Measurement invariance of the parent-reported Strengths and Difficulties Questionnaire in autistic adolescents.
Chloe Turcan, Henry Delamain, Asher Loke and 3 others
PMID 38481018WHAT IT FOUND
The parent-reported Strengths and Difficulties Questionnaire did not work as a stable measure of emotional and behavioural difficulties in autistic UK teenagers, or as a comparable measure with non-autistic teenagers.
Use it cautiously and alongside autism-specific tools.
Key findings
01The parent-reported SDQ did not hold as a measure of the same emotional and behavioural difficulties over time in autistic adolescents, or as a comparable measure between autistic and non-autistic adolescents.
02In the 17-year-old comparison, 18 of 25 SDQ items did not function the same way for autistic and non-autistic groups.
03The biased items included the full conduct problems and prosocial behaviour subscales, most peer problems items and most reverse-coded items.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The autistic group was small (189 children) compared with the non-autistic group (4834), so findings about autistic adolescents are less stable. Only 5023 of 19244 parents before exclusions had complete SDQ data across all sweeps, and listwise deletion may have biased results. Autism status was based on parent report of a professional diagnosis and treated as yes/no, not a formal diagnosis or detailed spectrum assessment. The ordinal-data model failed to converge for autistic 11-year-olds, so results depend on the continuous-data model. Differential item functioning does not show whether item differences are unfair or whether they reflect real differences in how autistic and non-autistic adolescents experience difficulties. Attrition was not accounted for.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship or publication.
The easy way to misread this
Do not conclude that the SDQ is useless for every autistic adolescent or that its total score should be ignored. The study shows that the tested five-factor structure and comparisons did not hold, and the authors recommend using the measure cautiously, alongside autism-specific measures and clinical judgement.