ADHD Child Assessment

NICHQ Vanderbilt Assessment Scale—PARENT Informant

Directions: Each rating should be considered in the context of what is appropriate for the age of your child.

When completing this form, please think about your child’s behaviors in the past 6 months.

Is this evaluation based on a time when the child: was on medication was not on medication not sure?

Symptoms Never = 0 Occasionally = 1 Often = 2 Very Often = 3

1.	Does not pay attention to details or makes careless mistakes with, for example, homework	1	2	3
2.	Has difficulty keeping attention to what needs to be done	1	2	3
3.	Does not seem to listen when spoken to directly	1	2	3
4.	Does not follow through when given directions, fails to finish activities (not due to refusal or failure to understand)	1	2	3
5.	Has difficulty organizing tasks and activities	1	2	3
6.	Avoids, dislikes, or does not want to start tasks that require ongoing mental effort	1	2	3
7.	Loses things necessary for tasks or activities (toys, assignments, pencils or books)	1	2	3
8.	Is easily distracted by noises or other stimuli	1	2	3
9.	Is forgetful in daily activities	1	2	3
10.	Fidgets with hands or feet or squirms in seat	1	2	3
11.	Leaves seat when remaining seated is expected	1	2	3
12.	Runs about or climbs too much when remaining seated is expected	1	2	3
13.	Has difficulty playing or beginning quiet play activities	1	2	3
14.	Is “on the go” or often acts as if “driven by a motor”	1	2	3
15.	Talks too much	1	2	3
16.	Blurts out answers before questions have been completed	1	2	3
17.	Has difficulty waiting his or her turn	1	2	3
18.	Interrupts or intrudes in on others’ conversations and/or activities	1	2	3
19.	Argues with adults	1	2	3
20.	Loses temper	1	2	3
21.	Actively defies or refuses to go along with adults’ requests or rules	1	2	3
22.	Deliberately annoys people	1	2	3
23.	Blames others for his or her mistakes or misbehaviors	1	2	3
24.	Is touchy or easily annoyed by others	1	2	3
25.	Is angry or resentful	1	2	3
26.	Is spiteful and wants to get even	1	2	3
27.	Bullies, threatens, or intimidates others	1	2	3
28.	Starts physical fights	1	2	3
29.	Lies to get out of trouble or to avoid obligations (ie, “cons” others)	1	2	3
30.	Is truant from school (skips school) without permission	1	2	3
31.	Is physically cruel to people	1	2	3
32.	Has stolen things that have value	1	2	3
33.	Deliberately destroys others’ property	1	2	3
34.	Has used a weapon that can cause serious harm (bat, knife, brick, gun)	1	2	3
35.	Is physically cruel to animals	1	2	3
36.	Has deliberately set fires to cause damage	1	2	3
37.	Has broken into someone else’s home, business, or car	1	2	3
38.	Has stayed out at night without permission	1	2	3
39.	Has run away from home overnight	1	2	3
40.	Has forced someone into sexual activity	1	2	3
41.	Is fearful, anxious, or worried	1	2	3
42.	Is afraid to try new things for fear of making mistakes	1	2	3
43.	Feels worthless or inferior	1	2	3
44.	Blames self for problems, feels guilty	1	2	3
45.	Feels lonely, unwanted, or unloved; complains that “no one loves him or her”	1	2	3
46.	Is sad, unhappy, or depressed	1	2	3
47.	Is self-conscious or easily embarrassed	1	2	3

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Adapted from the Vanderbilt Rating Scales developed by Mark L.Wolraich, MD.

PERFORMANCE

Excellent=5 Above Average=4 Average=3 Somewhat A Problem=2 Problematic=1

48.	Overall school performance	1	2	3	4	5
49.	Reading	1	2	3	4	5
50.	Writing	1	2	3	4	5
51.	Mathematics	1	2	3	4	5
52.	Relationship with parents	1	2	3	4	5
53.	Relationship with siblings	1	2	3	4	5
54.	Relationship with peers	1	2	3	4	5
55.	Participation in organized activities (eg, teams)	1	2	3	4	5

Comments:

For Office Use Only

Total number of questions scored 2 or 3 in questions 1–9:

Total number of questions scored 2 or 3 in questions 10–18:

Total Symptom Score for questions 1–18:

Total number of questions scored 2 or 3 in questions 19–26:

Total number of questions scored 2 or 3 in questions 27–40:

Total number of questions scored 2 or 3 in questions 41–47:

Total number of questions scored 4 or 5 in questions 48–55:

Average Performance Score:

Note to parents: This scale is not a substitute for professional assessment. It helps give an understanding of symptoms used to diagnose ADHD. Mental health professionals use similar questionnaires to get information from teachers and others who have contact with children, since a diagnosis of ADHD requires that the symptoms be present in two or more settings. Diagnosis should be made only by a trained mental health professional after a complete assessment.

Scoring Instructions for the NICHQ Vanderbilt Assessment Scales

These scales should NOT be used alone to make any diagnosis. You must take into consideration information from multiple sources.

Scores of 2 or 3 on a single Symptom question reflect often-occurring behaviors. Scores of 4 or 5 on Performance questions reflect problems in performance.

The initial assessment scales, parent and teacher, have 2 components: symptom assessment and impairment in performance. On both the parent and teacher initial scales, the symptom assessment screens for symptoms that meet criteria for both inattentive (items 1–9) and hyperactive ADHD (items 10–18).

To meet DSM-IV criteria for the diagnosis, one must have at least 6 positive responses to either the inattentive 9 or hyperactive 9 core symptoms, or both. A positive response is a 2 or 3 (often, very often).

Scoring the Parent Assessment Scale

PREDOMINANTLY INATTENTIVE SUBTYPE