Effects of auditory stimulation upon non-nutritive sucking by premature infants.

Changes in non-nutritive sucking contingent upon presentation of an auditory stimulus previously found capable of eliciting heart-rate acceleration was investigated in a sample of 24 premature infants. Across 30 10-sec. presentations of the stimulus, only transient changes in sucking rate during the first 6 trials were observed, and these effects obtained primarily for those infants showing few abnormalities in their non-nutritive sucking behavior. These results were discussed as reflecting possible differences in infants' attention associated with sucking pathology and the dependence of psychological assessment upon the specific response index used.     

Reinforcement from the sucking environment and subsequent modification of sucking behavior in the human neonate

The reinforcing aspects of sucking behavior in 36 human newborns was examined in a limited instrumental conditioning paradigm where sucking was both operant and reinforcer. During training, response density (rate based on sucking opportunity time) and latency were measures of two components of nonnutritive sucking, contingent negative pressure suction, and incidental jaw movement. The strategy for determining the reinforcing aspects of sucking involved comparisons of three types of sucking stimuli as reinforcers. The nature of modified operant sucking was investigated during extinction by examining number of sucks per burst, number of bursts emitted, and interburst interval time. The feedback from sucking which acted as reinforcement was concluded to be response density. Sucking was modified by changes in pausing behavior, including response latency and pauses between bursts of sucks. The number of sucks per burst also showed a significant change under certain conditioning arrangements.     

Neonatal sucking: Effects of quantity of the response-contingent fluid upon sucking rhythm and heart rate

The temporal organization of neonatal nutritive sucking and heart rate were studied in two consecutive 4-min periods to analyze the effects of two quantities of response-contingent fluid. One group of newborns experienced only the larger amount, a second experienced the smaller, and two other groups experienced both in counterbalanced order. Cumulative pausing time and intersuck intervals (sucking rate within bursts) were both affected by the amount of fluid delivered at each response. At the start of sucking bursts, heart rate accelerated to a stable level. Within-burst heart rates were higher with increased quantity of contingently delivered fluid. The results are discussed in relation to the distinction between nutritive and nonnutritive sucking and to previous findings on the effects of fluid sweetness upon sucking.     

Analysis and treatment of finger sucking

We analyzed and treated the finger sucking of 2 developmentally typical children aged 7 and 10 years. The functional analysis revealed that the finger sucking of both children was exhibited primarily during alone conditions, suggesting that the behavior was maintained by automatic reinforcement. An extended analysis provided support for this hypothesis and demonstrated that attenuation of stimulation produced by the finger sucking resulted in behavior reductions for both children. Treatment consisted of having each child wear a glove on the relevant hand during periods when he or she was alone. Use of the glove produced zero levels of finger sucking for 1 participant, whereas only moderate reductions were obtained for the other. Subsequently, an awareness enhancement device was used that produced an immediate reduction in finger sucking.     

Neonates' heart rate,sucking rhythm,and sucking amplitude as a function of the sweet taste

In previous studies of human newborn sucking, the effects of increasing fluid sweetness and/or volume included a decrease in sucking rate within sucking bursts and, paradoxically, an increase in heart rate. To determine whether the heart rate increase can be attributed to increased sucking amplitude for sweeter fluids, sucking and heart rates of 20 full-term infants were studied. Half sucked for three consecutive 2-min periods, first receiving small drops of water for each suck, then no fluid, then 15% sucrose. The other half experienced the reverse order. The results for sucking and heart rate were consistent with previous studies; sucking rates within bursts were slowest for sucrose and fastest for no fluid. Heart rate was higher for sucrose than for the other fluid conditions, however, only in the water-first group. The heart rate increase was significant on statistical tests which controlled for sucking amplitude as well as for several other motor variables. Sucking amplitude itself varied with fluid sweetness in the water-first group only, in which it was highest for water. There were more total sucks, longer sucking bursts, and less time between successive bursts under the sucrose condition. Multivariate statistics helped establish a set of dependent variables—sucking rate within bursts, total number of sucks, and heart rate—which most parsimoniously describes the effects of fluid sweetness. A hedonic explanation of the response of newborns to sweetness is thus reiterated.     

The organization of non-nutritive sucking in the premature infant

Changes in non-nutritive sucking contingent upon the repeated presentation of unpatterned and patterned light stimulation were examined in a sample of 18 premature infants. Stimulus contingent sucking change in chronologically younger infants tended to be somewhat shorter in duration than that of the chronologically older infants and showed stimulus contingent sucking acceleration as well as suppression. Evidence was also found for less orienting among infants showing abnormalities in their sucking behavior. No evidence for habituation was found in any subgroup. Possible factors contributing to the strength and nature of stimulus contingent non-nutritive sucking changes in infants are discussed.     

Microcomputer measurement and analysis of newborn sucking

An on-line Basic computer program with on-line monitor prompts and read-out collects, stores, and digitizes pressure and latency of sucking responses for later analyses. The program and analog equipment are described, and approximate costs are noted.     

Vagus nerve stimulation: a new form of therapeutic brain stimulation

Although the vagus nerve has traditionally been considered to perform efferent functions, in reality it performs significant afferent functions as well, carrying information from the body, head, and neck to the brain. Preliminary studies examining this afferent activity led to the theory that vagus nerve stimulation (VNS) could successfully control seizure activity in persons who are refractory to antiepileptic medications. Unlike other forms of brain stimulation, VNS is unable to directly stimulate multiple discrete areas of the brain; however, through several pathways, it is able to relay sensory information to higher brain regions. An implantable VNS device known as the VNSTM NeuroCybernetic Prosthesis (NCP) System has been used in approximately 9,000 epilepsy patients in Europe and the United States since 1994. The implant has reduced seizure frequency by an average of 25% to 30%, with minimal side effects. Studies underway are also showing some degree of success in the management of treatment-refractory depression. The future efficacy of the implantable system in other disorders may depend on whether the implant can be more precisely focused to affect different brain regions. Research in this area is underway.