Silverman Scoring System

Score 10 = Severe respiratory distress

Score 7 = Impending respiratory failure
Score 0 = No respiratory distress
(From Silverman, W. and Anderson, D.: Pediatrics 17:1, 1956. Copyright
American Academy of Pediatrics.)

Ballard Maturational Assessment

The Ballard Maturational Assessment, Ballard Score, or Ballard Scale is a commonly used technique
of gestational age assessment. It assigns a score to various criteria, the sum of all of which is then
extrapolated to the gestational age of the baby. These criteria are divided
into Physical and Neurological criteria. This scoring allows for the estimation of age in the range of
26 weeks-44 weeks. The New Ballard Score is an extension of the above to include extremely preterm babies i.e. up to 20 weeks.
The scoring relies on the intra-uterine changes that the fetus undergoes during its maturation.
Whereas the neurological criteria depend mainly upon muscle tone, the physical ones rely on
anatomical changes. The neonate (less than 37 weeks of age) is in a state of

physiological hypotonia. This tone increases throughout the fetal growth period, meaning a
more premature baby would have lesser muscle tone.
It was developed in 1979