How to screen for social withdrawal in primary care: An evaluation of the alarm distress baby scale using item response theory

Egmose, Ida; Smith‐Nielsen, Johanne; Lange, Theis; Stougaard, Maria; Stuart, Anne Christine; Guédeney, Antoine; Væver, Mette Skovgaard

doi:10.1016/j.ijnsa.2021.100038

Cited by 7 publications

(4 citation statements)

References 46 publications

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“…They reported a 0.74 and 0.46 GLB coefficients, suggesting a good internal consistency for the full ADBB and a poor internal consistency for the m-ADBB. In contrast, Egmose et al ( 30 ) observed that the validity of the full ADBB might be improved with the removal of items 4, 6, and 8 as suggested in the m-ADBB, using Item Response Theory. We did not obtain the interrater agreement for the m-ADBB, however, previous studies have shown promising interrater agreement using the m-ADBB ( 6 , 21 , 33 ), since in the modified version, the items that were difficult to score and highly correlated with each other were removed ( 20 ).…”

Section: Discussionmentioning

confidence: 92%

“…Guedeney et al ( 6 ) argued that because of its simplified coding and scoring scheme, as compared to the full ADBB, the m-ADBB may well prove to be a more practical solution for evaluating withdrawal behavior in vulnerable populations. On the other hand, Egmose et al ( 30 ) suggested that the m-ADBB could be used as a first-line screening tool, and the full ADBB could be used to assess social withdrawal in specific at-risk populations.…”

Section: Methodsmentioning

confidence: 99%

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The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale

Martínez¹,

Grollemund²,

Gavelle³

et al. 2022

Front. Pediatr.

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BackgroundSocial withdrawal is a risk indicator for infant development with both organic and non-organic causes. Cleft lip and palate (CLP) impose a higher risk of physical and emotional distress in infants and alters parent-infant relationships. The ADBB scale is a screening tool to identify social withdrawal as a sign of distress in infants. The aim of this study is to evaluate the prevalence of social withdrawal behavior in infants with CLP using the full 8-item ADBB scale and the modified 5-item ADBB scale, and to examine the feasibility of both scales.Methods145 infants with Cleft Lip and Palate were enrolled and video recorded during a pediatric consultation. All infants were scored by two expert raters trained in ADBB scale, and subsequently scored with the m-ADBB by an independent expert. We measured the interrater agreement for the full ADBB scale and psychometric properties of both scales.ResultsThe full ADBB scale identified 15.9% of infants as having social withdrawal behavior (score above cutoff ≥5). Among the infants evaluated with the m-ADBB scale, 44.9% had a score above the suggested cutoff (≥2). For both scales, the item “vocalization” showed the higher scores. We found a good internal consistency for the full ADBB (Cronbach's alpha = 0.82) and an acceptable internal consistency for the modified ADBB (Cronbach's alpha = 0.71). The interrater agreement for the full ADBB scale was excellent (kappa = 0.837). The Spearman correlation coefficient between the total scores of the two versions was 0.88 (P < 0.001).ConclusionOur results indicate a relatively high prevalence of social withdrawal in infants with Cleft Lip and Palate, especially evaluated with the modified 5-item ADBB scale. We found that the full ADBB and the modified ADBB scales are feasible to use as screening tools of social withdrawal in this population.Clinical Trial RegistrationThis trial is registered on ClinicalTrials.gov, identifier: NCT00993993. The data is the property of Assistance Publique, Hôpitaux de Paris.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale

Martínez¹,

Grollemund²,

Gavelle³

et al. 2022

Front. Pediatr.

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“…It is also important to consider whether there are some items that are better at explaining social withdrawal. A recent study in the same sample found that the items self‐stimulating gestures (item 4), vocalizations (item 5) and response to stimulation (item 6) may be less useful when using the ADBB as a universal screening instrument in a community sample (Egmose et al, 2021). Thus, future research should investigate how both a lower cut‐off and a modified version of the ADBB would be more useful as a screening instrument in low‐risk samples.…”

Section: Discussionmentioning

confidence: 99%

Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort

Stuart

Stougård

Smith‐Nielsen

et al. 2022

British J of Dev Psycho

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Infant social withdrawal is a risk factor for non-optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2-3, 4-7 and 8-12 months postpartum. Linear regressions showed that prematurity predicted higher infant social withdrawal at all time points, and maternal symptoms of PPD were positively associated with withdrawal at 2-3 months. Logistic regressions showed that odds for elevated social withdrawal were increased with elevated levels of maternal symptoms of PPD at 2-3 and 8-12 months. Partner's symptoms of PPD were not associated with withdrawal. Future studies should investigate how PPD symptoms and prematurity may impact the individual development of social withdrawal.

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“…The modified ADBB (m-ADBB) examines social withdrawal through only five domains: Facial expression; Eye contact; Vocalization; Activity level, and Relationship with the observer, and has a simplified mode of scoring [ 9 ]. This modified version has been used both in high-income [ 10 – 12 ] and low-income countries [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

Kvestad,

Ulak,

Ranjitkar

et al. 2024

BMC Pediatr

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Background Social withdrawal in infants may be a signal of distress and a precursor for non-optimal development. Objective To examine the relationship between infant social withdrawal and neurodevelopment up to 4 years in Nepalese children. Methods A total of 597 Nepalese infants 6–11 months old were assessed with the modified Alarm Distress Baby Scale (m-ADBB), and of these, 527 with the Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III) during early childhood, and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and NEPSY-II subtests at 4 years. We examined whether social withdrawal defined by the m-ADBB was associated with neurodevelopmental scores in regression models. Results Children socially withdrawn in infancy had lower Bayley-III language scores (-2.6 (95% CI -4.5, -0.7)) in early childhood. This association seems to be driven by the expressive communication subscale (-0.7 (95% CI -1.0, -0.3)), but not the receptive communication subscale (-0.2 (95% CI -0.6, 0.1)). There were no differences in the other Bayley-III scores or the WPPSI-IV and NEPSY-II scores at 4 years in children who were socially withdrawn or not. Conclusion Social withdrawal in infancy was reflected in early language development but not cognitive functioning at 4 years.

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How to screen for social withdrawal in primary care: An evaluation of the alarm distress baby scale using item response theory

Cited by 7 publications

References 46 publications

The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale

The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale

Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

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