Using the Strengths and Difficulties Questionnaire (SDQ) Multi-informant Algorithm to Screen Looked-after Children for Psychiatric Disorders

Background: Child psychiatric disorders are common among children in foster and residential care, but often go undetected and therefore untreated.

Aims: To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.

Method: SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1,028 looked-after 5-17 year olds from a nationwide English survey.

Results: Multi-informant SDQs (parents, teachers, older children) identified individuals with a psychiatric diagnosis with a specificity of 80 % and a sensitivity of 85%. The SDQ prediction works best when SDQs have been completed by both carers and teachers. When it is only possible to have one adult informant, carers and teachers provide information of roughly equal predictive value. By contrast, self-reports by 11-17 year olds provide little extra information when there is already an adult informant.

Conclusion: Using multi-informant SDQs as a regular screening measure for looked-after children could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.