To calculate the score for a baby that is 18 inches long based on the reference point of 20 inches:
- Determine how far the baby's length (18 inches) deviates from the reference point (20 inches).
- The difference is: 18 inches - 20 inches = -2 inches.
Since the scoring system assigns scores based on the distance from 20 inches, with the standard being that a baby measuring higher than 20 inches receives a positive score (e.g., +1 for 21 inches), we can conclude that a baby measuring lower than 20 inches receives a negative score.
Thus, the baby that is 18 inches long would receive a score of -2.