Link to the thesis of Doctor Isabelle Souski :

Summary : Relational withdrawal in infants is an important warning signal because of the potential severity of its causes and its consequences on development. The M-ADBB scale is a validated clinical tool for the early identification of relational withdrawal. It can be used in routine clinical practice and could be relevantly integrated into the practice of general practitioners who are in the front line for the follow-up of many children. The aim of this study is to evaluate the applicability of the M-ADBB scale by general practitioners practicing in primary care.

Method: This is a qualitative study using thematic analysis. The data were obtained from individual semi-directed interviews with general practitioners working in private practice, PMI or day care centers. Some of them had been trained in the M-ADBB scale, the others were made aware of the tool through a quick presentation.

Results: 56 physicians were contacted, 27 of whom participated in the study. Learning the tool and using it seemed affordable for most physicians. More than 92% of the physicians surveyed considered the M-ADBB scale to have a positive contribution to their practice. This indicates that the scale has a significant validity. Often constrained by time, practitioners use the M-ADBB scale more in the face of risk factors or concern after an initial assessment of the child.

Conclusion: The M-ADBB scale is a tool adapted to the practice of general practitioners, and its use is particularly feasible in a strategy of targeted screening for relational withdrawal in infants. Following the recommendations issued in 2020 by the “1000 Days Commission” and by the HAS in France concerning neurodevelopmental disorders, the M-ADBB scale seems all the more relevant in the practice of general practitioners in primary care.

Expert’s note: If the training of pediatricians and nursery nurses has existed since the beginning of the ADBB and M-ADBB, it is only now that general medicine is interested in it. The interest of this research is to demonstrate that this early screening tool, the M-ADBB, can be used reliably by people who are neither specialized in mental health nor in child development. We have seen the same thing in the training of professionals with a lower training in early childhood or even without initial specialized training. This means that the M-ADBB could be used extremely widely to identify babies in difficulty at an early stage and thus create a fully functional early identification network, which will however need to be supplemented by training on recommendations in terms of intervention and referral to specialists.