Blower Sarah L, Mooney Kate E, Gridley Nicole, Larkin Fionnuala, Bywater Tracey J, Melendez-Torres G J
Department of Health Sciences, Seebohm Rowntree Building, University of York, York, YO10 5DD, UK.
Carnegie School of Education, Carnegie Hall, 222, Headingley Campus, Leeds Beckett University, Leeds, LS1 3HE, UK.
J Patient Rep Outcomes. 2025 Jun 23;9(1):72. doi: 10.1186/s41687-025-00905-1.
Prevention and early intervention are key to addressing poor child mental health. Systematic reviews have highlighted a lack of brief, valid and reliable outcome measures that can be implemented in both research and practice to assess social, emotional and behavioural outcomes in the early years. The Preschool Strengths and Difficulties Questionnaire (2-4 years) is a promising candidate to fill this gap, but the measurement properties of this tool are not yet known in very young children.
A secondary data analysis of two clinical trial datasets was conducted to examine the internal consistency reliability and structural validity of the parent-report English preschool version of the Strengths and Difficulties Questionnaire in a sample of 505 infants with mean average age of 18 months (SD .81). The measure was designed for children aged 2-4 years and was not modified prior to use with 1-year-olds in this study. Structural validity was examined in two Confirmatory Factor Analyses (CFA) testing two-factor and five-factor models (representing factor structures proposed by the developers of SDQ), and McDonald's coefficient Omega was estimated for each subscale with values > .70 considered acceptable.
The model fit values for the two-factor model demonstrated a poor fit to the data (X = 626.067(151) = p < .001, CFI = 0.612, RMSEA = 0.079 [90% CI .073 to .085], SRMR = .077) and the omega value was below acceptable at ω = .57 for the internalising subscale and ω = .76 for the externalising subscale. The five-factor model also demonstrated a poor fit to the data (X = 836.813(242) = p < .001, CFI = 0.676, RMSEA = 0.070 [90% CI .065 to .075], SRMR = .081). Omega values were below acceptable for three out of five subscales.
We concluded that the measure has poor internal consistency and lacks structural validity in this very young age group. Further research to adapt the SDQ in order to improve content and face validity is recommended prior to any further psychometric analyses with this very young age group. The paucity of robust and practical outcome measures of early social, emotional and behavioural poses significant challenges to the early identification of need and evaluation of interventions.
预防和早期干预是解决儿童心理健康问题的关键。系统评价强调,缺乏可在研究和实践中实施的简短、有效且可靠的结果测量方法,以评估幼儿期的社会、情感和行为结果。《学前优势与困难问卷》(2 - 4岁)是填补这一空白的一个有潜力的工具,但该工具在非常年幼的儿童中的测量特性尚不清楚。
对两个临床试验数据集进行二次数据分析,以检验《优势与困难问卷》家长报告英文版学前版在505名平均年龄为18个月(标准差0.81)的婴儿样本中的内部一致性信度和结构效度。该测量工具是为2至4岁儿童设计的,在本研究中未针对1岁儿童进行修改就使用了。在两个验证性因素分析(CFA)中检验结构效度,测试两因素和五因素模型(代表SDQ开发者提出的因素结构),并对每个子量表估计麦克唐纳系数欧米伽,值大于0.70被认为是可接受的。
两因素模型的模型拟合值表明与数据拟合不佳(卡方 = 626.067(151),p < 0.001,CFI = 0.612,RMSEA = 0.079 [90%置信区间0.073至0.085],SRMR = 0.077),内化子量表的欧米伽值在ω = 0.57时低于可接受水平,外化子量表的欧米伽值在ω = 0.76时低于可接受水平。五因素模型也显示与数据拟合不佳(卡方 = 836.813(242),p < 0.001,CFI = 0.676,RMSEA = 0.070 [90%置信区间0.065至0.075],SRMR = 0.081)。五个子量表中有三个的欧米伽值低于可接受水平。
我们得出结论,该测量工具在这个非常年幼的年龄组中内部一致性较差且缺乏结构效度。建议在对这个非常年幼的年龄组进行任何进一步的心理测量分析之前,进一步研究调整SDQ以提高内容和表面效度。早期社会、情感和行为的稳健且实用的结果测量方法的匮乏,对需求的早期识别和干预评估构成了重大挑战。