The whole method of determining consciousness is changed when it comes to infants and young children, doctors have discovered. Often, the severity of a head impact is overestimated, but it’s much more common for the reverse to be true. When an infant cries because of a head impact, it is thought to indicate full consciousness, when in fact serious brain damage may have occurred.
The Glasgow Coma Scale (GCS) uses verbal and motor responses to assess consciousness, which is not possible for preverbal infants. Even after they learn to speak, a frightened but fully conscious child might not be able to fully aid in assessing his or her own state of mind. Doctors in The Bronx are well-aware of attempts to devise a scale that operates for children who are five years of age or less, so their needs can be better served.
Pediatricians and neurological nurses have studied these preverbal responses and are of great help in devising a scale that can assist in the treatment of small children. One such scale includes social, adaptive, vocal and motor responses, and even suck/cough responses, either spontaneous or induced by stimulus. Each of these was given a score from 0 to 4. Another scale was based off the Glasgow scale for eye opening and motor responses, but it had different criteria for the verbal portion, including such things as smiling, eye orientation, consolability, and interaction.