LaGasse Linda L, Neal A Rebecca, Lester Barry M
Department of Pediatrics, Brown Medical School, Infant Development Center, Women and Infants Hospital, Providence, Rhode Island 02903, USA.
Ment Retard Dev Disabil Res Rev. 2005;11(1):83-93. doi: 10.1002/mrdd.20050.
Infant crying signals distress to potential caretakers who can alleviate the aversive conditions that gave rise to the cry. The cry signal results from coordination among several brain regions that control respiration and vocal cord vibration from which the cry sounds are produced. Previous work has shown a relationship between acoustic characteristics of the cry and diagnoses related to neurological damage, SIDS, prematurity, medical conditions, and substance exposure during pregnancy. Thus, assessment of infant cry provides a window into the neurological and medical status of the infant. Assessment of infant cry is brief and noninvasive and requires recording equipment and a standardized stimulus to elicit a pain cry. The typical protocol involves 30 seconds of crying from a single application of the stimulus. The recorded cry is submitted to an automated computer analysis system that digitizes the cry and either presents a digital spectrogram of the cry or calculates measures of cry characteristics. The most common interpretation of cry measures is based on deviations from typical cry characteristics. Another approach evaluates the pattern across cry characteristics suggesting arousal or under-arousal or difficult temperament. Infants with abnormal cries should be referred for a full neurological evaluation. The second function of crying--to elicit caretaking--involves parent perception of the infant's needs. Typically, parents are sensitive to deviations in cry characteristics, but their perception can be altered by factors in themselves (e.g., depression) or in the context (e.g., culture). The potential for cry assessment is largely untapped. Infant crying and parental response is the first language of the new dyadic relationship. Deviations in the signal and/or misunderstanding the message can compromise infant care, parental effectiveness, and undermine the budding relationship. (c) 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:83-93.
婴儿啼哭向潜在的照顾者发出痛苦信号，这些照顾者能够缓解引发啼哭的不良状况。啼哭信号是由几个控制呼吸和声带振动的脑区协同作用产生的，哭声即由此而来。先前的研究表明，啼哭的声学特征与神经损伤、婴儿猝死综合征、早产、疾病状况以及孕期药物接触等相关诊断之间存在关联。因此，对婴儿啼哭的评估为了解婴儿的神经和健康状况提供了一个窗口。对婴儿啼哭的评估简便且无创，需要记录设备和标准化刺激以引发疼痛啼哭。典型的方案是单次施加刺激后记录30秒的啼哭。记录的啼哭会提交给一个自动计算机分析系统，该系统将啼哭数字化，要么呈现啼哭的数字频谱图，要么计算啼哭特征的测量值。对啼哭测量值最常见的解读是基于与典型啼哭特征的偏差。另一种方法是评估啼哭特征的模式，表明唤醒不足、过度唤醒或气质困难。哭声异常的婴儿应转介进行全面的神经学评估。啼哭的第二个功能——引发照料——涉及父母对婴儿需求的感知。通常，父母对啼哭特征的偏差很敏感，但他们的感知可能会受到自身因素（如抑郁）或环境因素（如文化）的影响而改变。啼哭评估的潜力在很大程度上尚未得到开发。婴儿啼哭和父母的反应是新的二元关系的第一语言。信号偏差和/或对信息的误解可能会损害婴儿护理、父母的效能，并破坏这种初萌的关系。（c）2005威利 - 利斯公司。《智力迟钝与发育障碍研究评论》2005年；11:83 - 93。
