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      Agreement between mothers’, fathers’, and teachers’ ratings of behavioural and emotional problems in 3–5-year-old children

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          Abstract

          Background

          The Strengths and Difficulties Questionnaire (SDQ), a valid and reliable instrument for measuring children’s mental health, is available in parent- and teacher versions, making it an ideal tool for assessing behavioural and emotional problems in young children. However, few studies have evaluated inter-parent agreement on the SDQ, and in most studies on SDQ agreement, parent scores are either provided by only one parent or have been combined into one parent score. Furthermore, studies on SDQ inter-rater agreement usually only reflect degree of correlation, leaving the agreement between measurements unknown. The aim of the present study was therefore to examine both degree of correlation and agreement between parent and teacher SDQ reports, in a community sample of preschool-aged children in Sweden.

          Methods

          Data were obtained from the Children and Parents in Focus trial. The sample comprised 4,469 children 3–5-years-old. Mothers, fathers and preschool teachers completed the SDQ as part of the routine health check-ups at Child Health Centres. Inter-rater agreement was measured using Pearson correlation coefficient and intraclass correlation (ICC).

          Results

          Results revealed poor/fair agreement between parent and teacher ratings (ICC 0.25–0.54) and good/excellent agreement between mother and father ratings (ICC 0.66–0.76). The highest level of agreement between parents and teachers was found for the hyperactivity and peer problem subscales, whereas the strongest agreement between parents was found for the hyperactivity and conduct subscales.

          Conclusions

          Low inter-rater agreement between parent and teacher ratings suggests that information from both teachers and parents is important when using the SDQ as a method to identify mental health problems in preschool children. Although mothers and fathers each provide unique information about their child’s behaviour, good inter-parent agreement indicates that a single parent informant may be sufficient and simplify data collection.

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          Most cited references42

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          Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity.

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            Psychometric Properties of the Parent and Teacher Versions of the Strengths and Difficulties Questionnaire for 4- to 12-Year-Olds: A Review

            Since its development, the Strengths and Difficulties Questionnaire (SDQ) has been widely used in both research and practice. The SDQ screens for positive and negative psychological attributes. This review aims to provide an overview of the psychometric properties of the SDQ for 4- to 12-year-olds. Results from 48 studies (N = 131,223) on reliability and validity of the parent and teacher SDQ are summarized quantitatively and descriptively. Internal consistency, test–retest reliability, and inter-rater agreement are satisfactory for the parent and teacher versions. At subscale level, the reliability of the teacher version seemed stronger compared to that of the parent version. Concerning validity, 15 out of 18 studies confirmed the five-factor structure. Correlations with other measures of psychopathology as well as the screening ability of the SDQ are sufficient. This review shows that the psychometric properties of the SDQ are strong, particularly for the teacher version. For practice, this implies that the use of the SDQ as a screening instrument should be continued. Longitudinal research studies should investigate predictive validity. For both practice and research, we emphasize the use of a multi-informant approach.
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              The validity of the multi-informant approach to assessing child and adolescent mental health.

              Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – original draft
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                1 November 2018
                2018
                : 13
                : 11
                : e0206752
                Affiliations
                [1 ] Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
                [2 ] Research Enhancing Adolescent and Child Health (REACH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
                TNO, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-2540-4082
                http://orcid.org/0000-0001-9809-4110
                Article
                PONE-D-18-13460
                10.1371/journal.pone.0206752
                6211744
                30383861
                c2535aa2-3f09-4131-898a-e991cc205d77
                © 2018 Fält et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 4 May 2018
                : 18 October 2018
                Page count
                Figures: 0, Tables: 7, Pages: 17
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100001862, Svenska Forskningsrådet Formas;
                Award ID: 259-2012-68
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100009230, Landstinget i Uppsala län;
                Award Recipient :
                This research was supported by the common grant of major Swedish research funders (FORMAS, Vetenskapsrådet, FAS and VINNOVA) termed "Mental health of children and adolescents" (grant number 259-2012-68) and by Uppsala County Council's fund for research. The funding sources have not been involved in the study or in writing the article.
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                People and Places
                Population Groupings
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                People and Places
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                Children
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                Biology and Life Sciences
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                Parenting Behavior
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                Custom metadata
                The participants in this study have not consented to deposition of the data. Data also contains sensitive information on children. Due to ethical restrictions related to protecting patient confidentiality, all relevant data are available upon request and approval from the Senior Registrar Clerk at Uppsala University. Requests may be sent to the Principal Investigator, Professor Anna Sarkadi ( anna.sarkadi@ 123456pubcare.uu.se ) or to Uppsala Universitet ( registrator@ 123456uu.se ), to request the data used for the analyses in this paper.

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