{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T08:16:46Z","timestamp":1774599406545,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"Background<\/jats:title>Social withdrawal is a risk indicator for infant development with both organic and non-organic causes. Cleft lip and palate (CLP) impose a higher risk of physical and emotional distress in infants and alters parent-infant relationships. The ADBB scale is a screening tool to identify social withdrawal as a sign of distress in infants. The aim of this study is to evaluate the prevalence of social withdrawal behavior in infants with CLP using the full 8-item ADBB scale and the modified 5-item ADBB scale, and to examine the feasibility of both scales.<\/jats:p><\/jats:sec>Methods<\/jats:title>145 infants with Cleft Lip and Palate were enrolled and video recorded during a pediatric consultation. All infants were scored by two expert raters trained in ADBB scale, and subsequently scored with the m-ADBB by an independent expert. We measured the interrater agreement for the full ADBB scale and psychometric properties of both scales.<\/jats:p><\/jats:sec>Results<\/jats:title>The full ADBB scale identified 15.9% of infants as having social withdrawal behavior (score above cutoff \u22655). Among the infants evaluated with the m-ADBB scale, 44.9% had a score above the suggested cutoff (\u22652). For both scales, the item \u201cvocalization\u201d showed the higher scores. We found a good internal consistency for the full ADBB (Cronbach's alpha = 0.82) and an acceptable internal consistency for the modified ADBB (Cronbach's alpha = 0.71). The interrater agreement for the full ADBB scale was excellent (kappa = 0.837). The Spearman correlation coefficient between the total scores of the two versions was 0.88 (P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our results indicate a relatively high prevalence of social withdrawal in infants with Cleft Lip and Palate, especially evaluated with the modified 5-item ADBB scale. We found that the full ADBB and the modified ADBB scales are feasible to use as screening tools of social withdrawal in this population.<\/jats:p><\/jats:sec>Clinical Trial Registration<\/jats:title>This trial is registered on ClinicalTrials.gov<\/jats:ext-link>, identifier: NCT00993993. The data is the property of Assistance Publique, H\u00f4pitaux de Paris<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.804802","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T06:41:10Z","timestamp":1657176070000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale"],"prefix":"10.3389","volume":"10","author":[{"given":"Carla","family":"P\u00e9rez 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