Developmental Issues: Infants and Toddlers

  • Kenneth D. Craig
  • Ruth V. E. Grunau


The newborn emerges from the protective intrauterine environment well-equipped biologically to experience pain and display acute distress when tissue damage occurs. Pain will be a common experience for the infant and young child when physical development and socialization influences are occurring at a remarkable pace. Despite pain’s dramatic and traumatic nature, our understanding of pain in the newborn and young child only recently has received concerted attention, and there have been serious misconceptions held by many practitioners and scholars. There also has been a substantial lag between our rapidly developing understanding of pain in the very young child and applications of this knowledge base in clinical settings.


Facial Expression Reaction Pattern Developmental Issue Painful Event Facial Action Code System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Academy of Pediatrics (1975). Report of the ad hoc task force on circumcision. Pediatrics, 56, 610.Google Scholar
  2. Ames, E. W. (1985). Mundus et infans. Canadian Psychology, 26, 262–274.CrossRefGoogle Scholar
  3. Anand, K. J. S., & Aynsley-Green, A. (1985). Metabolic and endocrine effects of surgical ligation of patent ductus arteriosus in the human preterm neonate: Are there implications for further improvement of postoperative outcome? Modern Problems in Paediatrics, 23, 143–157.Google Scholar
  4. Anand, K. J. S., & Aynsley-Green, A. (1988). Does the newborn infant require potent anaesthesia during surgery? Answers from a randomized trial of halothane anaesthesia. In R. Dubner, G. F. Gebhart, & M. R. Bond (Eds.), Pain research and clinical management (Vol. 3, pp. 329–335). Amsterdam: Elsevier.Google Scholar
  5. Anand, K. J. S., & Carr, D. B. (1989). The neuroanatomy, neurophysiology, and neurochemistry of pain, stress, and analgesia in newborns and children. Pediatric Clinics of North America, 36, 795–822.PubMedGoogle Scholar
  6. Anand, K. J. S., & Hickey, P. R. (1987). Pain and its effects in the human neonate and fetus. New England Journal of Medicine, 317(21), 1321–1329.PubMedCrossRefGoogle Scholar
  7. Anand, K. J. S., Sippell, W. G., & Aynsley-Green, A. (1987). Randomized trial of fentanyl anaesthesia in preterm babies undergoing surgery: Effects on the stress response. Lancet, i, 243–268.CrossRefGoogle Scholar
  8. Apley, J. (1975). The child with abdominal pains (2nd ed.). London: Blackwell.Google Scholar
  9. Bailey, C. R., & Miller, N. K. (1983). Routine circumcision of the male neonate. Canadian Nurse, 79, 28–31.Google Scholar
  10. Barr, R. G. (1989a). Pain in children. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (2nd ed., pp. 568–588). London: Churchill Livingstone.Google Scholar
  11. Barr, R. G. (1989b). Recasting a clinical enigma: The case of infant crying problems (and colic). In P. Zelazo & R. G. Barr (Eds.), Challenges to development paradigms: Implications for theory, assessment and treatment (pp. 44–63). New York: Erlbaum.Google Scholar
  12. Bennett, E. J., & Bowyer, D. E. (1982). Principles of pediatric anesthesia. Springfield, IL: C.C. Thomas.Google Scholar
  13. Beyer, J. E., DeGood, D. E., Ashley, L. D., & Russell, G. A. (1983). Patterns of postoperative analgesic use with adults and children following cardiac surgery. Pain, 17, 71–81.PubMedCrossRefGoogle Scholar
  14. Beyer, J. E., & Wells, N. (1989). The assessment of pain in children and adolescents. Pediatric Clinics of North America, 36, 837–854.PubMedGoogle Scholar
  15. Branson, S. M., & Craig, K. D. (1988). Children’s spontaneous strategies for coping with pain: A review of the literature. Canadian Journal of Behavioural Science, 20, 402–412.CrossRefGoogle Scholar
  16. Brazelton, T. B. (1984). Neonatal Behaviour Assessment Scale (2nd ed.). Spastics International Medical Publications, Monograph #88. Philadelphia: J. B. Lippincott.Google Scholar
  17. Brown, J. M., O’Keefe, J., Sanders, S. H., & Baker, B. (1986). Developmental changes in children’s cognition to stressful and painful situations. Journal of Pediatric Psychology, 11, 343–357.PubMedCrossRefGoogle Scholar
  18. Campos, R. G. (1989). Comfort measures for infant pain. Sensory Integration News, 16, 2–8.Google Scholar
  19. Carey, W. B. (1983). “Colic” or excessive crying in young infants. In M. D. Levine, W. B. Carey, A. C. Crocker, & R. T. Gross (Eds.), Developmental-behavioral pediatrics (pp. 517–521). Philadelphia: Saunders.Google Scholar
  20. Chandler, M., Fritz, A. S., & Hala, S. (1989). Small scale deceit: Deception as a marker of 2-, 3- and 4-year-olds’ early theories of mind. Child Development, 60, 1263–1277.PubMedCrossRefGoogle Scholar
  21. Craig, K. D. (1980). Ontogenetic and cultural determinants of the expression of pain in man. In H. W. Kosterlitz & L. Y. Terenius (Eds.), Pain and society (pp. 39–52). Dahlem Konferenzen. Weinheim/Deerfield Beach, FL/Basal: Verlag Chemie.Google Scholar
  22. Craig, K. D. (1983). Modeling and social learning factors in chronic pain. In J. J. Bonica, U. Lindblom, & A. Iggo (Eds.), Advances in pain research and therapy (Vol. 5, pp. 813–828). New York: Raven Press.Google Scholar
  23. Craig, K. D. (1986). Pain in context: Social modeling influences. In R. A. Sternbach (Ed.), The psychology of pain (2nd ed., pp. 67–96). New York: Raven Press.Google Scholar
  24. Craig, K. D. (1989). Clinical pain measurement from the perspective of the human laboratory. In C. R. Chapman & J. D. Loeser (Eds.), Issues in pain measurement (pp. 220–230). New York: Raven Press.Google Scholar
  25. Craig, K. D., & Grunau, R. V. E. (in press). Neonatal pain perception and behavioral measurement. In K. J. S. Anand & P. J. McGrath (Eds.), Neonatal pain and distress. Amsterdam: Elsevier Science.Google Scholar
  26. Craig, K. D., Grunau, R. V. E., & Aquan-Assee, J. (1988). Judgment of pain in newborns: Facial activity and cry as determinants. Canadian Journal of Behavioural Science, 20, 442–451.CrossRefGoogle Scholar
  27. Craig, K. D., McMahon, R. S., Morison, J. D., & Zaskow, C. (1984). Developmental changes in infant pain expression during immunization injections. Social Science and Medicine, 19, 1331–1337.PubMedCrossRefGoogle Scholar
  28. Craig, K. D., & Patrick, C. J. (1985). Facial expression during induced pain. Journal of Personality and Social Psychology, 48, 1080–1091.PubMedCrossRefGoogle Scholar
  29. Craig, K. D., & Prkachin, K. M. (1983). Nonverbal measures of pain. In R. Melzack (Ed.), Pain measurement and assessment (pp. 173–179). New York: Raven Press.Google Scholar
  30. Craig, K. D., & Wyckoff, M. G. (1987). Cultural factors in chronic pain management. In G. D. Burrows, D. Elton, & G. Stanley (Eds.), Handbook of chronic pain management (pp. 99–108). Amsterdam: Elsevier Science.Google Scholar
  31. Ekman, P., & Friesen, W. V. (1978). Facial Action Coding System: A technique for the measurement of facial movement. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  32. Eland, J. M., & Anderson, J. E. (1977). The experience of pain in children. In A. Jacox (Ed.), Pain: A sourcebook for nurses and other professionals (pp. 453–471). Boston: Little, Brown.Google Scholar
  33. Fordyce, W. E. (1976). Behavioral methods for chronic pain and illness. St. Louis: Mosby.Google Scholar
  34. Franck, L. S. (1986). A new method to quantitively describe pain behaviour in infants. Nursing Research, 35, 28–31.PubMedCrossRefGoogle Scholar
  35. Fuller, B. F., & Horii, Y. (1988). Spectral energy distribution in four types of infant vocalizations. Journal of Communication Disorders, 21, 251–262.PubMedCrossRefGoogle Scholar
  36. Gaffney, A. A., & Dunne, E. A. (1986). Developmental aspects of children’s definitions of pain. Pain, 26, 105–117.PubMedCrossRefGoogle Scholar
  37. Gaffney, A. A., & Dunne, E. A. (1987). Children’s understanding of the causality of pain. Pain, 29, 91–104.PubMedCrossRefGoogle Scholar
  38. Gottlieb, G. (1971). Ontogenesis of sensory function in birds and mammals. In E. Tobach, L. Avonson, & E. Shaw (Eds.), The biopsychology of development (pp. 67–128). New York: Academic Press.Google Scholar
  39. Grunau, R. V. E., & Craig, K. D. (1987). Pain expression in neonates: Facial action and cry. Pain, 28, 395–410.PubMedCrossRefGoogle Scholar
  40. Grunau, R. V. E., & Craig, K. D. (1990). Facial activity as a measure of neonatal pain perception. In D. C. Tyler & E. J. Krane (Eds.), Advances in pain research and therapy. Proceedings of the 1st International Symposium on Pediatric Pain (pp. 147–155). New York: Raven Press.Google Scholar
  41. Grunau, R. V. E., Johnston, C. C., & Craig, K. D. (1990). Facial and cry responses to invasive and non-invasive procedures in neonates. Pain, 42, 295–305.PubMedCrossRefGoogle Scholar
  42. Gunnar, M. R., Fisch, R. O., Korsvik, S., & Donhowe, J. M. (1981). The effects of circumcision on serum Cortisol and behaviour. Psychoneuroendocrinology, 6, 269–275.PubMedCrossRefGoogle Scholar
  43. Hay, D. F. (1986). Infancy. Annual Review of Psychology, 37, 135–161.PubMedCrossRefGoogle Scholar
  44. Izard, C. E., Hembree, E. A., Dougherty, L. M., & Spizzirri, C. C. (1983). Changes in facial expression of 2 to 19 month old infants following acute pain. Developmental Psychology, 19, 418–426.CrossRefGoogle Scholar
  45. Izard, C. E., Huebner, R. R., Resser, D., McGiness, G. C., & Dougherty, L. M. (1980). The young infant’s ability to produce discrete emotional expressions. Developmental Psychology, 16, 132–140.CrossRefGoogle Scholar
  46. Johnston, C. C., & O’Shaugnessy, D. O. (1988). Acoustical attributes of infant pain cries: Discriminating features. In R. Dubner, G. F. Gebhart, & M. R. Bond (Eds.), Proceedings of the Vth World Congress on Pain (pp. 336–340). Amsterdam: Elsevier Science.Google Scholar
  47. Johnston, C. C., & Strada, M. E. (1986). Acute pain response in infants: A multidimensional description. Pain, 24, 373–382.PubMedCrossRefGoogle Scholar
  48. LeResche, L., & Dworkin, S. F. (1988). Facial expressions of pain and emotions in chronic TMD patients. Pain, 35, 71–78.PubMedCrossRefGoogle Scholar
  49. Leslie, A. (1988). Some implications of pretense for the development of theories of mind. In J. W. Astington, P. L. Harris, & D. R. Olson (Eds.), Developing theories of mind (pp. 19–46). New York: Cambridge University Press.Google Scholar
  50. Lester, B. M., & Zeskind, P. S. (1982). A biobehavioral perspective on crying in early infancy. In H. E. Fitzgerald, B. M. Lester, & M. W. Yogman (Eds.), Theory and research in behavioral pediatrics (Vol. 1, pp. 133–180). New York: Plenum.Google Scholar
  51. Levine, J. D., & Gordon, N. C. (1982). Pain in prelingual children and its evaluation by pain-induced vocalization. Pain, 14, 85–93.PubMedCrossRefGoogle Scholar
  52. Levy, D. M. (1960). The infant’s earliest memory of inoculation: A contribution to public health procedures. Journal of Genetic Psychology, 96, 3–46.PubMedGoogle Scholar
  53. Lipsitt, L. P., & Levy, N. (1959). Electrotactual threshold in the infant. Child Development, 30, 547–554.PubMedGoogle Scholar
  54. McGrath, P. J., & Craig, K. D. (1989). Developmental and psychological factors in children’s pain. Pediatric Clinics of North America, 36, 823–836.PubMedGoogle Scholar
  55. McGrath, P. J., Johnson, G., Goodman, J. T., Schillinger, J., Dunn, J., & Chapman, J. A. (1985). CHEOPS: A behavioral scale for rating postoperative pain in children. In H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in pain research therapy (Vol. 9, pp. 395–402). Proceedings of the Fourth World Congress on Pain. New York: Raven Press.Google Scholar
  56. McGrath, P. J., & Unruh, A. M. (1987). Pain in children and adolescents. Amsterdam: Elsevier.Google Scholar
  57. McGraw, M. B. (1941). Neural maturation as exemplified in the changing reactions of the infant to pin prick. Child Development, 12, 31–42.CrossRefGoogle Scholar
  58. McGraw, M. B. (1943). The neuromuscular maturation of the human infant. New York: Hafner.Google Scholar
  59. Muller, E., Hollien, H., & Murry, T. (1974). Perceptual response to infant crying: Identification of cry types. Journal of Child Language, 1, 89–95.CrossRefGoogle Scholar
  60. Munn, N. L. (1965). The evolution and growth of human behavior. Boston: Houghton Mifflin.Google Scholar
  61. Murray, A. D. (1979). Infant crying as an elicitor of parental behavior: An examination of two models. Psychological Bulletin, 86, 191–215.PubMedCrossRefGoogle Scholar
  62. Olson, D. R. (1989). Making up your mind. Canadian Psychology, 30, 617–627.CrossRefGoogle Scholar
  63. Oppenheim, R. W. (1982). The neuroembryological study of behavior: Progress, problems, perspectives. Current Topics in Developmental Biology, 17, 257–309.PubMedCrossRefGoogle Scholar
  64. Oster, H. (1978). Facial expression and affect development. In M. Lewis & L. A. Rosenbaum (Eds.), The development of affect (pp. 43–75). New York: Plenum.Google Scholar
  65. Owens, M. E. (1984). Pain in infancy: Conceptual and methodological issues. Pain, 20, 213–230.PubMedCrossRefGoogle Scholar
  66. Owens, M. E., & Todt, E. H. (1984). Pain in infancy: Neonatal reactions to a heel lance. Pain, 20, 77–86.PubMedCrossRefGoogle Scholar
  67. Patrick, C. J., Craig, K. D., & Prkachin, K. M. (1986). Observer judgments of acute pain: Facial action determinants. Journal of Personality and Social Psychology, 50, 1291–1298.PubMedCrossRefGoogle Scholar
  68. Piaget, J., & Inhelder, B. (1969). The psychology of the child. New York: Basic Books.Google Scholar
  69. Pigeon, H. M., McGrath, P. J., Lawrence, L., & MacMurray, S. B. (1989). Nurses’ perceptions of pain in the neonatal intensive care unit. Journal of Pain and Symptom Management, 4, 179–183.PubMedCrossRefGoogle Scholar
  70. Porter F. L., Miller, R. H., & Marshall, R. E. (1986). Neonatal pain cries: Effects of circumcision on acoustic features and perceived urgency. Child Development, 57, 790–802.PubMedCrossRefGoogle Scholar
  71. Porter, F. L., Porges, S. W., & Marshall, R. E. (1988). Newborn pain cries and vagal tone: Parallel changes in response to circumcision. Child Development, 59, 495–505.PubMedCrossRefGoogle Scholar
  72. Poznanski, F. O. (1976). Children’s reactions to pain: A psychiatrist’s perspective. Clinical Pediatrics, 15, 1114–1119.PubMedCrossRefGoogle Scholar
  73. Purcell-Jones, G., Dormon, F., & Sumner, E. (1988). Pediatric anaesthetists’ perceptions of neonatal and infant pain. Pain, 33, 181–187.PubMedCrossRefGoogle Scholar
  74. Reisman, J. E. (1987). Touch, motion, and proprioception. In P. Salapatek & L. Cohen (Eds.), Handbook of infant perception (pp. 265–303). New York: Academic Press.Google Scholar
  75. Ritchie, J. A. (1981). Development of body concept and concepts of illness and wellness. In M. Tudor (Ed.), Child development (pp. 370–372). New York: McGraw-Hill.Google Scholar
  76. Ross, D. M., & Ross, S. A. (1988). Childhood pain: Current issues, research and management. Baltimore, MD: Urban and Schwarzenberg.Google Scholar
  77. Rovee-Collier, C. K., & Fagan, J. W. (1981). The retrieval of memory in early infancy. In L. P. Lipsitt (Ed.), Advances in infancy research (Vol. 1, pp. 226–254). Norwood, NJ: Ablex.Google Scholar
  78. Sagi, A. (1981). Mothers’ and non-mothers’ identification of infant cries. Infant Behavior and Development, 4, 37–40.CrossRefGoogle Scholar
  79. Sammons, W. A. H. (1989). The self calmed baby. Boston: Little, Brown.Google Scholar
  80. Schechter, N. L., Allen, D. A., & Hanson, K. (1986). Status of pediatric pain control: A comparison of hospital analgesic usage in children and adults. Pediatrics, 77, 11–15.PubMedGoogle Scholar
  81. Selye, H. (1976). The stress of life. New York: McGraw-Hill.Google Scholar
  82. Sroufe, L. A. (1979). Socioemotional development. In J. Osofsky (Ed.), Handbook of infant development (pp. 462–518). New York: Wiley.Google Scholar
  83. Swafford, L. I., & Allan, D. (1968). Pain relief in the pediatric patient. Medical Clinics of North America, 52, 131–136.Google Scholar
  84. Thoden, D., & Koivisto, M. (1980). Acoustic analysis of the normal pain cry. In T. Murray & J. Murry (Eds.), Infant communication: Cry and early speech (pp. 124–151). Houston, TX: College-Hill Press.Google Scholar
  85. Volpe, J. J., & Koenigsberger, R. (1981). Neurological disorders. In G. B. Avery (Ed.), Neonatology: Pathophysiology and management of the newborn (pp. 910–963). Philadelphia: Lippincott.Google Scholar
  86. Wasz-Hockert, O., Michelsson, K., & Lind, J. (1985). Twenty-five years of Scandinavian cry research. In B. M. Lester & C. F. Z. Boukydis (Eds.), Infant crying: Theoretical and research perspectives. New York: Plenum.Google Scholar
  87. Whittmann, B. K., & Ross, A. G. (1986). Patterns of fetal activity and their relevance for the assessment of fetal wellbeing. In M. Hansmann, B. J. Hackeloer, & A. Staudach (Eds.), Ultrasound diagnosis in obstetrics and gynecology (pp. 6–9). New York: Springer-Verlag.Google Scholar
  88. Williamson, P. S., & Williamson, M. L. (1983). Physiologic stress reduction by a local anesthetic during newborn circumcision. Pediatrics, 71, 36–40.PubMedGoogle Scholar
  89. Wolff, P. H. (1969). The natural history of crying and other vocalizations in early infancy. In B. Foss (Ed.), Determinants of infant behavior (Vol. 4, pp. 81–115). London: Methuen.Google Scholar
  90. Wolff, P. H. (1987). The development of behavioral states and the expression of emotions in early infancy. Chicago: University of Chicago Press.Google Scholar
  91. Zeskind, P. S., & Marshall, T. R. (1988). The relation between variations in pitch and maternal perceptions of infant crying. Child Development, 49, 193–196.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1991

Authors and Affiliations

  • Kenneth D. Craig
  • Ruth V. E. Grunau

There are no affiliations available

Personalised recommendations