A validity and reliability study of assessment and screening for sustained withdrawal reaction in infancy: The Alarm Distress Baby scale

Abstract

Sustained withdrawal behavior in infancy is an important alarm signal to draw attention to both organic and relationship disorders. A withdrawal scale, the Alarm Distress Baby scale (ADBB), for infants between 2 and 24 months of age was built. This article describes the construction of the scale and the assessment of its psychometric properties. The ADBB has good content validity, based on the advice of seven experts. The scale has good criterion validity: first, as a measure of the infant's withdrawal reaction, with a very good correlation between nurse and pediatrician on the ADBB (r ϭ 0.84), and s second, as a screening procedure for detecting the developmental risk of the infant. The cutoff score of 5 with a sensitivity of 0.82 and a specificity of 0.78 was determined to be optimal for screening purposes. The scale has good construct validity, with good convergent validity with both the Spitz (1951) and the Herzog & Rathbun (1982) lists of symptoms of infant depression (r ϭ 0.61 and 0.60, respectively). s Exploratory factor analysis showed two different factors, consistent with the scale's construct. Reliability was satisfactory with good internal consistency for both subscales (the Cronbach ␣ ϭ 0.80 for the first subscale and 0.79 for the second) and for the global scale (␣ ϭ 0.83). The test-retest procedure showed good stability over time (r ϭ 0.90 and 0.84 for the two different raters). The scale could be used in 560• A. Guedeney and J. Fermanian relatively brief period of time. The scale can be used by nurses and psychologists or by medical doctors after a short period of training.RESUMEN: Cuando la conducta de ensimismarse o apartarse es sostenida durante la infancia nos encontramos frente a una importante señal de alarma que nos hace dirigir la atención hacia los trastornos orgánicos y los que se presentan dentro de una relación. Se ha establecido una escala para determinar el ensimismamiento en infantes entre los 2 y 24 meses de edad, la cual se denomina "Alarm Distress Baby scale" (ADBB). Este ensayo describe la estructuración de dicha escala y la evaluación de sus propiedades sicométricas. La ADBB tiene una muy buena validez de contenido, basándose en el consejo de siete expertos. La escala también posee una validez en cuanto al buen criterio: primero como una forma de medir la reacción de ensimismamiento del infante, con una buena correlación entre enfermera y pediatra en la ADBB (rs ϭ 0.84); y segundo, como un procedimiento investigativo para detectar el riesgo de desarrollo del infante. Se determinó que un puntaje máximo de 5, con una sensibilidad de 0.82, y una especifidad de 0.78, era el puntaje óptimo para los propósitos investigativos. La escala tiene asímismo una buena validez de estructuración, con buena validez convergente con referencia a las listas de síntomas de la depresión infantil de Spitz (1951) y de Herzog & Rathbun (1982) (rs: 0.61 y 0.60). El análisis del factor de exploración mostró dos diferentes factores, consistentes con la estructuración de la escala. La fiabilidad...

Perceived mother‐infant relationship difficulties in postnatal depression

“…The use of more objective instruments, e.g. the Alarm Distress Baby Scale (Guedeney and Fermanian, 2001) would therefore be helpful. Kumar (1997) studied 44 self-selected women (volunteers who responded to advertisements) who had suffered from at least one episode of postnatal mental illness, and who described the pregnancy as unexpected and often had a catastrophic response to their sense of failure to love one or more of her babies.…”

Potentials for infant mental health: Congress themes and moral development

“…Assessment in our field is used not only to guide treatment and understand strengths and problems in individual infants and their families but also is used to begin treatment. In a series of master lectures, we learned about new advances in assessing infant withdrawal behaviors (Antoine Guedeney's Alarm Distress Baby Scale; see Guedeney & Fermanian, 2001), assessing internal representations during pregnancy (Massimo Ammaniti), assessing maternal insightfulness into the emotional experience of the child (David Oppenheim), assessing responses to trauma in young children and their families (Joy Osofsky), assessing attachment (Neil Boris), assessing triangular communications among infants fathers and mothers (Elizabeth Fivaz-Depeursinge), and assessing family dynamic systems (Elizabeth Tutors).…”

Prevención del maltrato infantil: función del pediatra.2da parte. Prevención antes de que ocurra, ante la sospecha y con la confirmación del maltrato

“…pediatra debería saber usar para evaluar el desarrollo (escala de retraimiento relacional, 23 escala de sensibilidad materna, 24 escala de depresión materna, 25,26,27 lista de chequeo para autismo en menores de 2 años -CHAT-28 y prueba nacional de pesquisa -PRUNAPE-). 29 Es importante que el pediatra se forme y entrene en familia, funciones familiares y estilos de crianza.…”