Validating Office-Based Screening for Psychosocial Strengths and Difficulties Among Youths in Foster Care

Youths in foster care have psychological strengths, as well as difficulties. With limited mental health resources, screening practices need to identify at-risk youth who most likely would benefit from services.

Using a primary-care practice that cared for all foster youths in one New York county, researchers had youths (aged 11 to 17) and their foster parents complete a Strengths and Difficulties Questionnaire (SDQ) during well-child visits. The researchers wanted to determine whether a primary-care provider could reliably elicit accurate information on a youth’s social–emotional status.

The SDQ 25-item questionnaire can be administered in five minutes and covers five domains:

  1. Emotional symptoms
  2. Conduct problems
  3. Hyperactivity/inattention
  4. Peer problems
  5. Prosocial behaviors

The researchers categorized clinically significant problems according to whether they were reported by youth only, parent only or both. Parents were more likely than youth to report conduct problems, hyperactivity/inattention and social-emotional problems.

Researchers compared the SDQ scores with assessment results from a Children’s Interview for Psychiatric Syndromes (ChIPS), an extensive structured interview by trained clinicians. The SDQ sensitivity for detecting youth with significant mental health issues was lowest for youth data alone (54%), higher for parent data alone (71%) and highest (93%) for combined data.