 SPOILER: The filmmakers were concerned for Miko Hughes (qv), so a  mechanical doll with animated facial features was used for several  sequences: 1) when Gage is near the semi which initially kills him  2) when he slices Juds Achilles tendon 3) when he cuts out his  mothers eye 4) when he is given the shot by his father. The waxy  look to the dolls features are particularly noticeable. Miko  himself has said he remembers playing with the doll on set.