Vanderbilt ADHD Teacher Rating Scale (page 1 of 2)
Child’s Name _________________ Date of Birth __________ Grade ____ Today’s Date ______________
Completed by ___________________
Subject Taught (if applicable) _________________________
Each rating should be considered in the context of what is appropriate for the age of the child.
If you have completed a previous assessment, your rating should reflect the child’s behavior since you last completed a form.
Symptoms
Never
Occasionally
Often
Very Often
1.
Does not pay attention to details or makes careless mistakes, such
as in homework
0
1
2
3
2.
Has difficulty sustaining attention to tasks or activities
0
1
2
3
3.
Does not seem to listen when spoken to directly
0
1
2
3
4.
Does not follow through on instruction and fails to finish schoolwork
(not due to oppositional behavior or failure to understand)
0
1
2
3
5.
Has difficulty organizing tasks and activities
0
1
2
3
6.
Avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort
0
1
2
3
7.
Loses things necessary for tasks or activities (school assignments,
pencils, or books)
0
1
2
3
8.
Is easily distracted by extraneous stimuli
0
1
2
3
9.
Is forgetful in daily activities
0
1
2
3
10.
Fidgets with hands or feet or squirms in seat
0
1
2
3
11.
Leaves seat when remaining in seated is expected
0
1
2
3
12.
Runs about or climbs excessively when remaining seated is
expected
0
1
2
3
13.
Has difficulty playing or engaging in leisure activities quietly
0
1
2
3
14.
Is “on the go” or often acts as if “driven by a motor”
0
1
2
3
15.
Talks too much
0
1
2
3
16.
Blurts out answers before questions have been completed
0
1
2
3
17.
Has difficulty waiting his or her turn
0
1
2
3
18.
Interrupts or intrudes in on others (butts into conversations or
games)
0
1
2
3
19.
Loses temper
0
1
2
3
20.
Actively defies or refuses to comply with adults’ requests or rules
0
1
2
3
21.
Is angry or resentful
0
1
2
3
22.
Is spiteful and vindictive
0
1
2
3
23.
Bullies, threatens, or intimidates others
0
1
2
3
24.
Initiates physical fights
0
1
2
3
25.
Lies to obtain goods for favors or to avoid obligations (“cons” others)
0
1
2
3
26.
Is physically cruel to people
0
1
2
3
27.
Has stolen items of nontrivial value
0
1
2
3
28.
Deliberately destroys others’ property
0
1
2
3
27
Vanderbilt ADHD Teacher Rating Scale (page 2 of 2)
Child’s Name _______________________________ Today’s Date _______________
Symptoms
Never
Occasionally
Often
Very Often
29.
Is fearful, anxious, or worried
0
1
2
3
30.
Is self-conscious or easily embarrassed
0
1
2
3
31.
Is afraid to try new things for fear of making mistakes
0
1
2
3
32.
Feels worthless or inferior
0
1
2
3
33.
Blames self for problems, feels guilty
0
1
2
3
34.
Feels lonely, unwanted, or unloved; complains that “no one loves
him/her”
0
1
2
3
35.
Is sad, unhappy, or depressed
0
1
2
3
Performance
Problematic
Average
Above Average
Academic Performance
Reading
1
2
3
4
5
Mathematics
1
2
3
4
5
Written Expression
1
2
3
4
5
Classroom Behavior
Relationship with Peers
1
2
3
4
5
Following Directions/Rules
1
2
3
4
5
Disrupting Class
1
2
3
4
5
Assignment Completion
1
2
3
4
5
Organizational Skills
1
2
3
4
5
Comments:
For Office Use Only
SYMPTOMS:
Number of questions scored as 2 or 3 in questions 1-9:
____________
Number of questions scored as 2 or 3 in questions 10-18:
____________
Total symptom score for questions 1-18:
____________
Number of questions scored as 2 or 3 in questions 19-28:
____________
Number of questions scored as 2 or 3 in questions 29-35:
____________
Vanderbilt ADHD Diagnostic Teacher Rating Scale was developed by Mark L. Wolraich, MD.
28
Reproduced and format adapted by R. Hilt, MD and PAL with permission.
Vanderbilt ADHD Parent Rating Scale (page 1 of 2)
Child’s Name _________________ Date of Birth __________ Grade ____ Today’s Date ______________
Completed by ___________________
Relationship to child:
mom
dad
other: ____________
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.
Symptoms
Never
Occasionally
Often
Very Often
1.
Does not pay attention to details or makes careless mistakes, such as in
homework
0
1
2
3
2.
Has difficulty sustaining attention to tasks or activities
0
1
2
3
3.
Does not seem to listen when spoken to directly
0
1
2
3
4.
Does not follow through on instruction and fails to finish schoolwork (not
due to oppositional behavior or failure to understand)
0
1
2
3
5.
Has difficulty organizing tasks and activities
0
1
2
3
6.
Avoids, dislikes, or is reluctant to engage in tasks that require sustained
mental effort
0
1
2
3
7.
Loses things necessary for tasks or activities (school assignments,
pencils, or books)
0
1
2
3
8.
Is easily distracted by extraneous stimuli
0
1
2
3
9.
Is forgetful in daily activities
0
1
2
3
10.
Fidgets with hands or feet or squirms in seat
0
1
2
3
11.
Leaves seat when remaining in seated is expected
0
1
2
3
12.
Runs about or climbs excessively when remaining seated is expected
0
1
2
3
13.
Has difficulty playing or engaging in leisure activities quietly
0
1
2
3
14.
Is “on the go” or often acts as if “driven by a motor”
0
1
2
3
15.
Talks too much
0
1
2
3
16.
Blurts out answers before questions have been completed
0
1
2
3
17.
Has difficulty waiting his or her turn
0
1
2
3
18.
Interrupts or intrudes in on others (butts into conversations or games)
0
1
2
3
19.
Argues with adults
0
1
2
3
20.
Loses temper
0
1
2
3
21.
Actively defies or refuses to comply with adults’ requests or rules
0
1
2
3
22.
Deliberately annoys people
0
1
2
3
23.
Blames others for his or her mistakes or misbehaviors
0
1
2
3
24.
Is touchy or easily annoyed by others
0
1
2
3
25.
Is angry or resentful
0
1
2
3
26.
Is spiteful and vindictive
0
1
2
3
27.
Bullies, threatens, or intimidates others
0
1
2
3
28.
Initiates physical fights
0
1
2
3
29.
Lies to obtain goods for favors or to avoid obligations (“cons” others)
0
1
2
3
30.
Is truant from school (skips school) without permission
0
1
2
3
31.
Is physically cruel to people
0
1
2
3
Vanderbilt ADHD Parent Rating Scale (page 2 of 2)
Child’s Name _______________________________ Today’s Date _______________
Symptoms
Never
Occasionally
Often
Very Often
32.
Has stolen things of nontrivial value
0
1
2
3
33.
Deliberately destroys others’ property
0
1
2
3
34.
Has used a weapon that can cause serious harm (bat, knife, brick, gun)
0
1
2
3
35.
Is physically cruel to animals
0
1
2
3
36.
Has deliberately set fires to cause damage
0
1
2
3
37.
Has broken into someone else’s home, business, or car
0
1
2
3
38.
Has stayed out at night without permission
0
1
2
3
39.
Has run away from home overnight
0
1
2
3
40.
Has forced someone into sexual activity
0
1
2
3
41.
Is fearful, anxious, or worried
0
1
2
3
42.
Is afraid to try new things for fear of making mistakes
0
1
2
3
43.
Feels worthless or inferior
0
1
2
3
44.
Blames self from problems, feels guilty
0
1
2
3
45.
Feels lonely, unwanted, or unloved; complains that “no one loves him/her”
0
1
2
3
46.
Is sad, unhappy, or depressed
0
1
2
3
47.
Is self-conscious or easily embarrassed
0
1
2
3
Performance
Problematic
Average
Above Average
Academic Performance
Reading
1
2
3
4
5
Mathematics
1
2
3
4
5
Written Expression
1
2
3
4
5
Classroom Behavior
Relationship with Peers
1
2
3
4
5
Following Directions/Rules
1
2
3
4
5
Disrupting Class
1
2
3
4
5
Assignment Completion
1
2
3
4
5
Organizational Skills
1
2
3
4
5
Comments:
For Office Use Only
SYMPTOMS:
Number of questions scored as 2 or 3 in questions 1-9:
__________
Number of questions scored as 2 or 3 in questions 10-18:
__________
Total symptom score for questions 1-18:
_________
Number of questions scored as 2 or 3 in questions 19-26:
__________
Number of questions scored as 2 or 3 in questions 27-40:
__________
Number of questions scored as 2 or 3 in questions 41-47:
__________
Vanderbilt ADHD Diagnostic Parent Rating Scale was developed by Mark L. Wolraich, MD.
30
Reproduced and format adapted by R. Hilt, MD and PAL with permission.
Scoring the Vanderbilt ADHD Scales
The Vanderbilt rating scale is a screening and information gathering tool which can assist
with making an ADHD diagnosis and with monitoring treatment effects over time.
The
Vanderbilt rating scale results alone do not make a diagnosis of ADHD or diagnose any
other
disorder—one must consider information from multiple sources to make
a clinical
diagnosis.
Symptom items 1-47 are noted to be significantly present if the parent or teacher
records
the
symptom
as
“often
or
very
often”
present
(a
2
or
3
on
the
scale).
The
“performance” items at the end are felt to be significant if the parent or teacher records either
a 1 or 2 on each item.
Parent Version
Predominantly Inattentive Subtype
Requires 6 or more counted behaviors on items 1 through 9 and a performance problem
(score of 1 or 2) in any of the items on the performance section.
Predominantly Hyperactive/Impulsive Subtype
Requires 6 or more counted behaviors on items 10 through 18 and a performance
problem
(score of 1 or 2) in any of the items on the performance section.
Combined Subtype
Requires 6 or more counted behaviors each on both the inattention and hyperactivity/
impulsivity dimensions.
Oppositional-defiant disorder
Requires 4 or more counted behaviors on items 19 through 26.
Conduct disorder
Requires 3 or more counted behaviors on items 27 through 40.
Anxiety or depression
Requires 3 or more counted behaviors on items 41 through 47.
Teacher Version
Predominantly Inattentive Subtype
Requires 6 or more counted behaviors on items 1 through 9 and a performance problem
(score of 1 or 2) in any of the items on the performance section.
Predominantly Hyperactive/Impulsive Subtype
Requires 6 or more counted behaviors on items 10 through 18 and a performance
problem
(score of 1 or 2) in any of the items on the performance section.
Combined subtype
Requires 6 or more counted behaviors each on both the inattention and
hyperactivity/impulsivity dimensions.
Oppositional defiant and conduct disorders
Requires 3 or more counted behaviors from questions 19 through 28.
Anxiety or depression
Requires 3 or more counted behaviors from questions 29 through 35.
The performance section is scored as indicating some impairment if a child scores 1 or 2
on at least 1 item.
31