The Alarm Distress Baby Scale (ADBB) is a well-validated and widely-used observation aid to support early identification of social withdrawal in babies. Developed by child psychiatrist Prof. Antoine Guedeney, it aids the observations of babies’ social behaviours such as eye contact, facial expression, vocalisation and activity levels, and helps the adults around the baby to understand how they are engaging with the world. 

With funding from The Royal Foundation Centre for Early Childhood, the iHV, in partnership with the University of Oxford, conducted an initial study to assess the acceptability and feasibility of implementing the ADBB and its modified version, the m-ADBB, into health visitors’ routine practice.

The study ran from 1 May 2023 - 28 February 2024 and involved health visitors working in South Warwickshire NHS Foundation Trust and Humber Teaching NHS Foundation Trust.

The findings suggested that the ADBB and m-ADBB training enhanced health visitors’ observational skills for assessing signs of social withdrawal in babies and it was feasible to incorporate the m-ADBB within routine 6-8-week health visitor contacts.

In October 2024, The Royal Foundation Centre for Early Childhood agreed further funding for the iHV, in collaboration with the University of Oxford, to conduct a second phase of work to address several of the recommendations for policy, practice and further research.

ADBB Study: A mixed-methods feasibility and acceptability study of using the Alarm Distress Baby Scale (ADBB) within universal health visiting practice in England (April 2024)

Citation: Baldwin S, Fanner M, Beauchamp H, Gilroy V, Barlow J. (2024) ADBB Study: A mixed-methods feasibility and acceptability study of using the Alarm Distress Baby Scale (ADBB) within universal health visiting practice in England, Institute of Health Visiting.

Img_ADBB Study: A mixed-methods feasibility and acceptability study of using the Alarm Distress Baby Scale (ADBB) within universal health visiting practice in England (April 2024)

Published papers


Feasibility and acceptability of using the Alarm Distress BaBy (ADBB) scale within universal health visiting practice in England: a mixed-methods study protocol

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Baldwin S, Insan N, Beauchamp H, Gilroy V, Morton A, Barlow J. (2023) Feasibility and acceptability of using the Alarm Distress BaBy (ADBB) scale within universal health visiting practice in England: a mixed-methods study protocol. BMJ Open, 13 (11). 

Feasibility and acceptability of the Alarm Distress Baby Scale (ADBB) in universal health visiting practice in England: a mixed-methods study using Normalisation Process Theory

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Baldwin S, Fanner M, Beauchamp H, Gilroy V, Morton A, May C, Barlow J. (2025) Feasibility and acceptability of the Alarm Distress Baby Scale (ADBB) in universal health visiting practice in England: a mixed-methods study using Normalisation Process Theory. BMJ Paediatrics Open, 9 (1). 

Contributing to health visiting research: Participating in the ADBB study

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Hardy K, Price R, Baldwin S. (2024) Contributing to health visiting research: Participating in the ADBB study. Journal of Family and Child Health, 1 (3).