NICHQ Vanderbilt Assessment Scale
TEACHER Informant

Directions
Each rating should be considered in the context of what is appropriate for the age of the child you are rating and should reflect that child’s behavior since the beginning of the school year. Please indicate the number of weeks or months you have been able to evaluate the behaviors:

Is this evaluation based on a time when the child  
Was on medication    Was not on medication    Not sure   

Please SelectNeverOccasionallyOftenVery Often      1. Fails to give attention to details or makes careless mistakes in schoolwork 

Please SelectNeverOccasionallyOftenVery Often      2. Has difficulty sustaining attention to tasks and activities  

Please SelectNeverOccasionallyOftenVery Often      3. Does not seem to listen when spoken to directly  

Please SelectNeverOccasionallyOftenVery Often      4. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand) 

Please SelectNeverOccasionallyOftenVery Often      5. Has difficulty organizing tasks and activities  

Please SelectNeverOccasionallyOftenVery Often      6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort 

Please SelectNeverOccasionallyOftenVery Often      7. Loses things necessary for tasks or activities (school assignments, pencils or books)  

Please SelectNeverOccasionallyOftenVery Often      8. Is easily distracted by extraneous stimuli  

Please SelectNeverOccasionallyOftenVery Often      9. Is forgetful in daily activities  

Please SelectNeverOccasionallyOftenVery Often    10. Fidgets with hands or feet or squirms in seat  

Please SelectNeverOccasionallyOftenVery Often    11. Leaves seat in classroom or in other situations in which remaining seated is expected  

Please SelectNeverOccasionallyOftenVery Often    12. Runs about or climbs excessively in situations in which remaining seated is expected  

Please SelectNeverOccasionallyOftenVery Often    13. Has difficulty playing or engaging in leisure activities quietly  

Please SelectNeverOccasionallyOftenVery Often    14. Is “on the go” or often acts as if “driven by a motor”  

Please SelectNeverOccasionallyOftenVery Often    15. Talks excessively  

Please SelectNeverOccasionallyOftenVery Often    16. Blurts out answers before questions have been completed  

Please SelectNeverOccasionallyOftenVery Often    17. Has difficulty waiting in line  

Please SelectNeverOccasionallyOftenVery Often    18. Interrupts or intrudes on others (e.g., butts into conversations/games)  

Please SelectNeverOccasionallyOftenVery Often    19. Loses temper  

Please SelectNeverOccasionallyOftenVery Often    20. Actively defies or refuses to comply with adults’ requests or rules  

Please SelectNeverOccasionallyOftenVery Often    21. Is angry or resentful  

Please SelectNeverOccasionallyOftenVery Often    22. Is spiteful and vindictive  

Please SelectNeverOccasionallyOftenVery Often    23. Bullies, threatens or intimidates others  

Please SelectNeverOccasionallyOftenVery Often    24. Initiates physical fights  

Please SelectNeverOccasionallyOftenVery Often    25. Lies to obtain goods for favors or to avoid obligations (e.g., “cons” others)  

Please SelectNeverOccasionallyOftenVery Often    26. Is physically cruel to people  

Please SelectNeverOccasionallyOftenVery Often    27. Has stolen items of nontrivial value  

Please SelectNeverOccasionallyOftenVery Often    28. Deliberately destroys others’ property  

Please SelectNeverOccasionallyOftenVery Often    29. Is fearful, anxious or worried  

Please SelectNeverOccasionallyOftenVery Often    30. Is self-conscious or easily embarrassed  

Please SelectNeverOccasionallyOftenVery Often    31. Is afraid to try new things for fear of making mistakes  

Please SelectNeverOccasionallyOftenVery Often    32. Feels worthless or inferior  

Please SelectNeverOccasionallyOftenVery Often    33. Blames self for problems; feels guilty  

Please SelectNeverOccasionallyOftenVery Often    34. Feels lonely, unwanted or unloved; complains that “no one loves him or her”  

Please SelectNeverOccasionallyOftenVery Often    35. Is sad, unhappy or depressed  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    36. Reading  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    37. Mathematics  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    38. Written expression  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    39. Relationship with peers  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    40. Following directions  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    41. Disrupting class  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    42. Assignment completion  

Please SelectExcellentAbove AverageAverageSomewhat of a ProblemProblematic    43. Organizational skills  

The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

Copyright ©2002 American Academy of Pediatrics and National Initiative for Children’s Healthcare Quality
Adapted from the Vanderbilt Rating Scales developed by Mark L.Wolraich, MD.  Revised - 0303