Infant Pain Expression Research Articles

Neural Network Performance Comparison in Infant Pain Expression Classifications

Infant pain is a non-stationary made by infants in response to certain situations. This infant facial expression can be used to identify physical or psychology status of infant. The aim of this work is to compare the performance of features in infant pain classification. Fast Fourier Transform (FFT), and Singular value Decomposition (SVD) features are computed at different classifier. Two different case studies such as normal and pain are performed. Two different types of radial basis artificial neural networks namely, Probabilistic Neural Network (PNN) and General Regression Neural Network (GRNN) are used to classify the infant pain. The results emphasized that the proposed features and classification algorithms can be used to aid the medical professionals for diagnosing pathological status of infant pain.

Effects of maternal parity, depression and stress on two-month-old infant expression of pain

Objective: This study investigates effects of maternal parity, mental health and frequency of touch on infant distress expressed during routine vaccination, as well as the ability of mothers to assess infant pain. Methods: 50 mothers (19 first-time mothers, 23 stressed, 8 depressed) and their 2-month-old infants (mean age 8.1 weeks, range 7–9 weeks) were videotaped during routine immunisation for off-line-analysis. Infant- related pain behaviours were coded before, during and after needle insertion. Maternal touch was coded throughout the immunisation procedure and maternal estimates of infant pain were established immediately after the procedure. Results: Infants of first-time mothers showed significantly more pain before the needle insertion as well as during the first vaccination, compared with infants of experienced mothers. In contrast to expectation, maternal mental health status and type of touch did not influence the level of pain expressed by infants. Mothers consistently overestimated infant pain and their assessments were poorly correlated with observed infant pain behaviours. Conclusion: These findings suggest that maternal parity may influence infant pain expression before vaccination. However, all mothers overestimate their infant’s pain. Further studies are required to resolve conflicting findings in this field of research, as findings may have policy implications in promoting adherence to the vaccination schedule.

A Quantitative Examination of Extreme Facial Pain Expression in Neonates: The Primal Face of Pain across Time

Many pain assessment tools for preschool and school-aged children are based on facial expressions of pain. Despite broad use, their metrics are not rooted in the anatomic display of the facial pain expression. We aim to describe quantitatively the patterns of initiation and maintenance of the infant pain expression across an expressive cycle. We evaluated the trajectory of the pain expression of three newborns with the most intense facial display among 63 infants receiving a painful stimulus. A modified “point-pair” system was used to measure movement in key areas across the face by analyzing still pictures from video recording the procedure. Point-pairs were combined into “upper face” and “lower face” variables; duration and intensity of expression were standardized. Intensity and duration of expression varied among infants. Upper and lower face movement rose and overlapped in intensity about 30% into the expression. The expression reached plateau without major change for the duration of the expressive cycle. We conclude that there appears to be a shared pattern in the dynamic trajectory of the pain display among infants expressing extreme intensity. We speculate that these patterns are important in the communication of pain, and their incorporation in facial pain scales may improve current metrics.

The Influence of Culture on Maternal Soothing Behaviours and Infant Pain Expression in the Immunization Context

To investigate how maternal culture (ie, individualist versus collectivist) influences soothing techniques and infant distress. Archival data were analyzed using a subsample of 80 motherinfant dyads selected from a larger database of infant pain expression. Mothers belonging to the individualist group used more affection behaviours when attempting to regulate their infants' distress. No differences were observed in mothers' touching, holding, rocking, vocalizing, caregiving or distracting their infants. Mothers' culture did not appear to be related to the level of distress expressed by their infants. These results suggest that the similarities in soothing and infant pain expression between individualist and collectivist cultures are more prominent than their differences.

Assessing Pain in Infancy: The Caregiver Context

Pain is largely accepted as being influenced by social context. Unlike most other developmental stages throughout the lifespan, infancy is marked by complete dependence on the caregiver. The present paper discusses the primary importance of understanding the caregiver context when assessing infant pain expression. Based on a review of research from both the infant pain and infant mental health fields, three lines of evidence are presented. First, pain assessment is as subjective as the pain experience itself. Second, assessors must be cognizant of the relationship between infant pain expression, and caregiver sensitivity and emotional displays. Finally, larger systemic factors of the infant (such as caregiver relationship styles, caregiver psychological distress or caregiver acculturative stress) directly impact on infant expression. As a result of infants' inability to give a self-report of their pain experience, caregivers play a crucial role in assessing the pain and taking appropriate action to manage it. Caregiver behaviours and predispositions have been shown to have a significant impact on infant pain reactivity and, accordingly, should not be ignored when assessing the infant in pain.

The expression of pain in infants with developmental delays.

To explore how infants with developmental delays express pain, we analysed facial expressions of infants receiving their routine immunization at around 4-6 months developmental age. The sample included eight infants with developmental disabilities (mean developmental age 4.8 months) and 30 typically developing infants (mean age 4 months). The Maximally Discriminative Facial Movement Coding system was used to code infant facial expressions during immunization. The pain expression was by far the most common of all facial expressions following immunization for both groups of infants. Those with disabilities produced significantly fewer discrete high-intensity expressions of pain, and significantly more blended expressions than typically developing infants. Expressions of fear, sadness and anger were relatively infrequent in both groups. Infants with disabilities used their upper face less often than typically developing infants, and their mid face was uncodeable more often. Infants with developmental delays were likely to show pain in facial expressions less clearly than typically developing infants. It is important for health care professionals to be aware that this may be the case when considering the administration of analgesia for such children.

The expression of pain in infants and toddlers: developmental changes in facial action

Age-related changes in the facial expression of pain during the first 18 months of life have important implications for our understanding of pain and pain assessment. We examined facial reactions video recorded during routine immunization injections in 75 infants stratified into 2-, 4-, 6-, 12-, and 18-month age groups. Two facial coding systems differing in the amount of detail extracted were applied to the records. In addition, parents completed a brief questionnaire that assessed child temperament and provided background information. Parents' efforts to soothe the children also were described. While there were consistencies in facial displays over the age groups, there also were differences on both measures of facial activity, indicating systematic variation in the nature and severity of distress. The least pain was expressed by the 4-month age group. Temperament was not related to the degree of pain expressed. Systematic variations in parental soothing behaviour indicated accommodation to the age of the child. Reasons for the differing patterns of facial activity are examined, with attention paid to the development of inhibitory mechanisms and the role of negative emotions such as anger and anxiety.

The facial expression of pain Better than a thousand words?

A diverse pattern of verbal and nonverbal activity communicates distress to others and permits inferences about the nature and severity of pain. The professional and scientific literature have focused heavily upon self-report measures, despite known limitations, with the potential benefits of nonverbal measures, and the important role of nonverbal communication, left relatively unexamined. Successes in objective description of a relatively specific facial reaction during painful events are described for both adults and infants. Detailed coding of facial activity provides a mechanism for understanding biological, behavioral, cognitive, and social parameters of pain that self-report measures do not address. Facial activity appears to be the most consistent expression of pain in infants. Age-specific patterns are described. In both clinical and nonclinical settings, observers often attach greater credibility to nonverbal expression than to self-report.

Developmental changes in infant pain expression during immunization injections

Developmental changes in pain expression provoked by routine immunization injections during the first 2 years of life were examined. An interval-sampling, behavioral observation system was developed to code categories of expressive behavior in infants, their mothers and the nurse responsible for the injection. Qualitative changes were observed in the infants' behavior, with those less than 12 months of age responding in a more spontaneous, diffuse manner, whereas the older infants displayed more anticipatory distress, descriptive language and goal-directed movement. Mothers and the nurse actively interacted with each other and the infant with a range of vocal and nonvocal actions. The findings justified the use of unobtrusive, naturalistic observation as a means of assisting practitioners who suffer from an inadequate knowledge-base on pain in children.