up to date • dental and skin health • mental and emotional health, including depression and conduct disorders • understanding of issues relating to healthy relationships, including sexuality and sexual activity, contraception, sexually transmitted infection and the particular risks of early sexual activity • access to sources of information and advice about a range of health issues, including the risks of alcohol, tobacco and other substance use, and access to sources of advice on modifying health risk behaviours. Assessment should be made of whether referral to specialist treatment for substance misuse is appropriate • assessment of the risks of child sexual exploitation, antisocial or youth offending behaviour, bullying, domestic abuse or sexually harmful behaviour. 34 Annex B: Strengths and Difficulties Questionnaire (SDQ) It is important to have some means of measuring on a regular basis the emotional and behavioural difficulties experienced by looked-after children at a national level. The way in which that is currently done is through the Strengths and Difficulties Questionnaire (SDQ). This was introduced into the Department for Education’s data collection for children looked after at 31 March in 2008 and is the outcome measure used for tracking the emotional and behavioural difficulties of looked-after children at a national level. The SDQ is a clinically validated brief behavioural screening questionnaire for use with 4-17 year olds or 2-4 year olds. It is internationally validated and simple to administer. It exists in three versions: for parents or carers, teachers and children aged 4-17, and can be used to screen for any problems related to a child’s emotional well-being. The SDQ comprises a series of statements that require a judgement on how well it describ