On the Frankl behavior rating scale, a child who refuses treatment, cries forcefully, and is overtly fearful is rated as:

The Frankl scale rates pediatric behavior 1 to 4: 1 = definitely negative (refusal, forceful crying, overt defiance or fear), 2 = negative (reluctant, uncooperative but not extreme), 3 = positive (accepts treatment cautiously), 4 = definitely positive (good rapport, interested, enjoys the visit).Other options: 2 is milder reluctance; 3 and 4 are cooperative and positive behaviors.Key exam takeaway: Frankl runs from 1 (definitely negative) to 4 (definitely positive); forceful refusal and crying = Frankl 1.