NICHQ Vanderbilt Assessment Follow-up-TEACHER Informant at a glance
What it is: The NICHQ Vanderbilt Assessment Follow-up-TEACHER Informant is a form for rating the behaviors of a child.
Where and when to file: Return this form to the Mailing address or Fax number under Please return this form to.
A filled-in NICHQ Vanderbilt Assessment Follow-up-TEACHER Informant example: a teacher rates one child
How to fill out NICHQ Vanderbilt Assessment Follow-up-TEACHER Informant, box by box
Teacher, class and child
Enter Teacher's Name, Class Time, Class Name/Period, Today's Date, Child's Name and Grade Level.
Directions and weeks of evaluating
Consider each rating in the context of what is appropriate for the age of the child you are rating, and reflect that child's behavior since the last assessment scale was filled out. Indicate the number of weeks or months you have been able to evaluate the behaviors.
Medication
Mark if this evaluation is based on a time when the child was on medication, was not on medication, or not sure.
Symptoms, 1 to 18
For Symptoms 1 to 18, mark 0 for Never, 1 for Occasionally, 2 for Often or 3 for Very Often.
Performance, 19 to 26
For Performance 19 to 26, mark 1 for Excellent to 5 for Problematic.
Side effects
For each side effect or problem the child has experienced in the past week, mark None, Mild, Moderate or Severe under: Are these side effects currently a problem?
For Change of appetite, Irritability in the late morning, late afternoon, or evening, Repetitive movements, tics, jerking, twitching, eye blinking, and Picking at skin or fingers, nail biting, lip or cheek chewing, explain under Explain/Comments.
Mailing address and Fax number
Return this form to the Mailing address or Fax number.
Sources
[1] NICHQ Vanderbilt Assessment Follow-up-TEACHER Informant (no issuer file) (the Official source link on this page).