After asking the patient a question, he or she pauses for inappropriately long period before initiating a response. Delay is considered a pause if it feels as though you are waiting for a response or if you consider repeating the question because it appears the patient has not heard you. Prompting usually indicates that the patient is aware of the questions, but has been having difficulty in developing his thoughts in order to make an appropriate reply. Rate severity on the frequency of these pauses. The patient's face appears, wooden, mechanical, frozen.
Facial musculature is generally expressionless and unchanging.
The patient does not change expression, or changes less than normally expected, as the emotional content of discourse changes. Because of this, emotions may be difficult to infer. Disregard changes in facial due to abnormal involuntary moments, such as ties and tardive dyskinesia. Marked Facial expressiveness is markedly decreased. Severe Patient's face is always leaden and blank, even after best efforts to stimulate facial expression.