDQ were completed by parents in this study.
Results: Children in the experimental group had a significantly higher decrease in Strengths and
Difficulties Questionnaire (
SDQ)
total scores.
No significant differences were found regarding the subscales of
SDQ or the
Total Difficulties score, between parents with different marital status, or level of education (recoded into high or low to increase the power in the analyses), with two exceptions.
In a previous validation study of the
SDQ [43] data were obtained from 263 randomly selected parents of children 5 — 15 years old in the general population, but the authors did not present the norms in detail besides a figure presenting mean value of the
Total Difficulties score of
SDQ and subscales for the entire sample.
Their mean
SDQ - S
total difficulty score (TDS) was 19.81 (range 9 — 33), and their pro-social scale mean was 7.93 (range 3 — 10).
ADOS - 2 CSS, SA CSS and RRB CSS Autism Diagnostic Observation Schedule Second Edition Composite Severity Score for
Total, Social Affect and Restrictive and Repetitive Behaviours, BAS SNC SS British Ability Scales Standard Nonverbal Composite Standard Score, VABS SOC SS, VABS COMM SS and VABS DLS SS Vineland Adaptive Behavior Scales Second Edition Standard Score for the Socialization, Communication and Daily Living Skills Domains,
SDQ Total Strengths and
Difficulties Questionnaire
Total Problems Score, NQF National Qualifications Framework, dev.
ADOS - 2 CSS, SA CSS and RRB CSS Autism Diagnostic Observation Schedule Second Edition Composite Severity Score for
Total, Social Affect and Restrictive and Repetitive Behaviours, BAS SNC SS British Ability Scales Standard Nonverbal Composite Standard Score, VABS SOC SS, VABS COMM SS and VABS DLS SS Vineland Adaptive Behavior Scales Second Edition Standard Score for the Socialization, Communication and Daily Living Skills Domains,
SDQ Total Strengths and
Difficulties Questionnaire
Total Problems Score, NQF National Qualifications Framework
The prosocial - and
total difficulties scale of the
SDQ - T had good Cronbach's alphas at all ages (between 0.75 — 0.83).
Both Theunissen and Mieloo suggested therefore using only the
Total Difficulties Score of the
SDQ for screening purposes; our study aligns with this recommendation [14,27].
Variables for child's functioning (cognitive level [BAS Standard Nonverbal Composite (SNC)-RSB-; daily living impairment [VABS DLS Standard Score (SS)-RSB-; emotional and behavioural
difficulties [
SDQ Total problems]-RRB- and socioeconomic factors (income and educational level) were dichotomised into clinically meaningful subgroups in order to better capture their significance, as well as to facilitate the interpretation of the parameters (Ragland 1992).
Standardized Cronbach's alpha coefficients (α) were computed for the
SDQ scales (emotional symptoms, conduct problems, hyperactivity / inattention, peer problems, prosocial behavior) impact score and
total difficulties score.
We used two mutually exclusive summary
SDQ scales: «
total difficulties» and «prosocial strengths».
We considered the child to have potential for «behaviour problems» if the
SDQ score was in the extreme 10 % of the distribution of scores over the whole MCS cohort at ages 3, 5 and 7 years [29], i.e. the top decile for the
total difficulties scale (17 +, 14 +, 15 +) and the bottom decile for the prosocial scale (< = 5, < = 6, < = 6) respectively.
Behaviour problems respectively at 5, 7 years:
SDQ score in the top decile for the
total difficulties scale, or bottom decile for the prosocial scale.
The means of the
SDQ self - report
total difficulties scores were very similar to those in a previous study in Great Britain.
Separately for boys and girls, we fitted logistic regression models for risk of behaviour problems assessed by each
SDQ scale (
total difficulties and prosocial) in each analysis period [30].
Behaviour problems respectively at 3, 5, 7 years, i.e.
SDQ score in the top decile for the
total difficulties scale, bottom decile for the prosocial scale.