The modified ADBB (m-ADBB):

Assessing for infant withdrawal during

routine examinations
Dr. Stephen Matthey1, Dr. Rudi rnec2,3, Prof. Antoine Guedeney4
1.

Sydney South West Area Health Service; 2/3. The University of Western Sydney / Karitane, Caring for families;
4. Hpital Bichat Claude Bernard, Paris.

Introduction
Infant social withdrawal can be an
indicator of both physical and
emotional difficulties in the infant.
The Full ADBB (Guedeney &
Fermanian, 2001) enables clinicians
to assess for such withdrawal during
routine clinical examinations.
Infants scoring as withdrawn on this
Full ADBB have been found to have
mothers reporting they were
depressed or sad since the birth
(Matthey et al., 2005).

Modification to the Full ADBB

In Australia many nurses routinely
assess infant development using
ratings of Satisfactory, Possible
Problem, or Definite Problem for
each item.
We thus undertook to modify the Full
ADBB to utilise this same rating
system.

m-ADBB
The m-ADBB consists of 5 items,
easily remembered by the acronym
FEVAR (i.e., like Fever, but slightly
mispelt !):

Training
Training in the use of the m-ADBB
may be conducted face-to-face
(1 day), or via distance education.
The training package contains:
Relevant literature.

Items

1. Facial Expression
2. Eye contact

Discussion on the differences

between the Full ADBB and the mADBB.

3. Vocalisation

4 to-view video clips, with scores.

4. Activity

3 practice video clips, to be rated.

5. Relationship (with the clinician or

observer).
Each item is rated as either:
- Satisfactory
- Possible Problem
- Definite Problem

Within our Australian context, it

appears that reducing the scoring
format from 8 to 5 items will also
increase inter-rater reliability, without
sacrificing validity.

6 reliability clips, to be rated.

Accreditation
Detailed feedback is given initially for
the practice clips. Once the user is
confident on these clips, he/she then
rates the reliability clips.
Rating the 6 reliability clips to a
required level of accuracy provides
accreditation for the user for 12
months.
A further set of video clips will need
to be rated at 12 months, to ensure
maintenance of the required
reliability level.

This resulted in our reducing the mADBB to 5 items.

Aims
It is anticipated that the m-ADDB will
facilitate:
- screening for infant withdrawal in
Australia
- high inter-rater reliability.

Acknowledgements
University of Western Sydney GWS
Postdoctoral Research Fellowship
Scheme

Contact details
For more information on the m-ADBB

Upcoming research
We will shortly be conducting a
project where we explore the
psychometric properties of the mADBB, including the stability (testretest reliability) of infant withdrawal
behaviour.

Dr. Stephen Matthey (Australia)

e: stephen.matthey@swsahs.nsw.gov.au

References

tel: +61 2 9616 4262

Guedeney, A., & Fermanian, J. (2001). A validity

and reliability study of assessment and screening
for sustained withdrawal reaction in infancy: the
Alarm Distress Baby Scale. Infant Mental Health
Journal, 22, 559-575.

Or for more information on training

on the Full ADBB
Prof. Antoine Guedeney (France)
e: guedeney@bch.ap-hop-paris.fr

Matthey, S., Guedeney, A., Starakis, N., & Barnett,

B. (2005). Assessing the social behaviour of infants:
Use of the ADBB scale and relationship to mother's
mood. Infant Mental Health Journal, 26(5), 442-458.