The impact of adult behaviors and vocalizations on infant distress during immunizations

J Pediatr Psychol. Nov-Dec 2008;33(10):1163-74. doi: 10.1093/jpepsy/jsn030. Epub 2008 Mar 28.


Objective: The Child-Adult Medical Procedure Interaction Scale-Infant Version (CAMPIS-IV) was used to examine the influence of adult and infant behaviors on infant distress following injections.

Methods: In this naturalistic observation study, videotaped interactions of 49 infants, parents, and nurses were coded using the CAMPIS-IV. A series of three lag sequential analyses were used to examine the immediate and delayed effects of each of the CAMPIS-IV criterion behaviors, as well as the effects of the onset of each behavior, on infant distress.

Results: Strong support was found for beneficial effects of the infants playing with an object and sucking, and for adults' belly-to-belly contact and nonprocedural talk to infant. Some benefit was found for bouncing, patting, and rocking the infant. Apologizing, empathizing, and reassuring the infant received no support, with some indication of detrimental effects.

Conclusions: The CAMPIS-IV was useful for identifying modifiable risk and protective factors for infants undergoing injections.

Publication types

  • Historical Article

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Attention*
  • Crying
  • Female
  • History, Ancient
  • Humans
  • Immunization / nursing
  • Immunization / psychology*
  • Infant
  • Infant Behavior
  • Male
  • Nurse-Patient Relations
  • Pain / psychology
  • Parenting / psychology*
  • Psychology, Child*
  • Verbal Behavior*