Strengths and Difficulties Questionnaire (SDQ)

The SDQ has 25 items rating behaviours over the previous 6 months on a three-point scale (not true, somewhat true, certainly true). Items group into five subscales, four assessing difficulties (Emotional Symptoms, Conduct Problems, Hyperactivity/Inattention, Peer Relationship Problems) and one assessing strengths (Prosocial Behaviour). A Total Difficulties Score sums the four difficulty subscales, with cut-offs at "close to average", "slightly raised", "high", and "very high".

The SDQ also has an Impact Supplement asking about distress, interference with home life, friendships, classroom learning, and leisure activities. The Impact score frequently matters more than the Total Difficulties Score for treatment decisions: a child can have moderate symptoms but high functional impact, or higher symptoms with low impact, and the intervention need is different in each.

In CAMHS, the SDQ is one of the most-used routine outcome measures and is administered at assessment and at intervals through treatment to track change. In schools, the SDQ is part of the Adoption Support Fund process for adopted and previously looked-after children, is sometimes used in pupil premium impact tracking, and is increasingly part of mental health audit in Senior Mental Health Lead schools.

For SEND, an SDQ Total Difficulties Score in the high or very high range, together with high Impact Score, is supportive evidence in an EHC needs assessment under the SEMH area of need. The SDQ does not diagnose; it identifies a pattern that warrants further assessment. A high SDQ score in a child who has not been assessed for autism, ADHD, or trauma is often the trigger for that next-step assessment.

The SDQ is freely available (youthinmind.com) and parents can self-administer the version for parents to look at their own child's pattern. The scoring algorithm uses UK norms.