article · Child Development
Children with language difficulties face higher risks of mental health challenges, but standard assessment tools rely heavily on language skills. An investigation of UK children aged 10 to 11 evaluated how language competence affects responses on two common self-report instruments: the Revised Child Anxiety and Depression Scale-25 (RCADS-25) and the Strengths and Difficulties Questionnaire-Youth Report (SDQ-YR). Language-related variations appeared in both instruments, affecting six RCADS-25 items and three SDQ-YR items. While these item-level differences did not alter overall anxiety and depression factor means on the RCADS-25, they did influence peer problems and prosocial factor means on the SDQ-YR. Other SDQ-YR subscales, covering emotional problems, conduct problems, and hyperactivity, remained unaffected. Consequently, RCADS-25 factor scores provide robust assessments across varying language abilities, whereas comparing certain SDQ-YR subscales across such groups requires caution.
Self-report questionnaires are widely used to identify mental health issues in children. Understanding how language difficulties alter questionnaire performance ensures clinicians and educators do not misinterpret results. This evidence helps professionals determine which assessment scales accurately reflect a young person's emotional state and which subscales require cautious interpretation when evaluating children with speech and language needs.
These findings inform developers and providers of youth mental health diagnostic tools and screening platforms. Psychologists, healthcare services, and educational organisations can use these insights to refine scoring guidelines for existing assessment instruments. The research represents applied validation of established clinical tools rather than a direct commercial product, highlighting where software platforms hosting the SDQ-YR and RCADS-25 must adapt interpretation protocols.
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Children with language difficulties are at elevated risk of mental health problems, yet tools commonly used to assess mental health rely heavily on language. It is unclear if children's language ability influences their self-report measures. We tested language-related measurement invariance using moderated non-linear factor analyses. We used self-report data from children (10-11 years) with a wide range of language abilities, living in the UK, on the Revised Child Anxiety and Depression Scale-25 (RCADS-25; n = 342; 171 female; 80 with language difficulties) and the Strengths and Difficulties Questionnaire-Youth Report (SDQ-YR; n = 349; 174 female; 84 with language difficulties). Language-related differences were identified in both measures: six RCADS-25 items and three SDQ-YR items functioned differently in relation to language ability. For the RCADS-25, these differences did not affect anxiety and depression factor means. For the SDQ-YR, language-related item differences did affect peer problems and prosocial factor means, but not emotional problems, conduct problems, or hyperactivity. RCADS-25 factor scores appear robust for children with language difficulties, though item responses should be interpreted cautiously. In contrast, language-related differences in the SDQ-YR may limit comparisons of peer problems and prosocial subscales across children with differing language abilities.
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DOI: 10.1093/chidev/aacag172
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