Unlike APGAR, this score is entirely focused on how hard a newborn is working to breathe, grading five specific signs of respiratory distress to help decide if a baby needs respiratory support.
No respiratory distress.
Mild distress.
Moderate distress.
Severe distress — impending failure.
APGAR is a broader, more universally taught delivery-room assessment. Silverman-Andersen is a more specialized neonatal/NICU tool focused purely on respiratory mechanics.
Five signs of work of breathing are each scored 0–2, for a total of 0–10. Unlike APGAR, a score of 0 is best — it means no respiratory distress — and higher scores mean more distress.
Paradoxical movement where the chest sinks as the abdomen rises during inspiration — a sign of severe respiratory effort scored 2 for chest/abdominal movement.
In newborns, especially preterm infants at risk of respiratory distress syndrome, to track work of breathing and decide when to escalate support.