Vanderbilt Assessment Scale – Fill Out and Use This PDF

Vanderbilt ADHD Diagnostic Parent Rating Scale

Page 1 of 3

VANDERBILT ADHD DIAGNOSTIC PARENT RATING SCALE

Child’s Name:

Today’s Date:

Date of Birth:

Age:

Grade:

Frequency Code:

0 = Never

1 = Occasionally

2 = Often

3 = Very Often

1.

Does not pay attention to details or makes careless mistakes, for example 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 instructions 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 seated is expected

0

1

2

3

12.

Runs about or climbs excessively in situations when remaining seated is expected

0

1

2

3

13.

Has difficulty playing or engaging in leisure/play activities quietly

0

1

2

3

14.

Is “on the go” or often acts as if “drive 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/her turn

0

1

2

3

18.

Interrupts or intrudes on others (e.g., 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

Vanderbilt ADHD Diagnostic Parent Rating Scale

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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 (i.e., “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

32.

Has stolen items 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 for 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

Vanderbilt ADHD Diagnostic Parent Rating Scale

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Problematic

Average

Above Average

1. Overall Academic Performance

1

2

3

4

5

a. Reading

1

2

3

4

5

b. Mathematics

1

2

3

4

5

c. Written Expression

1

2

3

4

5

Problematic

Average

Above Average

2. Overall Classroom Behavior

1

2

3

4

5

a. Relationship with peers

1

2

3

4

5

b. Following Directions/Rules

1

2

3

4

5

c. Disrupting Class

1

2

3

4

5

d. Assignment Completion

1

2

3

4

5

e. Organizational Skills

1

2

3

4

5