Concurrent validity of the strengths and difficulties questionnaire in an indigenous pre-school population

Paula Kersten, A.C. Vandal, Hinemoa Elder, R. Tauroa, Kathryn M. McPherson

Research output: Contribution to journalArticlepeer-review


The strengths and difficulties questionnaire (SDQ) is a frequently used tool for universal screening of pre-schoolers’ behavioural and emotional problems. However, evidence for its concurrent validity is equivocal and has not been tested in a Māori population. We aimed to evaluate the concurrent validity of the strengths and difficulties questionnaire (SDQ) in Māori pre-schoolers (tamariki), aged 4 and 5. We carried out a prospective study of 225 tamariki (46% female) for whom a recent SDQ was available from the New Zealand Ministry of Health’s Before School Check database. A trained nurse carried out a standardised wellbeing and behavioural assessment for these children. Sensitivity, specificity, positive predictive and negative predictive values were calculated, using optimal total difficulty scale threshold values published for the SDQ (parent version SDQ-P; teacher version SDQ-T). Primary outcome: an assessment-based child referral to Child and Adolescent Mental Health Services or to a Paediatric outpatient service. Secondary outcomes: assessment-based parental referral to a parenting programme and combined referral. The optimal thresholds for child referral were low for the SDQ-P (13) and SDQ-T (7). Child referral SDQ-P: sensitivity 62%, specificity 83%, positive predictive value 0.35, negative predictive value 0.94. Child referral SDQ-T: sensitivity 77%, specificity 78%, positive predictive value 0.31, negative predictive value 0.96. The findings demonstrate optimal threshold values for referral for Māori on the SDQ-P and SDQ-T are much lower when compared to published thresholds (17 vs. 16). Sensitivity values were also low. A surveillance approach for the assessment of psychosocial problems is recommended for pre-schoolers. Keywords: ValidationStrengths and difficulties questionnaire Māori Pre-school Screening
Original languageEnglish
Pages (from-to)2126-2135
Number of pages10
JournalJournal of Child and Family Studies
Issue number8
Publication statusPublished - 19 Apr 2017

Bibliographical note

The final publication is available at Springer via


  • Validation
  • Strengths and difficulties
  • questionnaire
  • Māori
  • Pre-school
  • Screening


Dive into the research topics of 'Concurrent validity of the strengths and difficulties questionnaire in an indigenous pre-school population'. Together they form a unique fingerprint.

Cite this