The Alarm Distress Baby Scale (ADBB), trialled in two NHS trusts with funding from the Royal Foundation Centre for Early Childhood, was used with babies aged six-to-eight weeks to observe social behaviours, such as eye contact, facial expression, vocalisation, activity levels and how they connect with the people and world around them.
In an evaluation report published by the Institute of Health Visiting and The University of Oxford, researchers say that it is ‘normal’ for babies to use withdrawal behaviours such as looking away, closing eyes and sneezing to control the pace of social engagement.
However, sustained social withdrawal behaviours could suggest an ‘early alarm signal’ for relational challenges and a ‘coping mechanism’ that babies may use if their initial protests are not responded.
The tool, which is widely used internationally to promote infant wellbeing and social development with parents, was developed in Paris by child psychiatrist Professor Antoine Guedeney.
It supports parents and carers with bonding and attachment and can be used to recognise early signs of psychological distress, enabling specialist support to be accessed as soon as it is needed.
Health visitors from South Warwickshire NHS Foundation Trust and Humber Teaching NHS Foundation Trust were trained in the use of a modified and full version of the tool and used their enhanced observation skills during appointments across a four-month period between July and November 2023.
They reported that it provided a ‘unique focus on the baby’ and enabled them to:
- have more meaningful conversations with parents and carers about the emotional wellbeing of their baby
• promote positive parent-infant interactions, attachment, and bonding;
• identify those babies and families in need of greater support during this critical period of development.
Second phase of research
The report recommends the research move to a second phase, offering an evaluation of the training in more sites and broadening it to other areas across the UK.
'We now want to move quickly to ensure we build on this work'.
Christian Guy, executive director of The Royal Foundation Centre for Early Childhood, said, ‘The quality of the relationships between babies and their parents or carers, during the first weeks and months of life, shapes their developing brains and lays the foundations for their future health and wellbeing. So, it is vital that we provide families with the best possible advice and support at this crucial time.
‘The results of the initial phase of testing are so encouraging. We now want to move quickly to ensure we build on this work, bringing the benefits of this model to more health visitors across the country so that, ultimately, more babies and their families get the support they need to thrive.’
Dr Jane Barlow, professor of evidence based intervention and policy evaluation at The University of Oxford, who oversaw the evaluation of the trial said, ‘The feedback from those involved has been overwhelmingly positive. It is truly exciting to think about impact this could have on families right across the country as we enter the next phase of this research.
