Strengths and Difficulties Training

South CumbriaNovember 2014

Aim

• To provide a framework for the delivery and recording of Strengths and Difficulties Questionnaires.

Learning Outcomes

• Understand the reasons for the SDQs and how the process works.

• Explain the provision of SDQs.• Distinguish between the overall stress level score and diagnostic

predictors.• Identify individual needs of each child and how to address these.• Demonstrate clear and concise recordings within individual care

plans.• Demonstrate effective responses to children and young people.• Understand the roles and responsibilities of the professionals

involved in SDQs.

SDQs

• In use since April 2008 as part of the Local Authority data return on CLA.

• The total SDQ score for each child is submitted• SDQ can be used to support the emotional and

behavioural health of Children Looked After.• Evidence suggests that Children looked After are

nearly 5 times more likely to have a mental health disorder than all children (Meltzer et al 2002, The mental health of CLA by Local Authotities in England)

What is the SDQ

• A short behavioural screening tool• Five sections - emotional difficulties, conduct

problems, hyperactivity / inattention, friendships and peer groups and positive behaviour.

• “impact supplement” to assist in the prediction of emotional health problems.

• The SDQ is internationally validated and appropriate for all groups.

Flow Chart – 1st Stage

• Child/Young Person enters into care system.• Social Worker to identify all relevant agencies

for the child.• Social Worker to send out SDQ to Carer within

2-3months. (Follow Joint Standard Operating Procedure, SOP, guidance, July 2013)

• Carer to complete SDQ and return to CLA Specialist Nurse Team

Flow Chart – Stage 2

• Initial Health Assessment to be completed within 28 days. (Too early for SDQ)

• Subsequent SDQ's to be sent to carer, by Health, 1 month prior to health assessment on all children and young people 3 – 17 year olds.

• If SDQ is not returned by carer, and it is not possible to be completed at health assessment, then SW to follow up at next statutory visit.

• Health will 'score' SDQ and forward to Children's Services Administrators.

• Score & actions to be included in Health Care Plan.• Health to email SW promptly if score is high.

Flow Chart – Stage 3

• Business Support to input scores on ICS, upload detailed 'front sheet' and email to Emotional Wellbeing Advanced Practitioner.

• EW AP to check scores, input on SDQ 'Tracker' and input on Case Notes to inform SW.

• SW to undertake any 'actions' required (as detailed in SDQ guidance) and record in Care Plan/Pathway Plan.

Scoring

• 0-13 is low• 14-17 is medium• 18-24 is high• 25-40 is very high

Be mindful of low scoring SDQs where 1 domain of SDQ is scoring high

Guidance on scoring

SCORE WORKER ACTION FURTHER ACTION0 - 13 Worker to assess.

Give advice to carer.Include in Care Plan & monitor

14 - 17 Discuss with carer/young person.Worker to work directly with carer/child to reduce concerns.

Include in Care Plan & monitor. Identify need, specific objectives, action & review outcomes.

18 - 24 Worker to continue support.As above, include Fostering Social Worker.Discuss in Supervision.Consider request to school for SDQ.

Include in Care Plan.Discuss with Supervisor.Consultation with EW AP.Identify need, specific objectives, action & review outcomes.

25 – 40 Discuss with Supervisor.Undertake child/YP SDQ.Request school SDQConsultation with EW APConsider EW referral.

Refer for actionInclude in Care PlanRequest CAMHS consultation.Consider referral to CAMHS.

Emotional Health in Babies and Young Children.

• All Health Visitors are able to assess an infants emotional and social progress through – Social and emotional questionnaires (ASQ:SE)

• Evidence based developmental screening tool to identify infants and children in need of further assessment.

• Actively involves parents/carers

ASQ:SE

• 7 behavioural areas• Self regulation• Compliance• Communication• Adaptive behaviours• Autonomy• Affect• Interactions with people

Improving Outcomes for CLA

• If SDQ is high – consider SDQ be completed by School or Nursery.

• The emotional well being of each child and young person should be part of the Care Plan

Examples.