The Alarm Distress Baby Scale can be used in clinics to detect distressed babies. It is also a good research tool to account for the effect of certain types of interventions or factors on the development of babies with organic and/or relational difficulties.
Indeed, the relational withdrawal reaction is a major clinical indicator because it is of great clinical relevance, since it is a signal coming from the baby and making it possible to understand his experience.
The ADBB scale is particularly useful for pre-post intervention assessments and monitoring the impact of these on the child himself and his experience of them.
A recent example is a study recently published in Paediatric (link) on the effect of 7-day intra-nasal oxytocin administration on feeding behaviour, social behaviour and parent/baby interactions in babies with Prader-Willi syndrome.
Prader Willi syndrome (PWS) is a rare genetic disease, characterized by major hypotonia during the neonatal period and the first two years of life, eating disorders (swallowing / sucking) and especially hyperphagia with risk of morbid obesity, learning difficulties and behavioural disorders, especially interaction disorders.
The idea of the research was to demonstrate that, by administering oxytocin, it was possible to improve the effects of Prader Willi syndrome on the baby’s behaviour.
Indeed, research on animals has demonstrated an effectiveness that oxytocin in different species (rat, primate, ..) on sucking behavior in young. Oxytocin is also known to be a neurohormone particularly involved in all social interactions in mammals (including humans), including the mother/baby bond and social interactions (bond).
ADBB was therefore used to assess relational withdrawal behaviour in 18 6-month-old babies with Prader WIlli syndrome before and after daily oxytocin administration over a 7-day period (full search here).
The results were as follows:
- No adverse effects or dose effects could be demonstrated.
Babies showed, on average, improved feeding behaviour, social behaviour and parent/child interactions. This could be demonstrated by a decrease in the mean relational withdrawal score measured with ADBB from 6.5 before oxytocin administration to 3.5 after administration.
- This means that before oxytocin administration, 62% of babies received a score above the threshold score of 5 (clinical score). After administration of oxytocin for one week, 81% of the babies received a score of less than 5 (below the clinical threshold) and therefore did not show relational withdrawal. The decrease or absence of relational withdrawal allowed for an improvement in parent-child interactions.
- The items on the scale that showed significant improvement were: facial expression, eye contact, general activity and relationship.
This study, very promising for intervention for babies with Prader Willi syndrome, shows the usefulness in research of a scale like ADBB that can easily be reused in test-retest and the relevance of the concept of relational withdrawal as a distress signal coming from the baby and to be identified and understood.