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Paediatric Assessment Scores

Published October 11, 2026 · Last updated October 11, 2026

A tour of the paediatric scoring tools: Apgar for newborns, the Pediatric Glasgow Coma Scale and Pediatric Trauma Score, PECARN for head trauma, the Westley croup score, the Rochester criteria and Gorelick scale, PEWS, PALS hypotension thresholds, and BMI-for-age.

Paediatric scoring tools are built around age- and size-specific norms, and transferring an adult threshold to a child is a recurring source of error. The library spans newborn assessment, neurological and trauma scoring, common respiratory and infection presentations, ward deterioration, and growth.

This guide groups the paediatric calculators in the library by the situation each is used in.

Newborn assessment: the Apgar score

The Apgar score assigns points for appearance, pulse, grimace, activity, and respiration shortly after birth. It describes the newborn's condition and response to resuscitation at that moment; it is not designed to predict long-term outcome on its own.

Neurological and trauma scoring: Pediatric GCS, Pediatric Trauma Score, and PECARN

The Pediatric Glasgow Coma Scale modifies the verbal component of the adult scale for age while keeping the eye and motor components. The Pediatric Trauma Score grades injury severity in the injured child. The PECARN rule identifies children with minor blunt head trauma who are at very low risk of clinically important traumatic brain injury, supporting decisions about CT imaging.

Respiratory and infection tools: Westley, Rochester, and Gorelick

The Westley croup score grades the severity of viral croup using five components including stridor, air entry, and chest-wall retraction. The Rochester criteria risk-stratify febrile infants for serious bacterial infection, and the Gorelick scale predicts clinically important dehydration in children with gastroenteritis.

Ward deterioration and resuscitation thresholds: PEWS and PALS

The Brighton Pediatric Early Warning Score summarises behaviour and cardiovascular and respiratory observations to flag children at risk of deterioration on the ward. The PALS hypotension thresholds provide age-specific systolic blood pressure values used to define hypotension in paediatric resuscitation.

Growth assessment: BMI-for-age

The paediatric BMI calculator interprets body mass index against CDC growth charts by age and sex, because the meaning of a given BMI changes as a child grows. It is a screening tool read against the growth chart rather than an adult cutoff.

Using paediatric scores safely

Each tool is validated for a specific age band and clinical setting, and the interpretation is tied to the child's exact age and weight. Where a score informs an urgent decision, it complements — and never overrides — a thorough clinical assessment.

Calculators in this guide

Related guides

References

  • Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260-267.
  • AAP Committee on Fetus and Newborn, ACOG Committee on Obstetric Practice. The Apgar score. Pediatrics. 2015;136(4):819-822.
  • Tepas JJ 3rd, Ramenofsky ML, Mollitt DL, et al. The Pediatric Trauma Score as a predictor of injury severity in the injured child. J Pediatr Surg. 1987;22(1):14-18.
  • James HE, Trauner D. The Glasgow Coma Scale. In: James HE, Anas NG, Perkin RM, eds. Brain Insults in Infants and Children. Orlando, FL: Grune & Stratton; 1985:179-182.
  • Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170.
  • Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978;132(5):484-487.
  • Jaskiewicz JA, McCarthy CA, Richardson AC, et al. Febrile infants at low risk for serious bacterial infection — an appraisal of the Rochester criteria and implications for management. Pediatrics. 1994;94(3):390-396.
  • Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. 1997;99(5):E6.
  • Monaghan A. Detecting and managing deterioration in children. Paediatr Nurs. 2005;17(1):32-35.
  • Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC Growth Charts for the United States: Methods and Development. Vital Health Stat 11. 2002;(246):1-190.