How does the paediatric GCS differ from the adult GCS?

The eye-opening and motor components are identical, but the verbal component uses infant-appropriate descriptors. Instead of orientation it scores cooing/babbling, irritable crying, crying to pain, moaning, and no response, because pre-verbal children cannot follow adult orientation prompts.

What is the maximum and minimum score?

The minimum total is 3 (1 in each domain) and the maximum is 15. A score of 3 represents deep coma and 15 represents a fully responsive child.

What total indicates severe impairment?

As in adults, a total of 8 or below indicates severe impairment and usually mandates airway protection. Scores of 9 to 12 are moderate and 13 to 15 are mild.

Up to what age is the modified verbal scale used?

The infant-adapted verbal descriptors are intended for pre-verbal children, conventionally under 2 years. Older children who can speak in sentences are scored with the standard adult verbal scale.

Paediatric GCS Calculator (Children <2 years)

Paediatric Glasgow Coma Scale for infants

The Glasgow Coma Scale (GCS) is the standard bedside measure of consciousness, but its adult verbal descriptors assume a patient who can follow orientation questions. For pre-verbal children under 2 years a modified verbal scale is used so that crying and babbling patterns substitute for spoken orientation. This calculator sums the three sub-scores into a total from 3 to 15.

How it works

The total GCS is the sum of three independently scored domains: Eye opening (1 to 4), Verbal response (1 to 5), and Motor response (1 to 6). The eye and motor scales are identical to the adult GCS. The paediatric verbal scale replaces adult descriptors as follows: 5 = coos and babbles, 4 = irritable cry, 3 = cries to pain, 2 = moans to pain, 1 = no response. Always record the best response in each domain.

Total GCS = Eye (1-4) + Verbal (1-5) + Motor (1-6)
Range: 3 (deep coma) to 15 (fully responsive)

Severity bands and tips

A total of 13 to 15 is mild, 9 to 12 is moderate, and 8 or below is severe and usually warrants definitive airway protection. Always document the breakdown (for example E3 V4 M5 = 12) rather than the total alone, because two children with the same total can have very different clinical pictures. Re-score serially to detect trends, and remember that intubation, sedation, or eye swelling can artificially limit the testable domains.