Strengths and Difficulties Questionnaire (SDQ)

The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used screening measures in child and adolescent mental health.

Questions: 25
Duration: 5 min
Original title: SDQ — Strengths and Difficulties Questionnaire (parent 4-17)
Adaptation: Strengths and Difficulties Questionnaire (SDQ)
Authors: Goodman, R.
Created: 1997

The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used screening measures in child and adolescent mental health. Designed for completion by parents or caregivers, this brief instrument captures a balanced profile of a youth's behavioral, emotional, and social functioning over the past six months. Rather than focusing exclusively on pathology, it systematically measures both positive attributes and clinical challenges, offering a nuanced baseline for therapeutic work.

In clinical practice, the parent-report SDQ serves as an efficient tool for identifying emerging difficulties before they escalate. It maps broadly across the key domains of developmental psychopathology, making it highly valuable during intake assessments or when exploring problems in CBT. By quantifying internalizing and externalizing behaviors, it helps clinicians structure their case conceptualization and prioritize intervention targets effectively.

Because of its brevity and high responsiveness to clinical change, the SDQ is exceptionally well-suited for routine outcome monitoring. Repeating the measure at regular intervals allows clinicians to track a child's trajectory, validating therapeutic progress or signaling the need to adjust the treatment plan. It facilitates collaborative discussions with parents, grounding CBT overview discussions in concrete, observable behavioral data.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

20/ 40

The SDQ is a brief behavioural and emotional screening questionnaire for children and adolescents aged 4 to 17 years, completed by a parent or guardian. It comprises 25 items describing positive and negative attributes, divided into 5 subscales of 5 items: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behaviour. The sum of the 4 difficulty subscales yields a total difficulties score (0-40). A tool widely used for screening, referral, and follow-up in child psychiatry and primary care.

0–13

Close to average

14–16

Slightly raised

17–19

High

20–40

Very high

The most concerning scores.

Scoring

Sum per subscale + total difficulties score (sum of the 4 difficulty subscales), total score from 0 to 40, each item is rated on a 3-point scale (from 0 to 2).

Difficulties and strengths

Difficulties scales (high = more difficulties)

Emotional symptoms

010

5 · High

assesses subjective emotional distress, including worry, unhappiness, fearfulness, somatic complaints, and clinginess in new situations.

Conduct problems

010

5 · High

captures behavioural difficulties including temper outbursts, fighting, disobedience, lying, and stealing.

Hyperactivity / Inattention

010

5 · Close to average

measures overactivity, restlessness, distractibility, and difficulties with sustained attention and reflective thinking.

Peer relationship problems

010

5 · Very high

captures difficulties in peer relationships, including social isolation, being bullied, preferring adult company, and difficulty maintaining friendships. The most concerning scores.

Positive scale (low = concerning)

Prosocial behaviors

010

4 · Very low

assesses positive social attributes including consideration for others, sharing, helpfulness, kindness, and volunteering. Lowest prosocial behaviour (concerning).

The Total Difficulties score sums four scales (emotional, conduct, hyperactivity, peer problems); the prosocial scale is interpreted inversely — a LOW score is concerning — and is not included in the total.

Goodman et al.View the study ↗

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What the test measures

The SDQ measures five distinct domains of child and adolescent psychological functioning, integrating both problematic and adaptive behaviors.

Emotional symptoms: Assesses internalizing struggles, including anxiety, depressive affect, somatic complaints, and fears, which might later become targets for fear-focused cognitive restructuring.
Conduct problems: Captures externalizing behaviors such as oppositionality, temper tantrums, rule-breaking, and aggression, often relevant when evaluating anger.
Hyperactivity/inattention: Evaluates restlessness, impulsivity, distractibility, and the ability to sustain attention on tasks.
Peer relationship problems: Identifies social difficulties, isolation, victimization, and an inability to connect with age-matched peers.
Prosocial behavior: Measures adaptive social strengths, including empathy, sharing, helpfulness, and kindness toward others.

This version of the questionnaire is designed to be completed by the parents or primary caregivers of youth aged 4 to 17 years.

When and why to use it

Clinicians deploy the parent-report SDQ across a variety of settings to quickly appraise a child's functioning and monitor ongoing therapeutic needs.

Intake screening: To establish a comprehensive baseline of emotional and behavioral presentations before diving into specific communication styles or family mindfulness schedules.
Differential orientation: To distinguish between internalizing distress and externalizing acting-out, helping to appropriately tailor the initial treatment focus.
Treatment monitoring: To track the trajectory of specific symptoms over the course of therapy, objectively measuring whether interventions are producing real-world change.
Family consultation: To anchor parent-clinician discussions in structured data, highlighting strengths alongside difficulties rather than focusing solely on problem behaviors.

Using a validated scoring framework elevates these observations beyond simple clinical impression, providing a standardized metric that clarifies severity and highlights areas requiring immediate attention.

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The questions

For each item, please mark the box for Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain. Please give your answers on the basis of the child's behaviour over the last six months or this school year.
1. Considerate of other people's feelings
Evaluates the child's fundamental capacity for empathy and awareness of others' emotional states.
- Not true
- Somewhat true
- Certainly true
2. Restless, overactive, cannot stay still for long
Assesses core signs of physical hyperactivity and an inability to remain settled.
- Not true
- Somewhat true
- Certainly true
3. Often complains of headaches, stomach-aches or feeling sick
Probes for somatic manifestations of psychological distress or anxiety.
- Not true
- Somewhat true
- Certainly true
4. Shares readily with other children (treats, toys, pencils, etc.)
Examines cooperative behavior and a willingness to share resources with peers.
- Not true
- Somewhat true
- Certainly true
5. Often has temper tantrums or hot tempers
Highlights difficulties in emotional regulation and the presence of explosive anger.
- Not true
- Somewhat true
- Certainly true
6. Rather solitary, tends to play alone
Identifies tendencies toward social isolation or a preference for solitary activities.
- Not true
- Somewhat true
- Certainly true
7. Generally obedient, usually does what adults request
Assesses behavioral compliance and responsiveness to adult authority.
- Not true
- Somewhat true
- Certainly true
8. Many worries, often seems worried
Captures generalized anxious rumination and frequent apprehensive thinking.
- Not true
- Somewhat true
- Certainly true
9. Helpful if someone is hurt, upset or feeling ill
Measures active prosocial responses to the distress or misfortune of others.
- Not true
- Somewhat true
- Certainly true
10. Constantly fidgeting or squirming
Focuses on motor restlessness and an inability to sit quietly.
- Not true
- Somewhat true
- Certainly true
11. Has at least one good friend
Evaluates the basic capacity to form and maintain a meaningful peer attachment.
- Not true
- Somewhat true
- Certainly true
12. Often fights with other children or bullies them
Probes for aggressive interpersonal behaviors and dominance over peers.
- Not true
- Somewhat true
- Certainly true
13. Often unhappy, down-hearted or tearful
Identifies core symptoms of low mood, sadness, and depressive affect.
- Not true
- Somewhat true
- Certainly true
14. Generally liked by other children
Assesses the child's overall social acceptance and popularity among peers.
- Not true
- Somewhat true
- Certainly true
15. Easily distracted, concentration wanders
Highlights attentional deficits and difficulties sustaining mental focus.
- Not true
- Somewhat true
- Certainly true
16. Nervous or clingy in new situations, easily loses confidence
Captures situational anxiety, separation distress, and low self-assurance in unfamiliar environments.
- Not true
- Somewhat true
- Certainly true
17. Kind to younger children
Measures protective and nurturing behaviors directed toward younger or more vulnerable peers.
- Not true
- Somewhat true
- Certainly true
18. Often lies or cheats
Assesses deceitful behaviors and a willingness to bypass rules for personal gain.
- Not true
- Somewhat true
- Certainly true
19. Picked on or bullied by other children
Identifies the child's vulnerability to peer victimization or social exclusion.
- Not true
- Somewhat true
- Certainly true
20. Often volunteers to help others (parents, teachers, other children)
Evaluates spontaneous helpfulness and active contribution to the social or family environment.
- Not true
- Somewhat true
- Certainly true
21. Thinks things out before acting
Examines cognitive impulsivity and the ability to deliberate before responding.
- Not true
- Somewhat true
- Certainly true
22. Steals from home, school or elsewhere
Probes for severe behavioral transgressions involving the theft of property.
- Not true
- Somewhat true
- Certainly true
23. Gets on better with adults than with other children
Highlights difficulties navigating peer dynamics, manifesting as a preference for adult company.
- Not true
- Somewhat true
- Certainly true
24. Many fears, easily scared
Captures specific phobic responses and a general susceptibility to fright.
- Not true
- Somewhat true
- Certainly true
25. Sees tasks through to the end, has a good attention span
Assesses the capacity for task completion and sustained attentional endurance.
- Not true
- Somewhat true
- Certainly true