标题:The Feasibility of the Full and Modified Versions of the Alarm Distress Baby Scale (ADBB) and the Prevalence of Social Withdrawal in Infants in Nepal
摘要:Background: Sustained social withdrawal in infancy may have organic and nonorganic
causes and could hinder normal development. The Alarm Distress Baby (ADBB) scale is
a widely validated screening tool of social withdrawal in children 2–24 months. The aim
of the current study was to evaluate the full and modified ADBB in Nepalese infants in a
community-based study.
Methods: We enrolled 600 infants who were video recorded during a pediatric
examination. The 36 infants first enrolled were scored by an expert rater, and the
subsequent 64 infants were scored by two trained staff with the full ADBB scale. Of
the 600 enrolled infants, 597 videos (including the 100 infants scored with the full
ADBB) were scored with the modified ADBB (m-ADBB) scale by the trained staff,
with 7% double scoring. We measured the interrater agreement and psychometric
properties of both scales.
Results: In the 64 infants scored with the full ADBB by two raters, the concordance
correlation coefficients (CCCs) indicated poor interrater agreement. For the m-ADBB,
the CCCs were better indicating acceptable agreement between raters. The greatest
lower bound (GLB) for reliability coefficient for the full ADBB scored by an expert
rater indicated good internal consistency, whereas the GLB coefficient for the m-ADBB
indicated poorer internal consistency. The Spearman correlation coefficient between the
total scores of the two versions was 0.82 (P < 0.001). Among the infants scored with
the full ADBB, 25% had a score above cutoff (≥5). Scored with the m-ADBB in the
full sample, 11.4% of the infants had a score above the suggested cutoff (≥2). In both
versions, children achieved high scores on vocalization.Conclusion: Our findings suggest that the m-ADBB is an acceptable approach to
achieve adequate interrater agreement in a large community-based study in Nepal.
Results indicate high prevalence of social withdrawal in this population. There are,
however, uncertainties on the internal consistency of the scales in this setting, and the
validity of the scales needs to be investigated further. More effective training strategies
for administration and additional cultural-specific instructions could be important
measures to explore before implementing the scale further in this setting.
关键词:ADBB; social withdrawal; infant; feasibility; Nepal