Criteria

Score 0

Score 1

Score 2

Face

No particular expression or smile

Occasional grimace or frown, withdrawn, disinterested

Frequent to constant quivering chin, clenched jaw

Legs

Normal position or relaxed

Uneasy, restless, tense

Kicking or legs drawn up

Activity

Lying quietly, normal position, moves easily

Squirming, shifting, back and forth, tense

Arched, rigid or jerking

Cry

No cry (awake or asleep)

Moans or whimpers; occasional complaint

Crying steadily, screams, sobs, frequent complaints

Controllability

Content, relaxed

Reassured by touching, hugging or being talked to, distractible

Difficult to console or comfort