Assessment of infant cry: acoustic cry analysis and parental perception

The ultrasonic vocalization (USV) syllable profile during neonatal opioid withdrawal and a kappa opioid receptor component to increased USV emissions in female mice

Rationale

Opioid use during pregnancy can lead to negative infant health outcomes, including neonatal opioid withdrawal syndrome (NOWS). NOWS comprises gastrointestinal, autonomic nervous system, and neurological dysfunction that manifest during spontaneous withdrawal. Variability in NOWS severity necessitates a more individualized treatment approach. Ultrasonic vocalizations (USVs) in neonatal mice are emitted in isolation as a stress response and are increased during opioid withdrawal, thus modeling a negative affective state that can be utilized to test new treatments.

Objectives

We sought to identify the behavioral and USV profile, brainstem transcriptomic adaptations, and role of kappa opioid receptors in USVs during neonatal opioid withdrawal.

Methods

We employed a third trimester-approximate opioid exposure model, where neonatal inbred FVB/NJ pups were injected twice-daily with morphine (10mg/kg, s.c.) or saline (0.9%, 20 ul/g, s.c.) from postnatal day(P) 1 to P14. This protocol induces reduced weight gain, hypothermia, thermal hyperalgesia, and increased USVs during spontaneous morphine withdrawal.

Results

On P14, there were increased USV emissions and altered USV syllables during withdrawal, including an increase in Complex 3 syllables in FVB/NJ females (but not males). Brainstem bulk mRNA sequencing revealed an upregulation of the kappa opioid receptor (Oprk1), which contributes to withdrawal-induced dysphoria. The kappa opioid receptor (KOR) antagonist, nor-BNI (30 mg/kg, s.c.), significantly reduced USVs in FVB/NJ females, but not males during spontaneous morphine withdrawal. Furthermore, the KOR agonist, U50,488h (0.625 mg/kg, s.c.), was sufficient to increase USVs on P10 (both sexes) and P14 (females only) in FVB/NJ mice.

Conclusions

We identified an elevated USV syllable, Complex 3, and a female-specific recruitment of the dynorphin/KOR system in increased USVs associated with neonatal opioid withdrawal severity.

Pain cues override identity cues in baby cries

Baby cries can convey both static information related to individual identity and dynamic information related to the baby's emotional and physiological state. How do these dimensions interact? Are they transmitted independently, or do they compete against one another? Here we show that the universal acoustic expression of pain in distress cries overrides individual differences at the expense of identity signaling. Our acoustic analysis show that pain cries, compared with discomfort cries, are characterized by a more unstable source, thus interfering with the production of identity cues. Machine learning analyses and psychoacoustic experiments reveal that while the baby's identity remains encoded in pain cries, it is considerably weaker than in discomfort cries. Our results are consistent with the prediction that the costs of failing to signal distress outweigh the cost of weakening cues to identity.

Recognition of others' interoceptive states in those with and without eating disorders

BACKGROUND

The ability to recognize one's own emotions is associated with one's ability to recognize others' emotions. Beyond the domain of emotion, however, the relationship between recognition of one's own internal states (interoception) and others' interoceptive states has not been investigated, either in the typical population or clinical groups with interoceptive difficulties (e.g. eating disorders; EDs).

METHOD

This study investigated recognition of one's own and others' internal states in adults with and without eating disorders, using a high frequency visual noise paradigm. Participants completed self-report measures of interoception, alexithymia (difficulties recognising one's own emotional internal states) and ED symptomatology, and the Heartbeat Counting Task measure of cardiac interoceptive accuracy.

RESULTS

Alexithymia was significantly negatively correlated with recognition of others' interoceptive states. EDs were not associated with difficulties recognising others' interoceptive states.

CONCLUSIONS

The ability to recognise one's own emotional internal states is associated with the recognition of others' interoceptive states, which may contribute to social skills and the ability to care for others.

Multi-modal analysis of infant cry types characterization: Acoustics, body language and brain signals

BACKGROUND

Infant crying is the first attempt babies use to communicate during their initial months of life. A misunderstanding of the cry message can compromise infant care and future neurodevelopmental process.

METHODS

An exploratory study collecting multimodal data (i.e., crying, electroencephalography (EEG), near-infrared spectroscopy (NIRS), facial expressions, and body movements) from 38 healthy full-term newborns was conducted. Cry types were defined based on different conditions (i.e., hunger, sleepiness, fussiness, need to burp, and distress). Statistical analysis, Machine Learning (ML), and Deep Learning (DL) techniques were used to identify relevant features for cry type classification and to evaluate a robust DL algorithm named Acoustic MultiStage Interpreter (AMSI).

RESULTS

Significant differences were found across cry types based on acoustics, EEG, NIRS, facial expressions, and body movements. Acoustics and body language were identified as the most relevant ML features to support the cause of crying. The DL AMSI algorithm achieved an accuracy rate of 92%.

CONCLUSIONS

This study set a precedent for cry analysis research by highlighting the complexity of newborn cry expression and strengthening the potential use of infant cry analysis as an objective, reliable, accessible, and non-invasive tool for cry interpretation, improving the infant-parent relationship and ensuring family well-being.

How can cry acoustics associate newborns' distress levels with neurophysiological and behavioral signals?

Introduction

Even though infant crying is a common phenomenon in humans' early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns.

Methods

Multimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants.

Results

We found correlations between most of the features extracted from the signals depending on the infant's arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy.

Conclusion

Our findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians.

Voice acoustics allow classifying autism spectrum disorder with high accuracy

Early identification of children on the autism spectrum is crucial for early intervention with long-term positive effects on symptoms and skills. The need for improved objective autism detection tools is emphasized by the poor diagnostic power in current tools. Here, we aim to evaluate the classification performance of acoustic features of the voice in children with autism spectrum disorder (ASD) with respect to a heterogeneous control group (composed of neurotypical children, children with Developmental Language Disorder [DLD] and children with sensorineural hearing loss with Cochlear Implant [CI]). This retrospective diagnostic study was conducted at the Child Psychiatry Unit of Tours University Hospital (France). A total of 108 children, including 38 diagnosed with ASD (8.5 ± 0.25 years), 24 typically developing (TD; 8.2 ± 0.32 years) and 46 children with atypical development (DLD and CI; 7.9 ± 0.36 years) were enrolled in our studies. The acoustic properties of speech samples produced by children in the context of a nonword repetition task were measured. We used a Monte Carlo cross-validation with an ROC (Receiving Operator Characteristic) supervised k-Means clustering algorithm to develop a classification model that can differentially classify a child with an unknown disorder. We showed that voice acoustics classified autism diagnosis with an overall accuracy of 91% [CI95%, 90.40%-91.65%] against TD children, and of 85% [CI95%, 84.5%-86.6%] against an heterogenous group of non-autistic children. Accuracy reported here with multivariate analysis combined with Monte Carlo cross-validation is higher than in previous studies. Our findings demonstrate that easy-to-measure voice acoustic parameters could be used as a diagnostic aid tool, specific to ASD.

A Scientometric Review of Infant Cry and Caregiver Responsiveness: Literature Trends and Research Gaps over 60 Years of Developmental Study

Infant cry is an adaptive signal of distress that elicits timely and mostly appropriate caring behaviors. Caregivers are typically able to decode the meaning of the cry and respond appropriately, but maladaptive caregiver responses are common and, in the worst cases, can lead to harmful events. To tackle the importance of studying cry patterns and caregivers' responses, this review aims to identify key documents and thematic trends in the literature as well as existing research gaps. To do so, we conducted a scientometric review of 723 documents downloaded from Scopus and performed a document co-citation analysis. The most impactful publication was authored by Barr in 1990, which describes typical developmental patterns of infant cry. Six major research thematic clusters emerged from the analysis of the literature. Clusters were renamed "Neonatal Pain Analyzer" (average year of publication = 2002), "Abusive Head Trauma" (average year of publication = 2007), "Oxytocin" (average year of publication = 2009), "Antecedents of Maternal Sensitivity" (average year of publication = 2010), "Neurobiology of Parental Responses" (average year of publication = 2011), and "Hormonal Changes & Cry Responsiveness" (average year of publication = 2016). Research clusters are discussed on the basis of a qualitative inspection of the manuscripts. Current trends in research focus on the neurobiology of caregiver responses and the identification of factors promoting maternal sensitivity. Recent studies have also developed evidence-based strategies for calming crying babies and preventing caregivers' maladaptive responses. From the clusters, two topics conspicuously call for future research: fathers' responsiveness to infant cry and the impact of caregiver relationship quality on cry responsiveness.

A self-training automatic infant-cry detector

Infant cry is one of the first distinctive and informative life signals observed after birth. Neonatologists and automatic assistive systems can analyse infant cry to early-detect pathologies. These analyses extensively use reference expert-curated databases containing annotated infant-cry audio samples. However, these databases are not publicly accessible because of their sensitive data. Moreover, the recorded data can under-represent specific phenomena or the operational conditions required by other medical teams. Additionally, building these databases requires significant investments that few hospitals can afford. This paper describes an open-source workflow for infant-cry detection, which identifies audio segments containing high-quality infant-cry samples with no other overlapping audio events (e.g. machine noise or adult speech). It requires minimal training because it trains an LSTM-with-self-attention model on infant-cry samples automatically detected from the recorded audio through cluster analysis and HMM classification. The audio signal processing uses energy and intonation acoustic features from 100-ms segments to improve spectral robustness to noise. The workflow annotates the input audio with intervals containing infant-cry samples suited for populating a database for neonatological and early diagnosis studies. On 16 min of hospital phone-audio recordings, it reached sufficient infant-cry detection accuracy in 3 neonatal care environments (nursery—69%, sub-intensive—82%, intensive—77%) involving 20 infants subject to heterogeneous cry stimuli, and had substantial agreement with an expert’s annotation. Our workflow is a cost-effective solution, particularly suited for a sub-intensive care environment, scalable to monitor from one to many infants. It allows a hospital to build and populate an extensive high-quality infant-cry database with a minimal investment.

Advanced paternal age diversifies individual trajectories of vocalization patterns in neonatal mice

Infant crying is a communicative behavior impaired in neurodevelopmental disorders (NDDs). Because advanced paternal age is a risk factor for NDDs, we performed computational approaches to evaluate how paternal age affected vocal communication and body weight development in C57BL/6 mouse offspring from young and aged fathers. Analyses of ultrasonic vocalization (USV) consisting of syllables showed that advanced paternal age reduced the number and duration of syllables, altered the syllable composition, and caused lower body weight gain in pups. Pups born to young fathers had convergent vocal characteristics with a rich repertoire, whereas those born to aged fathers exhibited more divergent vocal patterns with limited repertoire. Additional analyses revealed that some pups from aged fathers displayed atypical USV trajectories. Thus, our study indicates that advanced paternal age has a significant effect on offspring's vocal development. Our computational analyses are effective in characterizing altered individual diversity.

Acoustic Cry Characteristics of Infants as a Marker of Neurological Dysfunction: A Systematic Review and Meta-Analysis

BACKGROUND

Atypical cries have been identified in infants with neurological dysfunction. The aim of this study was to conduct a systematic review and meta-analysis to appraise existing evidence for associations between acoustic cry characteristics and neurological dysfunction in infants aged 18 months or less.

METHODS

PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I² indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale.

RESULTS

From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]).

CONCLUSIONS

Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.

Acute Maternal Stress Disrupts Infant Regulation of the Autonomic Nervous System and Behavior: A CASP Study

Exposure to maternal stress is assumed to influence infant health and development across the lifespan. The autonomic nervous system (ANS) is especially sensitive to the effects of the early caregiving environment and linked to predictors of later mental health. Understanding how exposure to maternal stress adversely affects the developing ANS could inform prevention. However, there is no agreed upon definition of maternal stress making its study difficult. Here we use the Caretaker Acute Stress Paradigm (CASP) to study the effects of maternal stress in an experimentally controlled laboratory setting. The CASP has 5 episodes, a natural play, followed by a caretaker stressor (or control) condition, another play, a classic still face episode, followed by another play. A total of 104 4-months-old infants and their mothers were randomly assigned to either the caretaker-stress or caretaker-control condition. Changes in behavior, heart rate (HR), and respiratory sinus arrhythmia (RSA) before and after the introduction of the stressor (or control condition) were recorded and compared. Infants in the maternal stress condition showed significantly more behavioral distress [X 2 = (1, N = 104) = 4.662, p = 0.031]. Moreover, infants whose mothers were in the stress condition showed an significant increase in heart rate after the caretaker condition [F (1, 102) = 9.81, p = 0.002]. Finally we observed a trend to faster RSA recovery in infants of the control condition [F (1, 75) = 3.539, p = 0.064]. Results indicate that exposure to acute maternal stress affects infant regulation of the autonomic nervous system and behavior.

Development and validation of the infant crying and parent well-being screening tool

This article describes the development and validation of the infant crying and parent well-being (ICPW) screening tool, developed to provide an effective and efficient way of identifying families struggling with infant crying and soothing. Construct validity for the ICPW was assessed using survey data from 290 parents of infants. Scores on the ICPW were associated with parental depression, parenting stress, and low co-parent confidence. Parents with positive ICPW screens-indicating additional support is needed-were more likely to have high or clinical levels of parenting stress than parents with negative screens. Inconsolable and excessive infant crying negatively impacts the well-being of parents, and most importantly, is the primary trigger for infant abuse. The ICPW is a unique, efficient tool that allows providers to screen for families who may need additional support around infant crying and soothing.

The Soundscape of Neonatal Intensive Care: A Mixed-Methods Study of the Parents' Experience

Parents who have infants hospitalised in neonatal intensive care units (NICUs) experience high levels of stress, including post-traumatic stress disorder (PTSD) symptoms. However, whether sounds contribute to parents’ stress remains largely unknown. Critically, researchers lack a comprehensive instrument to investigate the relationship between sounds in NICUs and parental stress. To address this gap, this report presents the “Soundscape of NICU Questionnaire” (SON-Q), which was developed specifically to capture parents’ perceptions and beliefs about the impact that sound had on them and their infants, from pre-birth throughout the NICU stay and in the first postdischarge period. Parents of children born preterm (n = 386) completed the SON-Q and the Perinatal PTSD Questionnaire (PPQ). Principal Component Analysis identifying underlying dimensions comprising the parental experience of the NICU soundscape was followed by an exploration of the relationships between subscales of the SON-Q and the PPQ. Moderation analysis was carried out to further elucidate relationships between variables. Finally, thematic analysis was employed to analyse one memory of sounds in NICU open question. The results highlight systematic associations between aspects of the NICU soundscape and parental stress/trauma. The findings underscore the importance of developing specific studies in this area and devising interventions to best support parents’ mental health, which could in turn support infants’ developmental outcomes.

Cry features of healthy neonates who passed their newborn hearing screening vs. those who did not

OBJECTIVES

Temporal and fundamental frequency (fo) variations in infant cries provide critical insights into the maturity of vocal control and hearing performances. Earlier research has examined the use of vocalisation properties (in addition to hearing tests) to identify infants at risk of hearing impairment. The aim of this study was to determine whether such an approach could be suitable for neonates.

METHODS

To investigate this, we recruited 74 healthy neonates within their first week of life as our participants, assigning them to either a group that passed the ABR-based NHS (PG, N = 36) or a group that did not, but were diagnosed as normally hearing in follow-up check at 3 months of life, a so-called false-positive group (NPG, N = 36). Spontaneously uttered cries (N = 2330) were recorded and analysed quantitatively. The duration, minimum, maximum and mean fo, as well as two variability measures (fo range, fo sigma), were calculated for each cry utterance, averaged for individual neonates, and compared between the groups.

RESULTS

A multiple analysis of variance (MANOVA) revealed no significant effects. This confirms that cry features reflecting vocal control do not differ between healthy neonates with normal hearing, irrespective of the outcome of their initial NHS.

CONCLUSIONS

Healthy neonates who do not pass the NHS but are normal hearing in the follow-up (false positive cases) have the same cry properties as those with normal hearing who do. This is an essential prerequisite to justify the research strategy of incorporating vocal analysis into NHS to complement ABR measures in identifying hearing-impaired newborns.

Epigenome-wide analysis identifies genes and pathways linked to acoustic cry variation in preterm infants

BACKGROUND

Preterm birth places infants at higher risk of adverse long-term behavioral and cognitive outcomes. Combining biobehavioral measures and molecular biomarkers may improve tools to predict the risk of long-term developmental delays.

METHODS

The Neonatal Neurobehavior and Outcomes in Very Preterm Infants study was conducted at nine neonatal intensive care units between April 2014 and June 2016. Cries were recorded and buccal swabs collected during the neurobehavioral exam. Cry episodes were extracted and analyzed using a computer system and the data were summarized using factor analysis. Genomic DNA was extracted from buccal swabs, quantified using the Qubit Fluorometer, and aliquoted into standardized concentrations. DNA methylation was measured with the Illumina MethylationEPIC BeadArray, and an epigenome-wide association study was performed using cry factors (n = 335).

RESULTS

Eighteen CpGs were associated with the cry factors at genome-wide significance (α = 7.08E - 09). Two CpG sites, one intergenic and one linked to gene TCF3 (important for B and T lymphocyte development), were associated with acoustic measures of cry energy. Increased methylation of TCF3 was associated with a lower energy-related cry factor. We also found that pitch (F₀) and hyperpitch (F₀ > 1 kHz) were associated with DNA methylation variability at 16 CpG sites.

CONCLUSIONS

Acoustic cry characteristics are related to variation in DNA methylation in preterm infants.

IMPACT

Preterm birth is a major public health problem and its long-term impact on health is not well understood. Cry acoustics, related to prematurity, has been linked to a variety of medical conditions. Biobehavioral measures and molecular biomarkers can improve prediction tools for long-term developmental risks of preterm birth. Variation in epigenetic modulation in preterm infants provides a potential link between preterm birth and unfavorable developmental outcomes.

The emotional canvas of human screams: patterns and acoustic cues in the perceptual categorization of a basic call type

Screams occur across taxonomically widespread species, typically in antipredator situations, and are strikingly similar acoustically, but in nonhuman primates, they have taken on acoustically varied forms in association with more contextually complex functions related to agonistic recruitment. Humans scream in an even broader range of contexts, but the extent to which acoustic variation allows listeners to perceive different emotional meanings remains unknown. We investigated how listeners responded to 30 contextually diverse human screams on six different emotion prompts as well as how selected acoustic cues predicted these responses. We found that acoustic variation in screams was associated with the perception of different emotions from these calls. Emotion ratings generally fell along two dimensions: one contrasting perceived anger, frustration, and pain with surprise and happiness, roughly associated with call duration and roughness, and one related to perceived fear, associated with call fundamental frequency. Listeners were more likely to rate screams highly in emotion prompts matching the source context, suggesting that some screams conveyed information about emotional context, but it is noteworthy that the analysis of screams from happiness contexts (n = 11 screams) revealed that they more often yielded higher ratings of fear. We discuss the implications of these findings for the role and evolution of nonlinguistic vocalizations in human communication, including consideration of how the expanded diversity in calls such as human screams might represent a derived function of language.

Melody complexity of infants' cry and non-cry vocalisations increases across the first six months

In early infancy, melody provides the most salient prosodic element for language acquisition and there is huge evidence for infants' precocious aptitudes for musical and speech melody perception. Yet, a lack of knowledge remains with respect to melody patterns of infants' vocalisations. In a search for developmental regularities of cry and non-cry vocalisations and for building blocks of prosody (intonation) over the first 6 months of life, more than 67,500 melodies (fundamental frequency contours) of 277 healthy infants from monolingual German families were quantitatively analysed. Based on objective criteria, vocalisations with well-identifiable melodies were grouped into those exhibiting a simple (single-arc) or complex (multiple-arc) melody pattern. Longitudinal analysis using fractional polynomial multi-level mixed effects logistic regression models were applied to these patterns. A significant age (but not sex) dependent developmental pattern towards more complexity was demonstrated in both vocalisation types over the observation period. The theoretical concept of melody development (MD-Model) contends that melody complexification is an important building block on the path towards language. Recognition of this developmental process will considerably improve not only our understanding of early preparatory processes for language acquisition, but most importantly also allow for the creation of clinically robust risk markers for developmental language disorders.

Trajectories of Mother-Infant Communication: An Experiential Measure of the Impacts of Early Life Adversity

Caretaking stability in the early life environment supports neurobehavioral development, while instability and neglect constitute adverse environments that can alter maturational processes. Research in humans suggests that different types of early life adversity (ELA) can have differential effects on caretaker relationships and later cognitive and social development; however, identifying mechanistic underpinnings will require animal models with translational validity. Two common rodent models, maternal separation (MS) and limited bedding (LB), influence the mother-infant relationship during a critical window of development. We hypothesized that these paradigms may affect the development of communication strategies on the part of the pup. Ultrasonic vocalizations (USVs) are a care-eliciting mechanism and ethologically relevant response to stressors in the rat pup. USV emission rates and acoustic parameters change throughout early development, presenting the opportunity to define developmental milestones in USVs that would reflect neurobehavioral aberrations if disrupted. This study investigated the effects of MS or LB on the dam-pup relationship by quantifying pup USVs, maternal behavior, and the relationship between the two. First, we used a generalized additive model approach to establish typical developmental trajectories of USV acoustic properties and determine windows of change in MS or LB rearing. Additionally, we quantified maternal behaviors and the predictability of maternal care sequences using an entropy rate calculation. MS and LB each shifted the developmental trajectories of USV acoustic parameters and call types in a sex-specific manner. MS more often impacted male USVs, while LB impacted female USVs. MS dams spent more time passive nursing, and LB dams spent more time on the nest. The predictability of maternal care was associated with the rate of USV emissions exclusively in females. Taken together, findings demonstrate sex- and model-specific effects of rearing environments on a novel developmental trajectory involving the mother-infant relationship, facilitating the translation of animal ELA paradigms to assess later-life consequences.

Development and Technical Validation of a Smartphone-Based Cry Detection Algorithm

Introduction: The duration and frequency of crying of an infant can be indicative of its health. Manual tracking and labeling of crying is laborious, subjective, and sometimes inaccurate. The aim of this study was to develop and technically validate a smartphone-based algorithm able to automatically detect crying. Methods: For the development of the algorithm a training dataset containing 897 5-s clips of crying infants and 1,263 clips of non-crying infants and common domestic sounds was assembled from various online sources. OpenSMILE software was used to extract 1,591 audio features per audio clip. A random forest classifying algorithm was fitted to identify crying from non-crying in each audio clip. For the validation of the algorithm, an independent dataset consisting of real-life recordings of 15 infants was used. A 29-min audio clip was analyzed repeatedly and under differing circumstances to determine the intra- and inter- device repeatability and robustness of the algorithm. Results: The algorithm obtained an accuracy of 94% in the training dataset and 99% in the validation dataset. The sensitivity in the validation dataset was 83%, with a specificity of 99% and a positive- and negative predictive value of 75 and 100%, respectively. Reliability of the algorithm appeared to be robust within- and across devices, and the performance was robust to distance from the sound source and barriers between the sound source and the microphone. Conclusion: The algorithm was accurate in detecting cry duration and was robust to various changes in ambient settings.

Associations Between Neonatal Cry Acoustics and Visual Attention During the First Year

It has been suggested that early cry parameters are connected to later cognitive abilities. The present study is the first to investigate whether the acoustic features of infant cry are associated with cognitive development already during the first year, as measured by oculomotor orienting and attention disengagement. Cry sounds for acoustic analyses (fundamental frequency; F0) were recorded in two neonatal cohorts at the age of 0–8 days (Tampere, Finland) or at 6 weeks (Cape Town, South Africa). Eye tracking was used to measure oculomotor orienting to peripheral visual stimuli and attention disengagement from central stimuli at 8 months (Tampere) or at 6 months (Cape Town) of age. Only a marginal positive correlation between fundamental frequency of cry (F0) and visual attention disengagement was observed in the Tampere cohort, but not in the Cape Town cohort. This correlation indicated that infants from the Tampere cohort with a higher neonatal F0 were marginally slower to shift their gaze away from the central stimulus to the peripheral stimulus. No associations between F0 and oculomotor orienting were observed in either cohort. We discuss possible factors influencing the current pattern of results suggesting a lack of replicable associations between neonatal cry and visual attention and suggest directions for future research investigating the potential of early cry analysis in predicting later cognitive development.

Musical Intervals in Infants' Spontaneous Crying over the First 4 Months of Life

INTRODUCTION

Perception and memorizing of melody and rhythm start about the third trimester of gestation. Infants have astonishing musical predispositions, and melody contour is most salient for them.

OBJECTIVE

To longitudinally analyse melody contour of spontaneous crying of healthy infants and to identify melodic intervals. The aim was 3-fold: (1) to answer the question whether spontaneous crying of healthy infants regularly exhibits melodic intervals across the observation period, (2) to investigate whether interval events become more complex with age and (3) to analyse interval size distribution.

METHODS

Weekly cry recordings of 12 healthy infants (6 females) over the first 4 months of life were analysed (6,130 cry utterances) using frequency spectrograms and pitch analyses (PRAAT). A preselection of utterances containing a well-identifiable, noise-free and undisturbed melodic contour was applied to identify and measure melodic intervals in the final subset of 3,114 utterances. Age-dependent frequency of occurrence of melodic intervals was statistically analysed using generalized estimating equations.

RESULTS

85.3% of all preselected melody contours (n = 3,114) either contained single rising or falling melodic intervals or complex events as combinations of both. In total 6,814 melodic intervals were measured. A significant increase in interval occurrence was found characterized by a non-linear age effect (3 developmental phases). Complex events were found to significantly increase linearly with age. In both calculations, no sex effect was found. Interval size distribution showed a maximum of the minor second as the prevailing musical interval in infants' crying over the first 4 months of life.

CONCLUSION

Melodic intervals seem to be a regular phenomenon of spontaneous crying of healthy infants. They are suggested to be a further candidate for developing an early risk marker of vocal control in infants. Subsequent studies are needed to compare healthy infants and infants at risk for respiratory-laryngeal dysfunction to investigate the diagnostic value of the occurrence of melodic intervals and their age-depending complexification.

A Caretaker Acute Stress Paradigm: Effects on behavior and physiology of caretaker and infant

While experimental stress paradigms of infants (arm restraint; the Still-Face) are powerful tools for infant research, no study has experimentally stressed mothers to observe its independent effects on infant stress regulation. Extant caretaker/maternal stress studies essentially are correlational and confounded by other conditions (e.g., depression). Here, we present a standard procedure, the Caregiver Acute Stress Paradigm (CASP), for stressing mothers during en face interactions with their infants. We hypothesized that infants of the stressed mothers would be more distressed than infants of non-stressed mothers. A total of 106 four-month-old infants and their mothers were randomly assigned to the experimental stress or non-stress manipulation. Confirming our hypothesis, infants of the stressed mothers were significantly more likely to become distressed and require terminating the procedure. While objective ratings of maternal behavior showed no difference between groups, mother in the stress condition self-rated the episode following the caretaker stress significantly lower than mothers in the non-stress group. The self-ratings in the maternal stress-group were reflected in infant cortisol. The findings indicate that CASP is an effective experimental paradigm for exploring the independent effects of an acute stress on caretakers, including effects of conditions, such as poverty or mental illness.

Perception of male and female infant cry aversiveness by adult men

Objective: The study aimed to determine why male infants are abused more frequently than female infants.Background: Infant crying is a well-known trigger for Shaken Baby Syndrome or Abusive Head Trauma (SBS/AHT). For unknown reasons, male infants are more often victims of SBS/AHT than female infants. We hypothesised that this sex difference in victimisation was attributable to either acoustic or movement differences between male and female infants when crying, or to gender stereotypes about infant crying (e.g. 'boys don't cry').Methods: Adult male participants rated auditory and video cry stimuli from male and female infants for aversiveness. Each infant was rated while wearing both blue and pink clothing to denote male or female gender.Results: In two experiments, male infants spent more time producing expiratory phonations than did female infants, and this variable was positively correlated with aversiveness ratings. Including visual stimuli increased male but not female infant cry aversiveness compared with audio stimuli alone. Finally, dressing infants in blue did not increase cry aversiveness.Conclusions: These findings suggest that both the tendency of male infants to produce more expiratory phonations when crying, as well as their visual appearance when crying, may contribute to their increased vulnerability to abuse.

Defining and distinguishing infant behavioral states using acoustic cry analysis: is colic painful?

BACKGROUND

To characterize acoustic features of an infant's cry and use machine learning to provide an objective measurement of behavioral state in a cry-translator. To apply the cry-translation algorithm to colic hypothesizing that these cries sound painful.

METHODS

Assessment of 1000 cries in a mobile app (ChatterBaby^TM). Training a cry-translation algorithm by evaluating >6000 acoustic features to predict whether infant cry was due to a pain (vaccinations, ear-piercings), fussy, or hunger states. Using the algorithm to predict the behavioral state of infants with reported colic.

RESULTS

The cry-translation algorithm was 90.7% accurate for identifying pain cries, and achieved 71.5% accuracy in discriminating cries from fussiness, hunger, or pain. The ChatterBaby cry-translation algorithm overwhelmingly predicted that colic cries were most likely from pain, compared to fussy and hungry states. Colic cries had average pain ratings of 73%, significantly greater than the pain measurements found in fussiness and hunger (p < 0.001, 2-sample t test). Colic cries outranked pain cries by measures of acoustic intensity, including energy, length of voiced periods, and fundamental frequency/pitch, while fussy and hungry cries showed reduced intensity measures compared to pain and colic.

CONCLUSIONS

Acoustic features of cries are consistent across a diverse infant population and can be utilized as objective markers of pain, hunger, and fussiness. The ChatterBaby algorithm detected significant acoustic similarities between colic and painful cries, suggesting that they may share a neuronal pathway.

Are Cry Studies Replicable? An Analysis of Participants, Procedures, and Methods Adopted and Reported in Studies of Infant Cries

Infant cry is evolutionarily, psychologically, and clinically significant. Over the last half century, several researchers and clinicians have investigated acoustical properties of infant cry for medical purposes. However, this literature suffers a lack of standardization in conducting and reporting cry-based studies. In this work, methodologies and procedures employed to analyze infant cry are reviewed and best practices for reporting studies are provided. First, available literatures on vocal and audio acoustic analysis are examined to identify critical aspects of participant information, data collection, methods, and data analysis. Then, 180 peer-reviewed research articles have been assessed to certify the presence of critical information. Results show a general lack of critical description. Researchers in the field of infant cry need to develop a consensual standard set of criteria to report experimental studies to ensure the validity of their methods and results.

Acoustic Correlates and Adult Perceptions of Distress in Infant Speech-Like Vocalizations and Cries

Prior research has not evaluated acoustic features contributing to perception of human infant vocal distress or lack thereof on a continuum. The present research evaluates perception of infant vocalizations along a continuum ranging from the most prototypical intensely distressful cry sounds ("wails") to the most prototypical of infant sounds that typically express no distress (non-distress "vocants"). Wails are deemed little if at all related to speech while vocants are taken to be clear precursors to speech. We selected prototypical exemplars of utterances representing the whole continuum from 0 and 1 month-olds. In this initial study of the continuum, our goals are to determine (1) listener agreement on level of vocal distress across the continuum, (2) acoustic parameters predicting ratings of distress, (3) the extent to which individual listeners maintain or change their acoustic criteria for distress judgments across the study, (4) the extent to which different listeners use similar or different acoustic criteria to make judgments, and (5) the role of short-term experience among the listeners in judgments of infant vocalization distress. Results indicated that (1) both inter-rater and intra-rater listener agreement on degree of vocal distress was high, (2) the best predictors of vocal distress were number of vibratory regimes within utterances, utterance duration, spectral ratio (spectral concentration) in vibratory regimes within utterances, and mean pitch, (3) individual listeners significantly modified their acoustic criteria for distress judgments across the 10 trial blocks, (4) different listeners, while showing overall similarities in ratings of the 42 stimuli, also showed significant differences in acoustic criteria used in assigning the ratings of vocal distress, and (5) listeners who were both experienced and inexperienced in infant vocalizations coding showed high agreement in rating level of distress, but differed in the extent to which they relied on the different acoustic cues in making the ratings. The study provides clearer characterization of vocal distress expression in infants based on acoustic parameters and a new perspective on active adult perception of infant vocalizations. The results also highlight the importance of vibratory regime segmentation and analysis in acoustically based research on infant vocalizations and their perception.

Perception of Cry Characteristics in 1-Month-Old Infants Later Diagnosed with Autism Spectrum Disorder

This study investigates parental perceptions of cries of 1-month-old infants later diagnosed with autism spectrum disorder (ASD) and non-ASD controls. Parents of children with and without ASD listened to cry recordings of infants later diagnosed with ASD and comparison infants and rated them on cry perception scales. Parents completed the Broad Autism Phenotype Questionnaire (BAPQ) to assess the potential relations between traits associated with autism and cry perception. Across parents, ASD infant cries were rated as more distressed, less typical, and reflecting greater pain, with no significant differences between parent groups. Parents of children with ASD scored higher on the BAPQ compared to parents of children without ASD. Follow up analyses explored the relations between BAPQ score and cry ratings.

Identification of Diseases in Newborns Using Advanced Acoustic Features of Cry Signals

Our challenge in the current study is to extend research on the cries of newborns for the early diagnosis of different pathologies. This paper proposes a recognition system for healthy and pathological cries using a probabilistic neural network classifier. Two different kinds of features have been used to characterize newborn cry signals: 1) acoustic features such as fundamental frequency glide (F0glide) and resonance frequencies dysregulation (RFsdys); 2) conventional features such as mel-frequency cestrum coefficients. This paper describes the automatic estimation of the proposed characteristics and the performance evaluation of these features in identifying pathological cries. The adopted methods for F0glides and RFsdys estimation are based on the derived function of the F0 contour and the jump "J" of the RFs between two subsequent tunings, respectively. The database used contains 3250 cry samples of full-term and preterm newborns, and includes healthy and pathologic cries. The obtained results indicate the important association between the quantified features and some studied pathologies, and also an improvement in the identification of pathologic cries. The best result obtained is 88.71% for the correct identification of health status of preterm newborns, and 82% for the correct identification of full-term infants with a specific disease. We conclude that using the proposed characteristics improves the diagnosis of pathologies in newborns. Moreover, the method applied in the estimation of these characteristics allows us to extend this study to other uninvestigated pathologies.

Video and audio processing in paediatrics: a review

OBJECTIVE

Video and sound acquisition and processing technologies have seen great improvements in recent decades, with many applications in the biomedical area. The aim of this paper is to review the overall state of the art of advances within these topics in paediatrics and to evaluate their potential application for monitoring in the neonatal intensive care unit (NICU).

APPROACH

For this purpose, more than 150 papers dealing with video and audio processing were reviewed. For both topics, clinical applications are described according to the considered cohorts-full-term newborns, infants and toddlers or preterm newborns. Then, processing methods are presented, in terms of data acquisition, feature extraction and characterization.

MAIN RESULTS

The paper first focuses on the exploitation of video recordings; these began to be automatically processed in the 2000s and we show that they have mainly been used to characterize infant motion. Other applications, including respiration and heart rate estimation and facial analysis, are also presented. Audio processing is then reviewed, with a focus on the analysis of crying. The first studies in this field focused on induced-pain cries and the newest ones deal with spontaneous cries; the analyses are mainly based on frequency features. Then, some papers dealing with non-cry signals are also discussed.

SIGNIFICANCE

Finally, we show that even if recent improvements in digital video and signal processing allow for increased automation of processing, the context of the NICU makes a fully automated analysis of long recordings problematic. A few proposals for overcoming some of the limitations are given.

Maternal experience of their infants' crying in the context of war trauma: Determinants and consequences

We examined, first, how prenatal maternal mental health and war trauma predicted mothers' experience of their infant crying, indicated by emotions, cognitions, and behavior; and second, how these experiences influenced the mother-infant interaction and infant development. Participants were 511 Palestinian mothers from the Gaza Strip, reporting their war trauma, symptoms of posttraumatic stress disorder (PTSD), depression, and perceived stress during pregnancy (Time 1). They reported experiences of infant crying at 4 months (Time 2), and the mother-infant interaction and infant sensorimotor and language development at 12 months of infants' age (Time 3). Results revealed that maternal mental health problems, but not war trauma, were important to experiences of infant crying. A high level of PTSD symptoms predicted negative emotions evoked by infant crying, and high depressive symptoms predicted low active and positive responses to crying. Unexpectedly, high prenatal perceived stress predicted high active and positive responsiveness. Concerning the consequences, mothers' sensitive interpretation of infant crying predicted optimal infant sensorimotor development, and mothers' active and positive responses predicted high emotional availability in mother-infant interaction. Crying is the first communication tool for infants, and mothers' sensitive responses to crying contribute to infant well-being. Therefore, reinforcing mother's optimal responses is important when helping war-affected dyads.

Comparison of Supervised-Learning Models and Auditory Discrimination of Infant Cries for the Early Detection of Developmental Disorders / Vergleich von Supervised-Learning Klassifikationsmodellen und menschlicher auditiver Diskriminationsfähigkeit zur Unterscheidung von Säuglingsschreien mit kongenitalen Entwicklungsstörungen

Infant cry classification can be performed in two ways: computational classification of cries or auditory discrimination by human listeners. This article compares both approaches.

An auditory listening experiment was performed to examine if various listener groups (naive listeners, parents, nurses/midwives and therapists) were able to distinguish auditorily between healthy and pathological cries as well as to differentiate various pathologies from each other.

Listeners were trained in hearing cries of healthy infants and cries of infants suffering from cleft-lip-and-palate, hearing impairment, laryngomalacia, asphyxia and brain damage. After training, a listening experiment was performed by allocating 18 infant cries to the cry groups.

Multiple supervised-learning classifications models were calculated on the base of the cries’ acoustic properties. The accuracy of the models was compared to the accuracy of the human listeners.

With a Kappa value of 0.491, listeners allocated the cries to the healthy and the five pathological groups with moderate performance. With a sensitivity of 0.64 and a specificity of 0.89, listeners were able to identify that a cry is a pathological one with higher confidence than separating between the single pathologies. Generalized linear mixed models found no significant differences between the classification accuracy of the listener groups. Significant differences between the pathological cry types were found.

Supervised-learning classification models performed significantly better than the human listeners in classifying infant cries. The models reached an overall Kappa value of up to 0.837.

Parenting-focused mindfulness intervention reduces stress and improves parenting in highly-stressed mothers of adolescents

Parent stress has been associated with negative outcomes for youth and may be particularly high during adolescence. Mindfulness interventions have the potential to reduce parent stress and to improve parenting behavior and parent-child relationship quality. The present randomized controlled study examined effects of a parenting-focused mindfulness intervention, the Parenting Mindfully (PM) intervention, for highly stressed parents of adolescents. Eighty three mothers of 12-17 year olds reporting high stress were randomly assigned to the PM intervention or to a minimal-intervention Parent Education (PE) control group. At pre- and post-intervention, mothers reported on their mindfulness, stress, parenting stress, mindful parenting, and parent-adolescent relationship quality. At pre- and post-intervention, mothers' observed parenting behaviors and reported negative emotional responses to a laboratory parent-adolescent interaction task (PAIT) were also collected. Findings indicated that the PM intervention, compared to PE, increased mothers' mindfulness, reduced parenting stress in two domains, increased mindful parenting related to emotional awareness in parenting, and improved parent-adolescent relationship quality. For mothers of girls (but not mothers of boys), the PM intervention also decreased negative parenting behavior and decreased negative emotional responses in PAIT. Effects sizes were medium to large. In sum, findings support parenting-focused mindfulness training as a viable intervention strategy for highly-stressed parents.

The Thorn in the Dyad: A Vision on Parent-Child Relationship in Autism Spectrum Disorder

Parents and children form a family: their characteristics balance personal and family well-being with healthy levels of stress. Research on parents of children with Autism Spectrum Disorder (ASD) demonstrated that higher levels of parental stress are associated with communication impairment, a core symptom of ASD. The aim of this article is to discuss the connection between non-verbal communication impairment and parental psychological distress, in families with children with ASD. The interaction between atypical communication and distress of parents likely determines a cascade effect on the parent-child dyad; in fact, it decreases the quality and frequency of interactions, preventing the establishment of a healthy parent-child relationship and leading to a series of collateral problems. To this perspective, guiding the parents to reframe their children’s atypical communicative behaviour can relieve parental stress and re-program the interactional routine. This observation stresses the importance of interventions centred on the dyad, especially during early development and soon after the diagnosis, when the communicative impairment may be extremely severe.

Flawed mothering or infant signaling? The effects of deficient acoustic cues on ovine maternal response

The neonate distress cry, which displays a similar acoustic structure across a range of mammalian species, is highly effective in attracting, even compelling, parental care. However, if this cry is defective, as found in human and rodent neonates with poor neurobehavioral function, is the signal less enticing? Using playback recordings of a ewe's own co-twins as stimuli in a two choice test, we compared the preference of each sheep dam for acoustic features of lamb distress calls to assess the impact of signal quality on maternal response. The results of this study indicate that lamb vocalizations with acoustic parameters reflecting poor vocal fold engagement and arousal were less likely to be preferred by their dam. Additionally, these calls were associated with delayed vocal initiation and poor infant survival behavior suggestive of subtle cognitive deficit; and support the possibility that, as in deer and rodents, ovine vocalizations within a specific fundamental frequency range may well be a trigger for optimal maternal behavior. This research has important implications for understanding failed maternal-young interactions in ungulate and other species, and for verifying standardization of infant stimuli used in maternal behavior studies.

Epigenetic mechanisms in the placenta related to infant neurodevelopment

As the 'third brain' the placenta links the developing fetal brain and the maternal brain enabling study of epigenetic process in placental genes that affect infant neurodevelopment. We described the characteristics and findings of the 17 studies on epigenetic processes in placental genes and human infant neurobehavior. Studies showed consistent findings in the same cohort of term healthy infants across epigenetic processes (DNA methylation, genome wide, gene and miRNA expression) genomic region (single and multiple genes, imprinted genes and miRNAs) using candidate gene and genome wide approaches and across biobehavioral systems (neurobehavior, cry acoustics and neuroendocrine). Despite limitations, studies support future work on molecular processes in placental genes related to neurodevelopmental trajectories including implications for intervention.

Physiological and self-report responses of parents of children with autism spectrum disorder to children crying

Little is known about the physiological response of parents of children with Autism Spectrum Disorder (ASD) to crying of children who have already received the diagnosis of ASD. This study aimed to compare cardiac dynamics via Inter-Beat Interval (IBI) and self-reported emotional states of parents of children with ASD and of parents with typically developing (TD) children while listening to crying of children with ASD (ASD cry) and of typically developing children (TD cry). Analyses revealed higher IBI in parents of children with ASD than IBI in parents of TD children while listening to both cry groups; however no differences on self-reported emotional states were observed. Parents of children with ASD were calmer (higher IBI) than parents of TD children while listening to crying. However, ASD cry did not elicit different IBI compared to TD cry. ASD cry and TD cry were differentiated based on parents' self-responses about what they felt during the listening of crying, their physiological responses showed no differences. These results highlight the similarities and differences between self-reported emotional states and physiological responses of parents of children with ASD, and also point to the importance of monitoring parents' physiological responses in addition to their subjective responses.

Neurobiology of culturally common maternal responses to infant cry

This report coordinates assessments of five types of behavioral responses in new mothers to their own infants' cries with neurobiological responses in new mothers to their own infants' cries and in experienced mothers and inexperienced nonmothers to infant cries and other emotional and control sounds. We found that 684 new primipara mothers in 11 countries (Argentina, Belgium, Brazil, Cameroon, France, Kenya, Israel, Italy, Japan, South Korea, and the United States) preferentially responded to their infants' vocalizing distress by picking up and holding and by talking to their infants, as opposed to displaying affection, distracting, or nurturing. Complementary functional magnetic resonance imaging (fMRI) analyses of brain responses to their own infants' cries in 43 new primipara US mothers revealed enhanced activity in concordant brain territories linked to the intention to move and to speak, to process auditory stimulation, and to caregive [supplementary motor area (SMA), inferior frontal regions, superior temporal regions, midbrain, and striatum]. Further, fMRI brain responses to infant cries in 50 Chinese and Italian mothers replicated, extended, and, through parcellation, refined the results. Brains of inexperienced nonmothers activated differently. Culturally common responses to own infant cry coupled with corresponding fMRI findings to own infant and to generic infant cries identified specific, common, and automatic caregiving reactions in mothers to infant vocal expressions of distress and point to their putative neurobiological bases. Candidate behaviors embedded in the nervous systems of human caregivers lie at the intersection of evolutionary biology and developmental cultural psychology.

Use of Audiometric Measurement for Assessment of Vocal-Fold Function in Postextubation Infants

Importance

Infants with vocal-fold motion impairment (VFMI) have an increased risk of aspiration and pulmonary complications. Flexible nasolaryngoscopy (FNL) is the gold standard for evaluation of vocal-fold mobility. Although safe, FNL causes measurable physiologic changes. Noxious stimuli, especially in neonates in the cardiovascular intensive care unit, may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse.

Objective

To examine whether bedside measurement of infant cry volume using a smartphone application can be a screening tool for vocal-fold movement in FNL.

Design, Study, and Participants

This case-control study performed from December 1, 2013, through January 31, 2015, included 42 infants in the intensive care unit at Texas Children's Hospital, Houston.

Main Outcomes and Measures

Patient cry volume in decibels was recorded using a smartphone application placed 12 in from their mouth.

Results

Forty-two infants were identified at the intensive care unit (median age, 33 days; 20 [48%] female and 22 [52%] male), 21 with VFMI and 21 without, based on FNL findings. A statistically significant difference was found in the mean cry volume of infants with (76.60 dB) and without (85.72 dB) VFMI. The absolute difference in the mean cry volume was 9.12 dB (95% CI, 2.74-15.50 dB). A cry volume of 90 dB or greater had a sensitivity of 90.4% (95% CI, 71%-97%) for identification of normal vocal-fold mobility. A cry volume of 75 dB or less had a specificity of 90.5% (95% CI, 71%-97%) for the identification of VFMI. The mean (SE) area under the receiver operating characteristic curve was 0.721 (0.080) (95% CI, 0.565-0.877). The cry volume, however, was not a good screen for aspiration.

Conclusions and Relevance

Bedside measurement of the cry volume with a smartphone application can be used by untrained health care professionals to screen patients for further evaluation of vocal-fold mobility using FNL.

Early-life status epilepticus acutely impacts select quantitative and qualitative features of neonatal vocalization behavior: Spectrographic and temporal characterizations in C57BL/6 mice

Early-life seizures are known to cause long-term deficits in social behavior, learning, and memory, however little is known regarding their acute impact. Ultrasonic vocalization (USV) recordings have been developed as a tool for investigating early communicative deficits in mice. Previous investigation from our lab found that postnatal day (PD) 10 seizures cause male-specific suppression of 50-kHz USVs on PD12 in 129 SvEvTac mouse pups. The present study extends these findings by spectrographic characterization of USVs following neonatal seizures. On PD10, male C57BL/6 pups were administered intraperitoneal injections of kainic acid or physiological saline. On PD12, isolation-induced recordings were captured using a broad-spectrum ultrasonic microphone. Status epilepticus significantly suppressed USV quantity (p=0.001) and total duration (p<0.05). Seizure pups also utilized fewer complex calls than controls (p<0.05). There were no changes in call latency or inter-call intervals. Spectrographic analysis revealed increased peak amplitude for complex, downward, short, two-syllable, and upward calls, as well as reduced mean duration for short and two-syllable calls in seizure mice. This investigation provides the first known spectrographic characterization of USVs following early-life seizures. These findings also enhance evidence for USVs as an indicator of select communicative impairment.

Computerized Lung Sound Screening for Pediatric Auscultation in Noisy Field Environments

GOAL

Chest auscultations offer a non-invasive and low-cost tool for monitoring lung disease. However, they present many shortcomings, including inter-listener variability, subjectivity, and vulnerability to noise and distortions. This work proposes a computer-aided approach to process lung signals acquired in the field under adverse noisy conditions, by improving the signal quality and offering automated identification of abnormal auscultations indicative of respiratory pathologies.

METHODS

The developed noise-suppression scheme eliminates ambient sounds, heart sounds, sensor artifacts, and crying contamination. The improved high-quality signal is then mapped onto a rich spectrotemporal feature space before being classified using a trained support-vector machine classifier. Individual signal frame decisions are then combined using an evaluation scheme, providing an overall patient-level decision for unseen patient records.

RESULTS

All methods are evaluated on a large dataset with 1000 children enrolled, 1-59 months old. The noise suppression scheme is shown to significantly improve signal quality, and the classification system achieves an accuracy of 86.7% in distinguishing normal from pathological sounds, far surpassing other state-of-the-art methods.

CONCLUSION

Computerized lung sound processing can benefit from the enforcement of advanced noise suppression. A fairly short processing window size (  s) combined with detailed spectrotemporal features is recommended, in order to capture transient adventitious events without highlighting sharp noise occurrences.

SIGNIFICANCE

Unlike existing methodologies in the literature, the proposed work is not limited in scope or confined to laboratory settings: This work validates a practical method for fully automated chest sound processing applicable to realistic and noisy auscultation settings.

Spectral and temporal properties of calls reveal deficits in ultrasonic vocalizations of adult Fmr1 knockout mice

The Fmr1 knockout (KO) mouse has commonly been used to investigate communication impairments, one of the key diagnostic symptoms observed in Fragile X syndrome (FXS) and Autism spectrum disorder (ASD). Many studies have found alterations in ultrasonic vocalizations (USVs) in neonatal Fmr1 KO mice, however, there is limited research investigating whether these deficits continue into adulthood. In the present study, we examine differences in female urine-induced ultrasonic vocalizations, scent marking behavior, odor discrimination, and open field activity in adult male Fmr1 KO and wildtype (WT) mice. Overall, we found extensive alterations between genotypes in both spectral and temporal properties of ultrasonic vocalizations. There was no difference in the average number of calls emitted by both genotypes, however, Fmr1 KO mice emitted calls of a higher frequency, decreased amplitude, and shorter duration than WT mice. Spectrographic analyses revealed statistically significant differences between genotypes in the types of calls emitted. Contrastingly, we found no differences in scent marking behavior, a form of social communication, or in odor discrimination and activity levels of the mice. The results corroborate previous studies emphasizing the importance of qualitative differences observed in vocalization behavior of Fmr1 KO mice, rather than quantitative measurements such as number of calls emitted. Overall, the study confirms the presence of abnormalities in vocalization behavior in adult Fmr1 KO mice that we believe are consistent with communication deficits seen in the syndrome.

Acoustic Properties of Cries in 12-Month Old Infants at High-Risk of Autism Spectrum Disorder

There is preliminary evidence that infant siblings of children with Autism Spectrum Disorder (ASD) have an atypical pattern of cry, characterized by higher fundamental frequency and increased dysphonation. This prospective study collected multiple cry samples of 12-month old siblings of children with ASD (n = 22, 'high-risk' group) and 12-month olds with no family history of ASD (n = 27, 'low risk' group). While there was no difference between groups in the fundamental frequency or degree of phonation of the cry samples, the duration of each cry unit was significantly shorter in the high-risk siblings (p < .05). The six infant siblings who received a diagnosis of ASD at age two had amongst the shortest recorded cry durations.

Distress vocalization delay in the neonate lamb as a neurobehavioral assessment tool

Acoustic features of infant distress vocalizations including latency and rate of emission are used as indices of neurological deficit and integrity in human and rodent neonates. This paper investigates the relationship between temporal characteristics of distress calls, elicited by an isolation stimulus, and indicators of neurobehavioral development over 12 hr postpartum in the neonate lamb. Delayed vocalization initiation was found to be associated with poor locomotor and orientation behavior reflecting the capacity of the lamb to reunite with and follow its dam, and a lowered rate of signal emission following commencement of vocalization. Animals demonstrating delayed vocalization initiation also appeared more likely to be of a birth weight predisposed to fetal distress, and to urinate when exposed to a novel environment. Based on these preliminary studies, we propose that compromised emission of vocal signals is indicative of neurobehavioral deficit in the neonate lamb.

Utilizing Infant Cry Acoustics to Determine Gestational Age

OBJECTIVES/HYPOTHESIS

The date of last menstruation period and ultrasonography are the most commonly used methods to determine gestational age (GA). However, if these data are not clear, some scoring systems performed after birth can be used. New Ballard Score (NBS) is a commonly used method in estimation of GA. Cry sound may reflect the developmental integrity of the infant. The aim of this study was to evaluate the connection between the infants' GA and some acoustic parameters of the infant cry.

STUDY DESIGN

A prospective single-blind study was carried out.

METHODS

In this prospective study, medically stable infants without any congenital craniofacial anomalies were evaluated. During routine blood sampling, cry sounds were recorded and acoustic analysis was performed. Step-by-step multiple linear regression analysis was performed.

RESULTS

The data of 116 infants (57 female, 59 male) with the known GA (34.6 ± 3.8 weeks) were evaluated and with Apgar score of higher than 5. The real GA was significantly and well correlated with the estimated GA according to the NBS, F0, Int, Jitt, and latency parameters. The obtained stepwise linear regression analysis model was formulized as GA=(31.169) - (0.020 × F0)+(0.286 × GA according to NBS) - (0.003 × Latency)+(0.108 × Int) - (0.367 × Jitt). The real GA could be determined with a ratio of 91.7% using this model.

CONCLUSIONS

We have determined that after addition of F0, Int, Jitt, and latency to NBS, the power of GA estimation would be increased. This simple formula can be used to determine GA in clinical practice but validity of such prediction formulas needs to be further tested.