How it's calculated
Eye opening (1-4), verbal response using age-appropriate preverbal criteria (1-5), and motor response (1-6) are summed for a total of 3-15, mirroring the adult GCS interpretation bands.
Interpretation
| Score | Category |
|---|---|
| 13-15 | Mild / normal |
| 9-12 | Moderate |
| ≤8 | Severe — consider airway protection |
Clinical use
- Used for infants and young children who cannot reliably follow commands or produce age-appropriate verbal responses, where the standard adult GCS verbal and motor criteria don't apply well.
- As with the adult scale, a score of 8 or below typically raises consideration of airway protection and escalation of care.
- Should be interpreted alongside the child's developmental baseline — some children with baseline developmental delay may not achieve a 'normal' top score even at their usual baseline.
- Serial assessment over time (trend) is often more informative than a single reading, particularly in evolving head injury or illness.
Frequently asked questions
What is the Pediatric GCS used for?
It assesses level of consciousness in infants and young children using age-appropriate verbal and motor criteria, since the standard adult GCS doesn't apply well to preverbal children.
At what age is the adult GCS used instead?
Once a child is reliably verbal and can follow age-appropriate commands (often by around 5 years, though this varies), the standard adult GCS criteria are typically used.
What does a Pediatric GCS of 8 or below mean?
As with the adult scale, this level typically raises consideration of airway protection and escalation of care, though clinical context always matters.
Does developmental delay affect the score?
Yes — a child with baseline developmental delay may not achieve what would otherwise be considered a 'normal' score even when at their own neurological baseline, so trend and clinical context matter.
References
- James H, Trauner D. The Glasgow Coma Scale. In: Head Injury in Children. 1985.
- Holmes JF, et al. Performance of the pediatric Glasgow Coma Scale in children with blunt head trauma. Acad Emerg Med. 2005;12(9):814-819.