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Objective To examine whether caregiver judgments of infant pain would vary systematically with different infant caregiver groups and infant age. Methods A total of 123 caregivers (41 parents, 41 in patient nurses, 41 pediatricians) viewed videotapes of the vigorous behavioral responses of healthy infants (aged 2, 4, 6, 12, and 18 months) to a routine immunization injection and provided ratings of both the affective distress and pain intensity observed. Results A principal components analysis of affective and intensity ratings yielded a weighted pain summary score for each injection event. Older infants were attributed significantly more pain than younger infants, even though the vigor of the behavioral reactions was experimentally controlled across age groups. A profile analysis contrasting observer groups indicated that pediatricians attributed significantly lower levels of pain than parents, while nurses were intermediate to the other groups, not significantly differing from either group. These systematic differences in judgments were consistent across infant age groups. Conclusions The findings reveal systematic sources of significant variations in observer judgments of infant pain. Despite an absence of differences in the behavioral reactions of the children, both the type of caregiver and their knowledge of the child's age systematically influenced attributions of pain to infants. This work suggests the important role of caregiver role variation and perceived developmental maturity as determinants of infant pain judgments and highlights potential areas of difficulty in controlling the unnecessary suffering of infants. [ABSTRACT FROM AUTHOR]

Objective: To examine whether children with developmental delays respond to painful events differently than nondelayed children.Methods: Sixty families participated. Children between the ages of 2 and 6 years were observed at daycare centers while engaged in usual daily activities, such as free play. Spontaneous painful incidents and the child's responses were recorded using an observational measure (Dalhousie Everyday Pain Scale) designed to capture pain behavior.Results: Children with developmental delays (n = 24) displayed a less intense distress response to an equivocal pain event than nondelayed children (n = 36). Children with developmental delays were more likely to display no reaction following a pain event, whereas children without delays cried more often. Further, children with developmental delays engaged in fewer help-seeking behaviors and were less likely to display a social response following a pain event than nondelayed children.Conclusions: Children with developmental delays appear to react in a different manner to pain events than nondelayed children do; we discuss a possible socio-communicative deficit. [ABSTRACT FROM AUTHOR]