Alarm Distress Baby Scale (ADBB)

The ADBB is a scale for assessing relational withdrawal in babies between 0 and 24 months of age, with 8 observation items. It is an observation aid validated by research.

The ADBB was developed by Pr. A. Guedeney (child psychiatrist, Hôpital Bichat Claude Bernard, AP/HP Paris). The Baby Alarm Distress Scale (ADBB) is an observation aid for child professionals (paediatricians, child psychiatrists, psychologists, nursery nurses, educators, etc.). It is used in clinical settings (screening), for the evaluation of interventions, and for research.

WHY LEARN TO ASSESS RELATIONAL WITHDRAWAL?

Withdrawal is a major component of the baby’s response to the alteration of the relationship that occurs during the still face experience or in the clinic during maternal depression.

Withdrawal behaviour is also one of the most stable developmental behaviours, despite the major changes that occur in the first three years of life.

Early relational withdrawal behaviour is therefore an important warning signal.

The baby’s defensive repertoire is indeed initially quite limited, and centres mainly around protest and withdrawal.

Withdrawal is more difficult to identify than protest, yet it is involved in many situations of early psychopathology, whether they are caused initially by a relational disorder, or by an organic disorder, as in intense and lasting pain.

We also offer webinars (video-conferences) or E-learning (6 hours) on Detecting psychological distress in babies aged 0-24 months – Training presenting the notion of relational withdrawal and the ADBB scales – level Initiation

General objective: To be able to detect and assess relational withdrawal in children between 0 and 24 months using the ADBB (Alarm Distress Baby Scale)

Operational objectives: at the end of the course you should be able to :

1. Define relational withdrawal,
2. Understand the links between relational withdrawal and developmental risk,
3. Name the main findings of research on relational withdrawal and the validity of the scale,
4. Cite and define each of the items in the ADBB scale,
5. Be aware of the legal, ethical and technical requirements for conducting an assessment,
6. Detect a relational withdrawal baby in all assessment situations in a reliable manner,
7. Reliably assess the severity of relational withdrawal.

• Theories and research on relational withdrawal
• Scoring manual and assessment methodology
• Training in scoring with the help of video documents: Finding your way around the ADBB Scale, first steps with the Scale
• More in-depth
• Test-retest and difficult items
• Using the video tool in the clinic
• Preparation for the final test (private certification)
• Final test

Alexandra Deprez, B-Families

Doctor in psychology, certified trainer for the ADBB, expert trainer and educational tutor. Child and adolescent psychologist. Trained in perinatal psychopathology and different attachment assessment tools (CARE-Index, Adult Attachement Interview, Strange Situation, Crowell Procedure..) and different modalities of informed attachment and trauma therapy interventions: Theraplay, EMDR etc..

Jocelyne Guillon, Humagogie ​: administrative tutor (management of registrations in France and administrative documents for the course) and Learning Community Manager.

The evaluations allow us to collect your comments and suggestions for improvement. They are also passed on to the trainers.

The evaluation procedure also makes it possible to determine whether the trainee has acquired the knowledge whose mastery constitutes the initial objective of the action.

• The evaluations carried out on the spot (at the end of the training course) and afterwards (1 to 3 months after the training courses) enable us to collect your comments and suggestions for improvement. They are also sent to the trainers. The evaluation procedure also makes it possible to determine whether the trainee has acquired the knowledge whose mastery constitutes the initial objective of the action.
  • Before : Pre-training questionnaire to assess participants’ expectations of the training.
  • During : The learning activities will be monitored throughout the course by recording the time spent on the platform, the trainees’ involvement in the learning community, and the completion of the pedagogical activities and exercises. During the virtual classes, exchanges on the understanding of the techniques, on their questioning for a practical application in their daily professional life and on their experimentation.
  • Afterwards: End-of-training evaluation during the last virtual class, then a cold evaluation by questionnaire sent by e-mail, 3 months after the end of the training.

For this distance learning course, learning activities are monitored throughout the course by recording connection times on the platform, recording attendance at virtual classes, your involvement in the learning community and the completion of teaching activities and exercises.

Exercises and analysis of videos and cases with feedback from the trainer take place throughout the course. This continuous evaluation will allow you to acquire the necessary skills to put the ADBB into practice in your clinical practice.

An individual mid-course evaluation is planned.

Your presence in the various virtual classes and your exchanges on the learning community on Slack and the video analyses will attest to your participation in the training.

A training certificate will be provided to you on these criteria after the training.

Validation of the final test (ADBB private certification).

Final attestation (private certification)

This is compulsory and involves scoring 20 ADBB videos and submitting your results to the trainer on an Excel file. Your results will be statistically tested to determine your reliability in assessing relational withdrawal. A final certificate will be given to you at the end of the training, informing you of the conditions under which you can use the ADBB Scale according to your results. This certificate is valid for a period of two years.

Why this period? Because a fine observation skill, if not maintained, diminishes with time. At the end of the training, you will be offered simple ways to maintain your ADBB competence, such as

• completing your practice through supervision, by joining the co-development community “Attachment in Practice” for at least 6 months
• or by re-registering for a training session (specific fee) in the use of the ADBB scale. You will then become a peer tutor. You will accompany the other learners to reflect without giving them the answers, while reviewing the content. It is also about being a driving force on the learning community.

Reliability criteria ( Criteria updated in April 2025):

• 🔹 Level 1 – Clinical certification: Use in clinical context with supervision (knows how to spot, without being autonomous for borderline cases)
  – Pearson correlation ≥ 0.60 ✅ (main criterion)
  – ICC ≥ 0.60
  – ≥ 10 cases out of 20 with a variance ≤ ±2 points
  – No serious error on non-clinical or massively concerning cases
  – Intuitive reading still allowed
• 🔹 Level 2 – Research certification: use in research, programme evaluation or stand-alone clinical standard (clinical consistency in decisions).
  – Pearson correlation ≥ 0.80 ✅ (primary endpoint)
  – ICC ≥ 0.70 (secondary)
  – ≥ 13 cases out of 20 correct within ±2 points
  – No strong systematic bias on items
  – Mean correlation ≥ 0.60 on: temperamental items and relational items.
• 🔹 Level 3 – Expert certification: autonomous use, supervision, training, advice in sensitive contexts, technical mastery + stable and sharable clinical judgement
  – Pearson correlation ≥ 0.90 ✅ (main criterion)
  – ICC ≥ 0.80
  – ≥ 15 cases out of 20 correct within ±2 points
  – No serious errors on extreme cases
  – Mean correlation ≥ 0.70 on: temperamental items and relational items
• 🪜 Level ‘on the way to expertise’: Recognition of very advanced profiles
  – Pearson ≥ 0.90 ✅ (main criterion)
  – ICC ≥ 0.75
  – ≥ 14 cases out of 20 correct
  – Correlation per factor between 0.60 and 0.70
  – No clinically worrying bias

The ADBB private certification is valid for 2 years, as this knowledge needs to be updated regularly and after 2 years biases may have developed and feedback from an ADBB expert is needed.

To maintain competence in the use of the ADBB scale, it is necessary to take part in an online reflective workshop on the ADBB scale at least once every two years (fee in addition to training and on request).

2025 Self-paced training, with a discussion forum to ask your questions, to connect to the trainer and ask your questions (estimate time for learners : 45 to 50 hours).

• Institutional/employer: 1250€  *(Tariff 01/2025) *
• Self-employed, liberal profession or private individual: 990€ * (Tariff 01/2025)*

2026 PRICES

Module 1 prices: €790/person (price for self-employed individuals), €1,150/person (price for employers)
Module 2 prices: €890/person (price for self-employed individuals), €1,250/person (price for employers)

Student/research project holder: contact us

*Humagogie is not subject to VAT, according to article 262 ter, I of the CGI.