Scarf Sign (Normal) on Physical Exam The scarf sign is used to assess developmental age and muscle tone in neonates. The infant's arm is pulled laterally across the chest; in the hypotonic infant, the elbow will cross the midline; in a term infant with normal tone, the elbow will not reach the midline. #Scarf #Sign #PhysicalExam #clinical #video #hypotonia #hypotonic #peds #pediatrics #tone #normal