NICHQ Vanderbilt Assessment Scale-TEACHER Informant at a glance
What it is: Each rating on the NICHQ Vanderbilt Assessment Scale-TEACHER Informant should reflect the child's behavior since the beginning of the school year.
Where and when to file: Please return this form to the Mailing address or Fax number on this form.
A filled-in NICHQ Vanderbilt Assessment Scale-TEACHER Informant example: a teacher rates one pupil
How to fill out NICHQ Vanderbilt Assessment Scale-TEACHER Informant, box by box
Teacher's Name, Class Time, Class Name/Period, Today's Date, Child's Name and Grade Level
Enter the Teacher's Name, Class Time, Class Name/Period, Today's Date, Child's Name and Grade Level.
Directions: weeks or months of evaluation
Consider each rating in the context of what is appropriate for the age of the child you are rating.
Indicate the number of weeks or months you have been able to evaluate the behaviors.
Symptoms 1 to 31
For symptoms 1 to 31, mark Never 0, Occasionally 1, Often 2 or Very Often 3.
Symptom 4 is Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand).
Symptoms (continued) 32 to 35
For symptoms 32 to 35, mark Never 0, Occasionally 1, Often 2 or Very Often 3.
Academic Performance
For Academic Performance, 36 Reading, 37 Mathematics and 38 Written expression, mark a number from 1 to 5 for each.
Classroom Behavioral Performance
For Classroom Behavioral Performance, 39 Relationship with peers, 40 Following directions, 41 Disrupting class, 42 Assignment completion and 43 Organizational skills, mark a number from 1 to 5 for each.
Please return this form to
Please return this form to, Mailing address and Fax number are lines on this form.
For Office Use Only
The Total number of questions scored 2 or 3 in questions 1-9, in questions 10-18 and in questions 19-28 are listed under For Office Use Only.
The Total Symptom Score for questions 1-18, the Total number of questions scored 2 or 3 in questions 29-35, the Total number of questions scored 4 or 5 in questions 36-43 and the Average Performance Score are listed under For Office Use Only.
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Sources
[1] NICHQ Vanderbilt Assessment Scale-TEACHER Informant (Revised - 1102) (the Official source link on this page).