What is the HCS?

The Head Control Scale (HCS) was designed by Jodi Thomas (PT) and Amy Armstrong-Heiinsoth. (OT) as an objective evaluation of head control regardless of medical diagnosis or age.

The HCS is an observational assessment developed for the user to observe stability and mobility and rate their observations on a 0-4 point scale (descriptors are provided for each rating) in each of four positions (supine, prone. pull to sit, and sitting

It was designed to be both quick to administer freely accessible and directly applicable to clinical practice.

The HCS has high interrater reliability and users report it to be a needed tool, applicable to clinical practice, and easy to use.

The HCS is free to use

Scroll down to find the link to download the scale.
It is always free to download/use as needed; it just cannot be changed or modified.

Intended use 

The intended use of the HCS is to assess head control objectively to:

• detect change over time. which allows therapists to document progress, maintenance or regression;
• assess the effectiveness of interventions provided in the clinic;
• be used in research studies  that investigate head control and provide evidence of best practice.

In each position  (supine, prone, pull-to sit and sitting) there are descriptors of different behaviors which are graded on a scale of 1-5. So for instance when observed in supine, the ability to keep the head in midline for up to 5 seconds is graded as a 2. 

The scores for each position are added to give a total score.

• The HCS  was not designed to identify delay.
• Normative values for the HCS do not exist. 

However, a score of 16 (highest score possible) would indicate full head control which is expected around 3-4 months of age (Long. 2019).