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| Clinical symptoms | Grade |
| Extreme (10) | Severe (9) | Moderate (8/7) | Mild (5) | Slight (0) |
|
| Voluntary movement | (1) Absent
(2) Acrocontracture
(3) Pain reflex but slight trembling and rough breathing | (1) Almost absent but parts of the extremities move minutely
(2) Part of the extremity flexed and part paralyzed
(3) Pain reflex or no pain reflex with clearly frowning face | (1) Occasional all/partial extremity movement with no intention
(2) Extremity could be paretic
(3) Brushing away reaction for pain | (1) Occasional movement to meet an object
(2) Capable of raising the arms upward or moving them in the intended direction, that is, face or head, imitating a posture of the tester | (1) Capable of movement with intention
(2) Capable of unassisted posture change (partial change inclusive)
(3) Moving wheelchair unassisted, even if awkwardly |
|
| Voluntary ingestion | Totally incapable of masticating and swallowing; on tube nutrition (gastric/nasal feeding) | (1) Almost on tube nutrition
(2) Saliva swallowing or mastication is found
(3) Capable of attempting slight perusal ingestion, that is, fruit juice, custard pudding, and so forth | (1) Capable of masticating; even if not, almost capable of assisted auroral ingestion by swallowing, though sometimes choking
(2) Insufficient peroral ingestion requires tube nutrition | (1) Capable of unassisted ingestion by swallowing; mastication could be awkward
(2) Capable of ingesting all the rice gruel served or chopped food with assistance
(3) Attempting to reach mouth with a passed spoon or put the food into mouth awkwardly | Ingesting on own using spoon awkwardly |
|
| Fecal and urinary incontinence | No observed somatic movement when evacuating/urinating | Slight somatic movement when evacuating/urinating | After incontinence, a displeased look or some signal is observed, that is, frequent somatic movement | (1) Forced regular evacuating and urinating lead to the prevention of fecal and urinary incontinence
(2) Communicating the fact in a certain way after incontinence | Except during the night, preevacuation and preurination communication is possible |
|
| Ophthalmography and visual recognition | (1) Eyes not opened
(2) Eyes opened, no blink reflex | (1) Eyes opened, blink reflex
(2) No following ocular movement and no focusing eyes on an object | (1) Looking straight toward the direction of the call
(2) Following a moving object or staring at a TV, although understanding is impossible | (1) Discriminating close relatives followed by a facial expression
(2) Favorite picture, among other things, induces a facial expression | (1) Capable of reading easy words
(2) Capable of understanding simple numbers
(3) When watching TV, response and laughter are apparent |
|
| Vocalizing and utterances | (1) No vocalizing
(2) No lip movement under tracheostomy | (1) Groaning, among others, without meaningful utterances
(2) Lip movement observed under tracheostomy | (1) A short utterance though not understandable
(2) Occasional inarticulate vocal response to calls
(3) Under tracheostomy, response to calls is through lip movement | (1) Occasional vocalizing of a meaningful word
(2) Vocal response to calls
(3) Imitating talking by the tester under tracheostomy | (1) Capable of vocalizing a simple word response
(2) Lip movement corresponds to what is asked |
|
| Change of expression | No response to ambient sound stimulations and TV sounds, among other things | Change of expression, such as smiling, crying, and anger, is not due to ambient stimulations | Change of expression is occasionally found in response to ambient stimulations | Change of expression, such as smiling, crying, and anger, closely matches an expected response to the ambient stimulation | Change of expression, such as crying and smiling, exactly matches an expected response to the ambient stimulation |
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