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Acoustic Cry Characteristics of Infants as a Marker of Neurological Dysfunction: A Systematic Review and
Harriet L S Lawford1, Hannah Sazon1, Céline Richard2
1Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.
Insights
Infants with neurological dysfunction exhibit distinct cry patterns, including higher fundamental frequency and unique melodic structures. Acoustic cry analysis may offer a noninvasive screening tool for high-risk infants.
Area of Science:
- Pediatric Neurology
- Acoustic Phonetics
- Developmental Pediatrics
Background:
- Atypical infant cries are linked to neurological dysfunction.
- Understanding these cry characteristics is crucial for early detection.
Purpose of the Study:
- To systematically review and meta-analyze evidence on acoustic cry characteristics in infants (≤18 months) with or at risk of neurological dysfunction.
- To appraise the association between specific cry features and neurological impairment.
Main Methods:
- Searched PubMed/MEDLINE, PsycINFO, CINAHL, and Embase for relevant peer-reviewed studies.
- Included studies with non-neurologically impaired control groups.
- Estimated pooled effect sizes using standardized mean difference (SMD) and odds ratio (OR), assessing heterogeneity and bias.
Main Results:
- Infants with neurological dysfunction showed higher mean and minimum fundamental frequency.
- Increased odds of hyperphonation, biphonation, and specific melodic patterns (rise-fall-rise, flat) were observed.
- Decreased odds of fall-rise-fall melodies were noted in affected infants.
Conclusions:
- Infants with neuropathology present with unique cries, including elevated fundamental frequency and atypical melodies.
- Despite limitations like heterogeneity, acoustic cry assessment shows promise for noninvasive, rapid screening of neurologically at-risk infants.
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.
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