Psychometric Properties and Norms for the Strengths and Difficulties Questionnaire Administered Online in an Australian Sample

Psychosocial wellbeing, parental concerns, and familial impact of children with developmental coordination disorder

BACKGROUND

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition impacting motor skill acquisition and competence. While previous studies have identified adverse psychosocial outcomes in DCD, they are limited by small or population-screened, community-based samples.

AIMS

To understand the psychosocial difficulties, parental concerns, and familial impacts of childhood DCD in a large population-based sample.

METHODS AND PROCEDURES

Parents of 310 children aged 4 - 18 years with a diagnosis of DCD (or synonymous term) completed the Impact for DCD survey. Parent-rated measures of emotional problems, peer problems, and prosocial behaviour were compared to normative data. Parental concerns for the impact of DCD on participation, interaction, emotional well-being, and the family system were examined.

OUTCOMES AND RESULTS

Compared to typically developing children, children with DCD were rated significantly higher for emotional and peer problems, and significantly lower for prosocial behaviours. Parents most commonly reported concerns for their child's future and withdrawal from physical activity. The presence of one or more co-occurring disorders did not significantly influence outcomes.

CONCLUSION AND IMPLICATIONS

Findings highlight the poor psychosocial outcomes for children with DCD. Crucially, poor psychosocial outcomes were just as likely in those with a single diagnosis of DCD as those with DCD and multiple co-occurring diagnoses. Parents reported concerns for their child (i.e., non-participation and social withdrawal) that are not targeted in existing DCD intervention modalities and emphasised the impact of DCD on the whole family unit.

WHAT THIS PAPER ADDS

This paper presents data from the largest parent-reported survey of children with a known diagnosis of DCD (or synonymous labels). It highlights the significant impact of DCD on psychosocial outcomes in children across age groups. The children in this study were rated by their parents to have significantly higher levels of emotional and peer problems, and lower prosocial behaviours, than similarly aged Australian children without DCD. It also challenges the misconception that poor psychosocial outcomes in DCD are the result of co-occurring disorders, with outcomes observed to be as poor in children with a sole diagnosis of DCD in this sample. Furthermore, findings highlighted the significant worry and concern that parents with DCD face, particularly around their child's participation and their emotional health. Finally, parents reported on the considerable impact that DCD had on their family unit, regularly causing worry and concern, influencing their choice of activities, and causing financial strain. These concerns and impacts are not addressed in current intervention models for DCD and highlight the need for support mechanisms moving forward.

The longitudinal associations among student externalizing behaviors, teacher-student relationships, and classroom engagement

Personal characteristics and classroom environment features both play important roles in predicting students' levels of classroom engagement. The present study took a person-environment transaction perspective to investigate how factors at both the personal (i.e., student externalizing behaviors) and relational (i.e., teacher-student relationships) levels jointly predict the development of classroom engagement behaviors in a sample of 784 elementary school students. Using a longitudinal cross-lagged model spanning across Grade 3 to Grade 5, we found a negative reciprocal association between teacher-student relationships and externalizing behaviors, such that a more positive teacher-student relationship predicted fewer externalizing behaviors in the subsequent academic year, and fewer externalizing behaviors predicted a more positive teacher-student relationship 1 year later. In addition, externalizing behaviors directly negatively predicted subsequent classroom engagement, whereas teacher-student relationships indirectly predicted subsequent classroom engagement by way of externalizing behaviors. Overall, students with more externalizing behaviors experienced more conflicts with and received less support from their teachers, which predicted the development of more externalizing behaviors and lower subsequent classroom engagement.

Promoting proactive bystander responses to racism and racial discrimination in primary schools: a mixed methods evaluation of the 'Speak Out Against Racism' program pilot

Background

Racism and racial discrimination are fundamental causes and determinants of health and health inequalities globally, with children and adolescents particularly vulnerable. Racial discrimination is a common stressor in the lives of many children and adolescents, with growing evidence of negative associations between racial discrimination and multiple domains of child and adolescent health. Addressing racism and racial discrimination must be core public health priorities, even more so among children and young people.

Schools are key settings in the lives of children and adolescents and become increasingly more important to identity formation. School communities, teachers and peers greatly influence children and adolescents’ beliefs about race and difference. Schools are therefore key sites for the delivery of population-based programs to reduce racism and promote proactive bystander behaviour and healthy resistance to racism among all children and adolescents as well as among the adults.

Methods

This study examines the feasibility and acceptability of the ‘Speak Out Against Racism (SOAR)’ program, a whole of school, multi-level, multi-strategy program that aimed to promote effective bystander responses to racism and racial discrimination in primary schools. A mixed-methods, quasi-experimental design was used. Students in Years 5 and 6 (10–12 years) across six schools completed surveys pre- and post- intervention (N = 645; 52% female; 6% Indigenous, 10% Middle Eastern, African, Latinx or Pacific Islander, 21% Asian, 52% Anglo/European). Focus groups with students and interviews with staff collected qualitative data about their experiences of the program and their views about the program’s perceived need, implementation, impacts and suggested improvements.

Results

Quantitative data showed student prosocial skills and teacher inter-racial climate improved in intervention schools compared to comparison schools. Qualitative data highlighted teacher attitudinal and behaviour change regarding racism, and student reduced interpersonal racial discrimination, improved peer prosocial norms, commitment to anti-racism, knowledge of proactive bystander responses and confidence and self-efficacy to intervene to address racism.

Conclusions

This study provides quantitative evidence of the potential of the SOAR program to improve the prosocial skills of students and their perceptions of the inter-racial school climate provided by their teachers. This program also provided qualitative evidence of the potential to promote teacher and student attitudinal and behavioural change. Further refinement and testing of the program in a large scale implementation trial is recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11469-2.

Psycho-Emotional and Behavioral Problems in Children With Growth Hormone Deficiency

Objective: To identify psychosocial problems and self-esteem in children with growth hormone deficiency (GHD) and define the role of some clinical and sociodemographic determinants in the conceptualization of internalizing and externalizing problems as criteria for psychosocial functioning. Materials and Methods: A GHD sample (46 prepubescent children) was selected and compared to a matched control group (80 healthy children). Psychosocial functioning in children with GHD was investigated using Goodman's "Strengths and Difficulties Questionnaire (SDQ)." The study of children's self-esteem was carried out by the Dembo-Rubinstein method. Results: This study reveals that the GHD sample has more internalizing problems and lower self-esteem. Higher score and frequency of assessment in the abnormal score for "total difficulties," "emotional problem," and "peer problem" were found in children with GHD. The SDQ score and the frequency of assessment in the abnormal score for all SDQ scales in children with more pronounced growth deficit (height SDS < -3) did not exceed the same indicators in children with less growth retardation (-3 < height SDS < -2). A comparison of psychosocial features in children with isolated growth hormone deficiency and multiple pituitary hormones deficiency did not reveal differences in SDQ score and the frequency of assessment in the abnormal score for all SDQ scales. It was found that children with GHD have a reduced level of assertions, low self-esteem, and a weak discrepancy between the level of assertions and self-esteem. Some sociodemographic determinants (male gender, age < 9 years, and low family income) and clinical determinants (low compliance and suboptimal growth response after 1 year of rGHh therapy) have an impact on the overall assessment of psychological problems in children with GHD. The internalizing difficulties are associated with certain clinical determinants (growth status and treatment status) and sociodemographic determinants (female gender, age < 9 years). Conclusions: The identification of low self-esteem and the high SDQ score for scales "total difficulties," "emotional problems," and "peer problems" indicates psychosocial maladjustment and conceptualization of internalizing problems in children with GHD.

Adults' facial impressions of children's niceness, but not shyness, show modest accuracy

Lay wisdom warns against "judging a book by its cover." However, facial first impressions influence people's behaviour towards others, so it is critical that we understand whether these impressions are at all accurate. Understanding impressions of children's faces is particularly important because these impressions can have social consequences during a crucial time of development. Here, we examined the accuracy of two traits that capture the most variance in impressions of children's faces, niceness and shyness. We collected face images and parental reports of actual niceness/shyness for 86 children (4-11 years old). Different images of the same person can lead to different impressions, and so we employed a novel approach by obtaining impressions from five images of each child. These images were ambient, representing the natural variability in faces. Adult strangers rated the faces for niceness (Study 1) or shyness (Study 2). Niceness impressions were modestly accurate for different images of the same child, regardless of whether these images were presented individually or simultaneously as a group. Shyness impressions were not accurate, for images presented either individually or as a group. Together, these results demonstrate modest accuracy in adults' impressions of niceness, but not shyness, from children's faces. Furthermore, our results reveal that this accuracy can be captured by images which contain natural face variability, and holds across different images of the same child's face. These results invite future research into the cues and causal mechanisms underlying this link between facial impressions of niceness and nice behaviour in children.

Gender differences in trajectories of depressive symptoms across childhood and adolescence: A multi-group growth mixture model

BACKGROUND

This study sought to identify depression trajectories across childhood and to model a range of child and family predictors of whether a child may be on an increasing trajectory towards depressive disorder in adolescence.

METHODS

Multi-group growth mixture modelling (MGMM) was used on a sample of 4983 children from the Longitudinal Study of Australia Children (LSAC). Depressive symptoms of these children were assessed over 10-years with six time-points, administered every second year commencing at 4 years via the parent report version of the Strength and Difficulties Questionnaire. Predictors of class membership were also examined.

RESULTS

Four trajectories were found to be the best fitting model characterising low-stable (75%); decreasing (11%); increasing (9%); high and rising (6%) groups. Females were more likely to be in a trajectory of increasing depressive symptoms between 4 and 14 years of age than males. Reactive temperament and maternal depression at four and six years of age were consistent predictors of increasing and high trajectories while persistent temperament acts as a protective factor for females.

LIMITATIONS

The findings should be interpreted in the light of limitations due to common-method variance and the absence of diagnostic indicators of depressive disorder.

CONCLUSIONS

We conclude that there are gender differences in patterns of depressive symptoms from childhood to adolescence and meaningful predictors of these early developmental trajectories. Preventative interventions in childhood targeting parents with depression and children with temperamental difficulties may be indicated.

Social determinants of psychological wellness for children and adolescents in rural NSW

Background

The mental wellness of children and adolescents in rural Australia is under researched and key to understanding the long-term mental health outcomes for rural communities. This analysis used data from the Australian Rural Mental Health Study (ARMHS), particularly the parent report Strengths and Difficulties Questionnaire (SDQ) measure for children under 18 years old and their reporting parent’s demographic information to compare this sample’s mental wellness scores to the Australian norms and to identify what personal, family, community and rurality factors contribute to child mental wellness as pertaining to the SDQ total and subdomain scores.

Method

Five hundred thirty-nine children from 294 families from rural NSW were included. SDQ scores for each child as well as personal factors (sex and age), family factors (employment status, household income and sense of community of responding parent), community SES (IRSAD) and rurality (ASCG) were examined.

Results

Children and adolescents from rural areas had poorer mental wellness when compared to a normative Australian sample. Further, personal and family factors were significant predictors of the psychological wellness of children and adolescents, while after controlling for other factors, community SES and level of rurality did not contribute significantly.

Conclusions

Early intervention for children and families living in rural and remote communities is warranted particularly for low income families. There is a growing need for affordable, universal and accessible services provided in a timely way to balance the discrepancy of mental wellness scores between rural and urban communities.

Cumulative Effects of Bullying and Racial Discrimination on Adolescent Health in Australia

This study examined how cumulative exposure to racial discrimination and bullying victimization influences the health of Australian adolescents (n = 2802) aged 10 to 11 years (19.3% visible ethnic minorities [nonwhite, non-Indigenous]; 2.6% Indigenous) using data from three waves (2010-2014) of the nationally representative Longitudinal Study of Australian Children (LSAC). Cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties. Higher accumulated exposure to both stressors across time was associated with increased body mass index z-scores and risk of overweight/obesity. Studies that examine exposure to single risk factors such as bullying victimization or racial discrimination at one time point only are likely to miss key determinants of health for adolescents from stigmatized racial-ethnic backgrounds and underestimate their stressor burden.

Development and Implementation of an Internet Survey to Assess Community Health in the Face of a Health Crisis: Data from the Pregnancy and Birth Survey of the Fukushima Health Management Survey, 2016

The Pregnancy and Birth Survey of the Fukushima Health Management Survey is a questionnaire survey that has been conducted annually since 2011 in Fukushima Prefecture. Since 2016, the survey has been available online as well as in paper form. This study aimed to determine whether making the survey available online improved response rates and to identify the characteristics of paper and online survey respondents and their results. Using LimeSurvey, we constructed an online survey environment that enabled responses via computer or mobile device. Respondents could choose whether to respond on paper or online. The response rate for the 2016 survey was 51.8%, an increase of 3.5% over the previous year. Of these responses, 15.8% were made online. Online respondents were mostly primiparous. Further, while there was no difference in the percentage of respondents who provided free responses, the amount written was higher in paper surveys than in online surveys. The combination of paper and online surveys increased convenience for respondents and contributed to improved response rates. In addition, paper surveys were superior in terms of allowing respondents to express their feelings and opinions.