Factors affecting yawning frequencies in preterm neonates.

Yawning is a long neglected behavioral pattern, but it has recently gained an increasing interdisciplinary attention for its theoretical implications as well as for its potential use as a clinical marker, with particular regard to perinatal neurobehavioral assessment. The present study investigated the factors affecting yawning frequencies in hospitalized preterm neonates (N = 58), in order to distinguish the effects of hunger and sleep-related modulations and to examine the possible impact of demographic and clinical variables on yawning frequencies. Results showed that preterm neonates yawned more often before than after feeding, and this modulation was not explained by the amount of time spent in quiet sleep in the two conditions. Moreover, second born twins, known to be more prone to neonatal mortality and morbidity, showed increased yawning rates compared to first born twins. Overall, our results are consistent with the hypothesis that yawning frequencies in preterm neonates are modulated by separate mechanisms, related e.g. to hunger, vigilance and stress. These findings, although preliminary and based only on behavioral data, might indicate that several distinct neuropharmacological pathways that have been found to be involved in yawn modulation in adults are already observable in preterm neonates.

Identifying fetal yawns based on temporal dynamics of mouth openings: A preterm neonate model using support vector machines (SVMs).

Fetal yawning is of interest because of its clinical, developmental and theoretical implications. However, the methodological challenges of identifying yawns from ultrasonographic scans have not been systematically addressed. We report two studies that examined the temporal dynamics of yawning in preterm neonates comparable in developmental level to fetuses observed in ultrasound studies (about 31 weeks PMA). In Study 1 we tested the reliability and construct validity of the only quantitative measure for identifying fetal yawns in the literature, by comparing its scores with a more detailed behavioral coding system (The System for Coding Perinatal Behavior, SCPB) adapted from the comprehensive, anatomically based Facial Action Coding System for Infants and Young Children (Baby FACS). The previously published measure yielded good reliability but poor specificity, resulting in over-representation of yawns. In Study 2 we developed and tested a new machine learning system based on support vector machines (SVM) for identifying yawns. The system displayed excellent specificity and sensitivity, proving it to be a reliable and valid tool for identifying yawns in fetuses and neonates. This achievement represents a first step towards a fully automated system for identifying yawns in the perinatal period.

Age-related differences in the acute pain facial expression during infancy.

BACKGROUND: The ontogenetic perspective on the development of emotional expressions in infants holds that infants' facial and vocal expressions evolved to serve crucial communicative functions in infancy and contribute to infants' survival. Infants' facial expressions should be contextualized by their own developmental stage rather than presuppositions from verbal populations. The overall aim of this paper was to examine age differences in the temporal patterning of elucidated facial expressions in the first minute following vaccination injections. METHODS: One hundred infants were videotaped longitudinally (2, 4, 6 and 12 months) from 2007-2012 during their routine vaccination appointment over the first year of life and five major negative facial configurations were identified using BabyFACS. In the current study, facial configurations were graphed in 5-s epochs for 1-min post-vaccination and subsequently analysed for facial expression by time effects using Repeated Measures ANOVAs at each age. RESULTS: Clear differences in temporal patterns were displayed as infants aged. ANOVA analyses indicated significant facial expression by time interactions at each age. CONCLUSIONS: Facial expressions illustrating intense/moderate distress and sensory overload were prominent in the first 15 s at the 2-, 4- and 6-month vaccination. However, expressions showing regulation of distress occurred progressively earlier over 1 min post-needle in older infants, suggesting a significant shift in regulatory capacity of pain-related distress occurs after 6-months of age. SIGNIFICANCE: An important developmental milestone was identified in infants' ability to regulate distress at 6 months. Supporting parents' infant pain management is particularly critical in the first months of life as infants' initial facial expressions appear to be more reflective of an organism overwhelmed by distress.

Facial Expressiveness in Infants With and Without Craniofacial Microsomia: Preliminary Findings.

OBJECTIVE: To compare facial expressiveness (FE) of infants with and without craniofacial macrosomia (cases and controls, respectively) and to compare phenotypic variation among cases in relation to FE. DESIGN: Positive and negative affect was elicited in response to standardized emotion inductions, video recorded, and manually coded from video using the Facial Action Coding System for Infants and Young Children. SETTING: Five craniofacial centers: Children's Hospital of Los Angeles, Children's Hospital of Philadelphia, Seattle Children's Hospital, University of Illinois-Chicago, and University of North Carolina-Chapel Hill. PARTICIPANTS: Eighty ethnically diverse 12- to 14-month-old infants. MAIN OUTCOME MEASURES: FE was measured on a frame-by-frame basis as the sum of 9 observed facial action units (AUs) representative of positive and negative affect. RESULTS: FE differed between conditions intended to elicit positive and negative affect (95% confidence interval = 0.09-0.66, P = .01). FE failed to differ between cases and controls (ES = -0.16 to -0.02, P = .47 to .92). Among cases, those with and without mandibular hypoplasia showed similar levels of FE (ES = -0.38 to 0.54, P = .10 to .66). CONCLUSIONS: FE varied between positive and negative affect, and cases and controls responded similarly. Null findings for case/control differences may be attributable to a lower than anticipated prevalence of nerve palsy among cases, the selection of AUs, or the use of manual coding. In future research, we will reexamine group differences using an automated, computer vision approach that can cover a broader range of facial movements and their dynamics.

Effects of the Lee Silverman Voice Treatment (LSVT® LOUD) on hypomimia in Parkinson's disease.

Given associations between facial movement and voice, the potential of the Lee Silverman Voice Treatment (LSVT) to alleviate decreased facial expressivity, termed hypomimia, in Parkinson's disease (PD) was examined. Fifty-six participants--16 PD participants who underwent LSVT, 12 PD participants who underwent articulation treatment (ARTIC), 17 untreated PD participants, and 11 controls without PD--produced monologues about happy emotional experiences at pre- and post-treatment timepoints ("T1" and "T2," respectively), 1 month apart. The groups of LSVT, ARTIC, and untreated PD participants were matched on demographic and health status variables. The frequency and variability of facial expressions (Frequency and Variability) observable on 1-min monologue videorecordings were measured using the Facial Action Coding System (FACS). At T1, the Frequency and Variability of participants with PD were significantly lower than those of controls. Frequency and Variability increases of LSVT participants from T1 to T2 were significantly greater than those of ARTIC or untreated participants. Whereas the Frequency and Variability of ARTIC participants at T2 were significantly lower than those of controls, LSVT participants did not significantly differ from controls on these variables at T2. The implications of these findings, which suggest that LSVT reduces parkinsonian hypomimia, for PD-related psychosocial problems are considered.

A longitudinal analysis of the development of infant facial expressions in response to acute pain: immediate and regulatory expressions.

Facial expressions during infancy are important to examine, as infants do not have the language skills to describe their experiences. This is particularly vital in the context of pain, where infants depend solely on their caregivers for relief. The objective of the current study was to investigate the development of negative infant facial expressions in response to immunization pain over the first year of life. Infant facial expressions were examined longitudinally using a subsample of 100 infants that were each videotaped during their 2-, 4-, 6-, and 12-month routine immunization appointments. Infant facial expressions were coded using BabyFACS (facial action coding system) for the first minute after a painful needle prick. Facial expressions were examined with a catalogue of the most commonly occurring facial expressions. Results demonstrated that clear differences were seen over ages. Infants display a variety of facial expressions with some of the components of adult pain expressions immediately after the needle and they abate shortly after. However, infants did not display adult expressions of discrete negative emotions. Instead, infants displayed a variety of generalized pain and distress faces aimed at gaining caregiver aid. The development of nonverbal communication in infants, particularly facial expressions, remains an important area of inquiry. Further study into accurately measuring infant negative emotions, pain, and distress is warranted.

Parental sensitivity to infant distress: what do discrete negative emotions have to do with it?

Parental sensitivity, a crucial element of attachment theory, refers to the ability to correctly interpret and respond appropriately to infants' signals. The question of whether infants' emotional expressions communicate discrete negative emotions has been widely debated in the literature on infant emotional development, but it has rarely been discussed in the parental sensitivity literature. This article explores how insights from the parental sensitivity literature and from evolutionary and dynamical systems perspectives on infant emotion expressions can be brought together to enhance our understanding of parental responsiveness to infant distress. The current research concludes that sensitivity does not rely on reading discrete negative emotions in infant signals, but rather on an integration of complex, graded distress expressions with contextual factors and iterative interaction processes.

Emotional facial expressions in European-American, Japanese, and Chinese infants.

Charles Darwin was among the first to recognize the important contribution that infant studies could make to our understanding of human emotional expression. Noting that infants come to exhibit many emotions, he also observed that at first their repertoire of expression is highly restricted. Today, considerable controversy exists regarding the question of whether infants experience and express discrete emotions. According to one position, discrete emotions emerge during infancy along with their prototypic facial expressions. These expressions closely resemble adult emotional expressions and are invariantly concordant with their corresponding emotions. In contrast, we propose that the relation between expression and emotion during infancy is more complex. Some infant emotions and emotional expressions may not be invariantly concordant. Furthermore, infant emotional expressions may be less differentiated than previously proposed. Together with past developmental studies, recent cross-cultural research supports this view and suggests that negative emotional expression in particular is only partly differentiated towards the end of the first year.

Emotion in the infant's face: insights from the study of infants with facial anomalies.

Darwin viewed "experiments in nature" as an important strategy for elucidating the evolutionary bases of human emotional expressions. Infants with craniofacial anomalies are of special interest because morphological abnormalities and resulting distortions or deficits in their facial expressions could make it more difficult for caregivers to read and accurately interpret their signals. As part of a larger study on the effects of craniofacial anomalies on infant facial expression and parent-infant interaction, infants with different types of craniofacial conditions and comparison infants were videotaped interacting with their mothers at 3 and 6 months. The infants' facial expressions were coded with Baby FACS. Thirty-seven slides of 16 infants displaying 4 distinctive infant expressions (cry face, negative face, interest, and smile) were rated by 38 naive observers on a 7-point scale ranging from intense distress to intense happiness. Their ratings were significantly correlated with ratings based on objective Baby FACS criteria (r > 0.9 in all infant groups). A 4 (infant group) x 4 (expression category) ANOVA showed a significant main effect for expression category, F(3) 5 71.9, P 5 0.000, but no significant effect for infant group or group 3 expression interaction. The observers' ratings were thus highly "accurate" in terms of a priori Baby FACS criteria, even in the case of infants with severely disfiguring facial conditions. These findings demonstrate that the signal value of infant facial expressions is remarkably robust, suggesting that the capacity to read emotional meaning in infants' facial expressions may have a biological basis.

Observing emotion in infants: facial expression, body behavior, and rater judgments of responses to an expectancy-violating event.

Eleven-month-old European-American, Japanese, and Chinese infants (ns = 23, 21, and 15, respectively) were videotaped during baseline and stimulus episodes of a covert toy-switch procedure. Infants looked longer at the object during the expectancy-violating event (stimulus episode) but did not produce more surprise-related facial expressions. American and Japanese infants produced more bodily stilling during stimulus than baseline, and American infants also produced more facial sobering. Naive raters viewing both episodes could correctly identify the expectancy-violating event. Rater judgments of surprise were significantly related to infants' bodily stilling and facial sobering. Judgments of interest were related to cessation of fussing. Thus, observer judgments of infant emotions can be systematically related to behaviors other than prototypic emotional facial expressions.