Using the Strengths and Difficulties Questionnaire to Aid in the Identification of Looked-After Children’s Mental He

1. Using the Strengths and Difficulties Questionnaire to Aid in the Identification of Looked-After Children’s Mental Health Needs Robyn A. Marquis, Marie-Pierre Paquet, & Robert J. Flynn University of Ottawa Centre for Research on Educational and Community Services

2. Overview • Introduction: Foster children & mental health • Proposed research • Results of current study • Conclusions • Questions & comments

3. Introduction: Foster Children & Mental Health • Child maltreatment associated with pervasive effects on subsequent development • More young people coming into care with complex needs than previous generations • National commission on Family Foster Care: “[children coming into care have] extraordinary health, mental health, behavioural and developmental needs”

4. More young people in care who have complex needs than previous generations • Prevalence of mental health difficulties among looked-after children varies • Strong association between young person’s behavioural, emotional problems and placement instability

5. Inattention to the mental health needs of looked-after children documented since 1980s • Early detection of social, behavioural, and psychological problems = priority • Strengths and Difficulties Questionnaire

6. Strengths and Difficulties Questionnaire • SDQ (Goodman, 1997): • 25-item questionnaire; ages 3 to 16 years • 5 scales: • 4 categories of problems • 1 category of strength • Items for each scale selected based on classification concepts of child psychopathology in the DSM-IV and ICD-10

7. SDQ in Child Welfare Research • SDQ increasingly being used within child welfare to screen psychological adjustment • Small number of published studies • Callaghan et al (2004); Iversen et al (2007); Minnis et al (2006); Teggart & Menary (2005) • SDQ can be used to improve the “detection and treatment of emotional and behavioural problems among looked-after children”

8. Proposed Research • Purpose: • To investigate the strengths and difficulties of looked-after children in ON, Canada • To compare the strengths and difficulties of looked-after children in Ontario with same-age British and American general population youth

9. Participants • Convenience sample • N = 492; aged 11 to 15 years • Year 5 (2005-2006) OnLAC project • 43% female; 57% male (mean age = 13.2) • Current Placement: 14.4% Group home 85.6% Foster Home

10. Measures: SDQ • SDQ part of AAR-C2 of the OnLAC project • Satisfactory reliability and validity (Goodman, 2001) • Able to discriminate between community and clinical samples (Goodman, 1997; Goodman & Scott, 1999) • Sensitivity of 85% and specificity of 80% vs. independent diagnosis of a clinician (Goodman, Ford, Corbin, Meltzer, 2004)

11. When SDQ scored: • Low Difficulties: Scores below the 80th percentile • Borderline/Medium Difficulties: Scores between the 80th and 90th percentiles • High Difficulties: Scores above the 90th percentile • Borderline & High Difficulties categories = “high risk” for meeting criteria for a psychiatric diagnosis (Goodman, 1997)

12. Results • Comparison between OnLAC youth and general population British youth and general population American youth • Scores in the Borderline and High Difficulties bands on the subscales and Total Difficulties

13. Results Emotional Symptoms Score

14. Conduct Problems Score

15. Hyperactivity-Inattention Problems Score

16. Peer Problems Score

17. Prosocial Behaviour Scores

18. Total Difficulties Scores

19. Conclusions & Implications • Ontario children living in out-of-home care: • Have a high level of disturbance • Are under-represented on prosocial behaviour • The results emphasize • SDQ as screening instrument • the importance of engaging in early detection of looked-after children’s mental health needs

20. Limitations • OnLAC specific • File-based, archival information • No professional follow-up

21. Question or Comments?

22. References • Callaghan, J., Young, B., Pace, F., & Vostanis, P. (2004). Evaluation of a new mental health service for looked after children. Clinical Child Psychology and Psychiatry, 9, 130-148. • Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581-586. • Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337- 1345. • Goodman, R., Ford, T., Corbin, T., & Meltzer, H. (2004). Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. European Child & Adolescent Psychiatry, 13, II/25–II/31. • Goodman, R., & Scott, S. (1999). Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? Journal of Abnormal Child Psychology, 27, 17-24. • Iversen, A. C., Jakobsen, R., Havik, T., Hysing, M., & Stormark, K. M. (2007). Mental health problems among child welfare clients living at home. Child Care in Practice, 13, 387-399. • Teggart, T. & Menary, J. (2005). An investigation of the mental health needs of children looked after by Craigvon and Banbridge health and social services trust. Child Care in Practice, 11, 39-49.