Related Experiment Video
Updated: May 10, 2026
The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
Detecting psychiatric disorders in preschoolers: screening with the strengths and difficulties questionnaire
Trude Hamre Sveen1, Turid Suzanne Berg-Nielsen, Stian Lydersen
1Department of Psychology, Norwegian University of Science and Technology, Norway. trude.hamre.sveen@svt.ntnu.no
Insights
Preschool screening for emotional and behavioral disorders using the Strengths and Difficulties Questionnaire demonstrates comparable efficiency to adult screening. However, impact scores and teacher information did not enhance prediction accuracy for early detection.
Area of Science:
- Developmental Psychology
- Child Psychiatry
- Screening and Diagnostics
Background:
- Early identification of psychopathology in preschoolers is crucial for timely intervention.
- The Strengths and Difficulties Questionnaire (SDQ) is a widely used screening tool, but its efficiency in preschool populations requires further validation.
- Understanding the added value of supplementary information, such as impact scores and teacher reports, can optimize screening protocols.
Purpose of the Study:
- To evaluate the screening efficiency of the Strengths and Difficulties Questionnaire for preschool psychopathology.
- To compare SDQ findings with established diagnostic criteria (DSM-IV) in a population-based sample of 4-year-olds.
- To assess the incremental utility of impact scores and teacher-provided information in improving screening accuracy.
Main Methods:
- A two-phase, population-based sample of 845 Norwegian preschoolers (age 4) was recruited.
- Diagnostic assessments were conducted using the Preschool Age Psychiatric Assessment interview, blinded to screening results.
- Receiver operating characteristic (ROC) analysis was employed to compare SDQ parent ratings against DSM-IV diagnoses.
Main Results:
- Parental SDQ ratings achieved a specificity of 88.8% and a sensitivity of 65.1% for emotional and behavioral disorders.
- The negative predictive value was high (97.9%), indicating effective rule-out of disorders, while the positive predictive value was lower (24.2%).
- Screening accuracy was not significantly improved by incorporating impact scores or teacher information.
Conclusions:
- The Strengths and Difficulties Questionnaire demonstrates comparable screening efficiency for preschool psychopathology as observed in older populations.
- While effective for ruling out disorders, the positive predictive value suggests caution in interpreting positive screens without further assessment.
- Further research is warranted to explore how preschool screening can best facilitate early detection and intervention services.
Objective:
To examine screening efficiency for preschool psychopathology by comparing the Strengths and Difficulties Questionnaire findings against diagnostic information, and to determine the added value of impact scores and teacher information.
Method:
Using a 2-phase sampling design, a population-based sample of 845 children 4 years of age was recruited from community health check-ups in Trondheim, Norway, screen score stratified and oversampled for high screening scores. Blinded to screen ratings, DSM-IV diagnoses were assigned using the Preschool Age Psychiatric Assessment interview, against which the Strengths and Difficulties Questionnaire scores were compared through receiver operating characteristic analysis.
Results:
Emotional and behavioral disorders were identified through parent ratings with a specificity of 88.8% (range, 87.0%-90.6%) and a sensitivity of 65.1% (range, 51.6-78.6%). The negative predictive value was 97.9% (range, 96.8%-98.9%), whereas the positive predictive value was 24.2% (range, 18.0%-30.3%) at a prevalence of 5.2%. Parental ratings identified more behavioral disorders (79.3%) than emotional disorders (59.2%). Screening for any disorder was somewhat less efficient: specificity, 88.9% (range, 87.0%-90.7%); sensitivity, 54.2% (range, 41.8%-66.6%); negative predictive value, 96.4% (range, 95.0%-97.8%); and positive predictive value, 25.9% (range, 19.6%-32.2%) at a prevalence of 6.7%. The area under the curve (AUC) value was 0.83 (range, 0.76-0.90) for emotional and behavioral disorders and 0.76 (range, 0.68-0.83) for any disorder. The prediction accuracy was not improved by impact scores or teacher information.
Conclusions:
The results indicate that preschoolers' emotional and behavioral disorders can be screened with the same efficiency as those of older children and adults. Other disorders were identified to a lesser extent. Further research should explore the potential of preschool screening to improve early detection and subsequent intervention.
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
01:30Oppositional Defiant Disorder
Diagnostic Criteria and...
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:28Conduct Disorder