This study examined the agreement between adolescents, their parents, and teachers when rating the psychological well-being of adolescents using the Strengths and Difficulties Questionnaire (SDQ). The study found fair agreement between adolescents and parents (r=0.44), fair agreement between adolescents and teachers (r=0.41), and good agreement between parents and teachers (r=0.70). The results indicate that while informants generally agree, there are also discrepancies, particularly between adolescents and other raters. The small sample size limits the generalizability of the findings.

1. Examining the inter-rater reliability of the Strengths and Difficulties
Questionnaire: Do the adolescent, parent and teacher rate the
adolescent’s psychological wellbeing similarly?
Conor Barry, Dr. Amanda Connell
Department of Clinical Therapies, University of Limerick
Background
Aims
Methodology
Results
Key Findings
In Ireland, as in the rest of the world, increasing
numbers of children and adolescents are presenting
with a wide range of psychological difficulties. Young
Irish males in particular rank among the highest in
Europe in presenting with psychiatric disorders and in
suicide rates (Cannon et al., 2013).
A multi-informant, multi-method approach to the
evaluation of a child’s psychological wellbeing is
considered the preferred, best-practice approach
(Becker et al., 2004). This usually includes a
combination of clinical interviews with the child and
his/her family members, and the use of screening
tools to evaluate the child’s mental wellbeing.
One screening tool that is gaining popularity
worldwide is the rating scale known as the Strengths
and Difficulties Questionnaire (SDQ) (Goodman, 1997).
Several studies have looked at inter-rater agreements,
predominantly in parent-child reports, using the SDQ.
Parents and teachers are considered the most
valuable informants in rating the child’s mental health.
However, there is scarce research evaluating the
reliability of the SDQ across three raters - the
adolescent child, the parent and the teacher.
Analysing agreements/discrepancies between three
raters could offer valuable insight into the difficulties
that adolescents are experiencing.
Student vs. Parent Student vs. Teacher Parent vs. Teacher
Figure 1: Correlations between
adolescent students and parents
total difficulties scores (r=0.44)
Figure 2: Correlations between
adolescent students and teachers
total difficulties scores (r=0.41)
Figure 3: Correlations between
parents and teachers total
difficulties scores (r=0.70)
Table 1: Pearson’s correlations between
all three informants on the SDQ subscales
To determine the level of inter-rater agreement
between three informant group pairs when using the
SDQ to rate the adolescent’s psychological well being:
(i) Adolescent students and their parents
(ii) Adolescent students and their teachers
(iii) The parents and teachers of adolescent
students
Figure 4: Mental health classification distributions based
on SDQ total scores as per each informant group
Sample Recruitment & Data Collection
Fifty-five male Transition Year (TY) students and their
parents were approached to participate. 14 students
(mean age 15.3) and their parents were recruited
(25.5% response rate). One teacher was also
recruited from the school. The students completed
the self-report version of the SDQ, while the parents
and teacher completed the proxy version.
The Strengths and Difficulties Questionnaire (SDQ)
The SDQ consists of 25 statements probing some
‘strengths’ and ‘difficulties’ that the child may be
experiencing, which the informant can rate as being
‘certainly true’, ‘somewhat true’ or ‘not true’. The 25
statements are divided into 5 subscales – emotional
problems, conduct problems, hyperactivity problems,
peer problems and the prosocial subscale. These
combine to form the total difficulties score, which
categorises the child’s mental health as ‘normal’,
‘borderline’ or ‘abnormal’.
Data Analysis
Data analysis was conducted using the Statistical
Programme for the Social Sciences (SPSS) Version 21.
Inter-rater agreements were analysed with Pearson’s
correlation coefficient. Cutoffs using Pearson’s for
levels of agreement (r values) were: <0.25=poor,
0.25-0.5=fair, 0.5-0.75=moderate to good,
>0.75=good to excellent (Portney and Watkins, 1993).
Student-Parent Agreement
Results of the current study found
there to be a ‘fair’ level of
agreement between students and
parents when rating the adolescent
students’ psychological wellbeing
using the SDQ (r=0.44). Weakest
correlations were seen on the
‘Conduct’ problems subscale (Table
1). A finding of discrepancies
between parent-child reports has
been the consensus from previous
studies and the current study’s
findings of ‘fair’ levels of agreement
appear to coincide with that of
previous research (Muris et al.,
2003).
Student-Teacher Agreement
The current study found student-
teacher agreements to be the
weakest of the three informant
pairs, but still exhibiting ‘fair’
levels of agreement (r=0.41). The
hyperactivity and conduct
subscales exhibited the weakest
correlations (Table 1). Little
research has assessed
agreements between community
based adolescents and their
secondary school teachers using
the SDQ. Further research is
needed to fully determine the
true levels of adolescent-teacher
agreements.
Parent-Teacher Agreement
This study found parents and
teachers to show the strongest
levels of agreement of the
three informant pairs (r=0.70).
These correlations were
statistically significant
(p=0.015) and can be classified
as ‘good’ levels of agreement,
with all subscales ranging from
fair to good. This figure is
higher than those shown in a
review of agreements between
parents and teachers of pre-
adolescent children by Stone et
al. (2010), where r values
ranged from 0.37 to 0.62.
Student-Parent Agreement Student-Teacher Agreement Parent-Teacher Agreement
Student Reports Parent Reports Teacher Reports
Further Discussion
Becker, A., Hagenberg, N., Roessner, V., Woerner, W. and Rothenberger, A. (2004) Evaluation of the self-reported SDQ in a clinical setting: Do self-reports tell us more than ratings by adult
informants?, European Child and Adolescent Psychiatry, 13(2), ii17-ii24. Cannon, M., Coughlan, H., Clarke, M., Harley, M. and Kelleher I. (2013) The Mental Health of Young People in Ireland: a
report of the Psychiatric Epidemiology Research across the Lifespan (PERL). Dublin: Royal College of Surgeons in Ireland. Goodman, R. (1997) The Strengths and Difficulties Questionnaire: a
research note, Journal of Child Psychology and Psychiatry, 38(5), 581-586. Muris, P., Meesters, C., Eijkelenboom, A. and Vincken, M. (2004) The self‐report version of the Strengths and
Difficulties Questionnaire: Its psychometric properties in 8‐ to 13‐year‐old non‐clinical children, British Journal of Clinical Psychology, 43(4), 437-448. Portney, L. G. and Watkins, M. P. (1993)
Foundation of Clinical Research: Application to Practice. East Norwalk: Appleton and Lange. Stone, L.L., Otten, R., Engels, R.C., Vermulst, A.A. and Janssens, J.M. (2010) Psychometric properties
of the parent and teacher versions of the Strengths and Difficulties Questionnaire for 4- to 12-year-olds: a review, Clinical Child and Family Psychology Review, 13(3), 254-274.
Prevalence of Abnormal/Borderline Cases
14.3% of the adolescent sample identified themselves as being in the ‘abnormal’ range and a further 7.1%
reported themselves in the ‘borderline’ range (21.4% total) (Figure 4). Despite the small sample size of this study,
these findings appear to support a finding of recent research that ‘one in five’ young Irish people are ‘at risk’ of
suffering a mental disorder (Cannon et al., 2013).
Limitations
The strength of this study’s findings is limited by both its small sample size and by the poor response rate. The
absence of female participants from this study’s sample also limits the generalisability of the findings to the wider
adolescent population. A study involving a large mixed-gender sample could help to both; (i) determine the inter-
rater reliability of the SDQ and (ii) offer a clearer view on the true scale of mental health problems in Ireland.