ADBB in Denmark

ADBB in Denmark: A national study of implementation, incidence and risk factors for social withdrawal in infants and young children across the country.

In Center for Early Intervention and Family Studies, we have trained health visitors in the Alarm Distress Baby Scale (ADBB) method since 2015. Today, the health visitors in 79 out of the country's 98 municipalities are trained and certified in the ABBB method, and during the spring 2022, as many as 80 municipalities will have implemented ADBB in their home visiting program. This means that for the first time in Denmark under the auspices of the public health home visiting program, we have a universal, largely nationwide tool for a systematic and standardized early detection of children who may show difficulties in their social contact and development. This tool makes it possible to implement early help and support for the infants and families who need it.

This project investigates:

  1. How ADBB is used across municipalities
  2. What the risk factors are in relation to social withdrawal in parents and the child itself
  3. What the prevalence of social withdrawal is across the country


At present, 58 of the 79 municipalities where ADBB has been implemented have agreed to participate in the project. We hope that more will join, as the municipalities that have implemented the ADBB method during 2020 will be invited to participate in the project during the spring 2022.

This project is based on data from Health Visitors' records and at present collaboration has been entered with 58 ADBB municipalities divided into 18/29 municipalities in the Capital Region (62.1%), 13/19 municipalities in the Central Jutland Region (68.4%), 10/17 municipalities in Region Zealand (58.8%), 10/22 municipalities in the Region of Southern Denmark (45.5%), and 7/11 municipalities in the North Jutland Region (63.6%).



The primary purpose of the national mapping of ADBB in Denmark is to uncover its implementation across the country. In CIF we recommend that the health visitors on a routinely basis conduct at least one ADBB screening of the child. It is however each municipality’s own responsibility to define actual guidelines for how often the children should be screened with ADBB. In this project we will examine if guidelines for both the number of and the point in time for ADBB observations affects the number of children in which an ADBB observation gives a cause for concern.


The second purpose of the national ADBB mapping is to uncover if there is a correlation between signs of social withdrawal and risk factors in parents and infants. We have previously found that prematurity predicts a higher degree of social withdrawal in all ages and that mothers’ depressive symptoms also predict social withdrawal when the child is 2-3 months. In this project we will in a larger sample examine if we can confirm this and examine connections between other risk factors as well.



The third purpose of this project is to map the prevalence of social withdrawal amongst infants and toddlers in Denmark. We expect a variation across municipalities/regions, among others due to the differences in the occurrence of risk factors like the depressive symptoms of parents.


Should you have any questions, please contact

Anne Christine Stuart 
+45 35 32 63 96

The project group

Mette Skovgaard Væver

Anne Christine Stuart. Photo: PersonalAnne Christine Stuart