procedures indicate that the infants have some ability to remember the painful event (Soud & Rogers, 1998, p. 689). Infants also can develop behaviors, such as stiffening and withdrawal, in response to the anticipation of repeated painful stimuli such as a heel lance (McCaffery & Pasero, 1999, p. 630).
             As these myths have been discredited, more importance has been placed on assessing the pain of the nonverbal child. The assessment, in itself, is challenging. How does a nurse assess the pain when verbal self-report is non-existent? Researchers Jacob and Puntillo (1999) surveyed the practice of childhood pain assessment and management and found that "nurses indicated that physiological changes, facial expression, and body language are determinants of pain" (p. 283). Because similar physiological changes can occur due to either the actual illness or the pain the infant is experiencing (Jorgensen, 1999
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