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IMPACT OF A RANDOMIZED HOME-VISITING TRIAL ON INFANT SOCIAL WITHDRAWAL IN THE CAPEDP PREVENTION STUDY

ABSTRACT:The goal of this study was to measure the effects of a home-based, preventive intervention on children’s sustained social withdrawal behavior at 18 months of age. The Competences parentales et Attachement dans la Petite Enfance: Diminution des risques lies aux troubles de santé mentale etPromotion de la resilience (CAPEDP) (Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience)study gathered a sample of vulnerable women, replicating (Olds, 2006) Elmira study, but with a more psychologically oriented frame of work. The eight-item Alarm Distress Baby Scale (ADBB; Guedeney & Fermanian, 2001) was used to assess social withdrawal behavior of the child at 18 months, and results were converted into the recent and simpler five-item Modified ADBB (m-ADBB) as well. Results show that the early implementation of a prevention program by specially trained and supervised psychologists might be effective in reducing social withdrawal behavior in 18-month-old infants. Mothers with fewer mood symptoms at recruitment seem to have profited more from the intervention, as their children had lower than expected levels of social withdrawal at 18 months. Because of its simplified coding and scoring scheme, as compared to the original ADBB, the m-ADBB might be an instrument that is more user-friendly given the time and resource restrictions that front line mental health and health workers face in their efforts to screen for effects of maternal postnatal depression.

Expert’s note: CAPEDP is the first major French research study on the effect of home visits for vulnerable postpartum populations for prevention purposes. Both the ADBB and the M-ADBB have been used as screening and follow-up tools under intervention, demonstrating the place of these instruments in the early prevention and early intervention clinic.