Child

Sex

male female

Posture (Posture)

Shown in the original only as a pictogram; the description reproduces the illustration.

Arms and legs extended 0 slight flexion of hips and knees 1 greater flexion of legs, arms extended 2 Arms slightly flexed, legs flexed and abducted 3 Arms and legs fully flexed 4

Wrist angle (Square Window)

above 90° -1 90° 0 60° 1 45° 2 30° 3 0° 4

Arm recoil

180° (no springing back) 0 140–180° 1 110–140° 2 90–110° 3 below 90° 4

Popliteal angle

180° -1 160° 0 140° 1 120° 2 100° 3 90° 4 below 90° 5

Scarf sign

Shown in the original only as a pictogram; the description reproduces the illustration.

Elbow reaches the opposite shoulder -1 Elbow crosses the opposite anterior axillary line 0 Elbow reaches the opposite anterior axillary line 1 Elbow reaches the midline 2 Elbow does not reach the midline 3 Elbow does not cross the ipsilateral axillary line 4

Heel to ear

Shown in the original only as a pictogram; the description reproduces the illustration.

Heel reaches the ear, leg extended -1 Heel near the ear 0 Heel does not quite reach shoulder level 1 Heel to chest level, knee slightly flexed 2 Heel to abdominal level, knee clearly flexed 3 Heel stays below the hip, knee strongly flexed 4

Skin

sticky, friable, transparent -1 gelatinous, red, translucent 0 smooth pink, visible veins 1 superficial peeling and/or rash, few veins 2 cracked, pale areas, occasional veins 3 parchment-like, deep cracks, no vessels 4 leathery, cracked, wrinkled 5

Lanugo

none -1 sparse 0 abundant 1 thinning 2 bald patches 3 predominantly bald 4

Sole of the foot

Heel–toe under 40 mm -2 Heel–toe 40–50 mm, no crease -1 above 50 mm, no fold 0 pale red lines 1 anterior transverse crease only 2 Creases over the anterior two thirds 3 Creases over the entire sole 4

Mammary gland

imperceptible -1 barely perceptible 0 flat areola, no bud 1 speckled areola, bud 1–2 mm 2 raised areola, bud 3–4 mm 3 full areola, bud 5–10 mm 4

Eye / ear

Eyelids firmly fused -2 Eyelids loosely fused -1 Eyelids open; pinna flat, stays folded 0 Pinna slightly curved, soft, slow recoil 1 well curved, soft, springs back readily 2 formed and firm, springs back immediately 3 thick cartilage, ear stiff 4

Genitalia (male)

Scrotum flat, smooth -1 Scrotum empty, faint rugation 0 Testes in the upper inguinal canal, sparse rugation 1 Testes descending, few rugae 2 Testes in the scrotum, good rugation 3 Testes hanging, deep rugae 4

Genitalia (female)

Clitoris prominent, labia flat -1 Clitoris prominent, small labia minora 0 Clitoris prominent, labia minora becoming larger 1 Labia majora and minora equally prominent 2 Labia majora large, minora small 3 Labia majora cover clitoris and minora 4

Scientific basis

Time point

Validated for examinations 0.2–96 hours after birth at 20–44 weeks; for children under 26 weeks, preferably within the first 12 hours.

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.