Infant Consciousness Level Reference
This reference describes observed infant responses. Soothing, gaze, and feeding-related responses differ with age and development. Adult JCS criteria cannot be applied directly. Do not judge normality or impairment solely from this table.
| Grade | Observation |
|---|---|
| Normal consciousness (0) | |
| 0 | Normal consciousness. The 2018 reference does not specify a further assessment criterion for score 0. |
| I — Awake without stimulation (1, 2, 3) | |
| 1 | Smiles in response to soothing or play, but the response is weak and does not progress to laughing aloud. |
| 2 | Does not smile when soothed, but can maintain eye contact. |
| 3 | Does not make eye contact with the mother (an observation example in the original reference, not a requirement for the mother to be present). |
| II — Aroused by stimulation (10, 20, 30) | |
| 10 | Shows an intention to drink when presented with a drink or nipple (an illustrative response, not an instruction to feed). |
| 20 | Opens the eyes and turns the gaze toward someone calling. |
| 30 | Opens the eyes only with repeated calling. |
| III — Not aroused by stimulation (100, 200, 300) | |
| 100 | Attempts to ward off painful stimulation. |
| 200 | Shows minor limb movement or grimacing in response to painful stimulation. |
| 300 | No observed response to painful stimulation. |
Consider sleep, postictal state, sedation, vision, hearing, motor response and feeding limitations, as well as the infant’s usual baseline. Descriptions of painful stimulation are NOT instructions to apply additional stimulation.
Interpretation, age limitations and original sources
Categories and observation examples
Group I (1–3) denotes spontaneous wakefulness, II (10–30) awakening with stimulation, and III (100–300) no awakening despite stimulation. An infant who opens the eyes and looks toward a caller illustrates grade 20. The grades are not additive and do not directly convert to adult JCS or the Glasgow Coma Scale.
Population and limitations
Reference observations for infants suspected of influenza encephalopathy in the relevant Japanese guidance, only when the described behaviors are developmentally applicable. The reference’s mention of eye contact with a mother is an example, not a requirement that the mother be present. The drink/nipple description is not advice to offer food or drink. Do not generalize this table to all infants or older children.
Evidence differences and unresolved sources
The 2009 Japanese influenza encephalopathy guideline Table 2 lists grades 1–300; the 2018 clinical strategy Table 2 adds grade 0, yielding ten categories. This page uses the 2018 version. The 1978 credited original book and the initially referenced 2005 material were not directly inspected. An exact age cutoff has not been established from the source documents.
Review status
Source comparison date 2026-11-10.