The SNAP-IV-26 is a rating scale that a parent or a teacher fills in about a child: nine items on inattention, nine on hyperactivity-impulsivity, and eight on oppositional behavior. Each item is rated from 0 to 3, and each subscale is scored as its average rating, from 0 to 3. See how to work out the averages, which cutoffs apply to parents and which to teachers, and how to track treatment, then record the result with the free template.
SNAP-IV result template
FreeSNAP-IV-26 RATINGS Date reviewed: [Date] Child: [Name or ID, age, school grade] Why rated: [New attention or behavior concern, ADHD assessment, or treatment check] Rating window: [The period raters were asked to describe, such as the past month] RATERS Parent or caregiver: [Name, relationship to the child, date completed] Teacher: [Name, class or subject, how long they have taught the child] Treatment during the window: [Medicine and dose for each rater's window, or none] SUBSCALE AVERAGES Inattention, items 1 to 9: [Parent average and teacher average, 0 to 3; band for each] Hyperactivity-impulsivity, items 10 to 18: [Parent and teacher averages; band for each] Combined ADHD, items 1 to 18: [Parent and teacher averages] Oppositional, items 19 to 26: [Parent and teacher averages; band for each] Rater cutoffs reached: [Which averages reach the parent or teacher cutoff for that subscale, or none] ITEMS RATED 2 OR 3 Inattention: [Parent count out of 9, teacher count out of 9] Hyperactivity-impulsivity: [Parent count out of 9, teacher count out of 9] Oppositional: [Parent count out of 8, teacher count out of 8] Blank items: [Item numbers left blank and whether they were asked, or none] HOME AND SCHOOL COMPARED Where the raters match: [Subscales and behaviors both describe] Where they split: [Subscales that differ by half a point or more, and the likely reason] CHANGE SINCE LAST RATING Earlier averages: [Date, rater, and each subscale average, or first rating] Change: [Rise or fall in each subscale, each rater against their own earlier form] IMPRESSION Rating pattern: [Inattentive, hyperactive-impulsive, combined, oppositional, or below threshold] Clinical summary: [Onset, settings, impairment, and other explanations weighed] PLAN Next step: [Full ADHD assessment, start or adjust treatment, school supports, or rate again] Next ratings due: [Which raters, and when] Clinician: [Name, credentials]
Use it for
The same form goes to a parent and to a teacher, and each fills in their own copy. They rate how well each behavior describes the child, from not at all to very much.
Avoid: Sending both copies home for the parent to fill in. Each rater stands for a setting, and the teacher’s view of the classroom is the point of the second form.
Add each subscale’s ratings and divide by its number of items: 9 for inattention, 9 for hyperactivity-impulsivity, and 8 for oppositional behavior.
Avoid: Adding all 26 ratings into one total. The subscales measure different things, and a grand total has no cutoff.
Read each average against the band, then against the cutoff for that rater and that subscale.
Avoid: Reading a teacher’s average against the parent cutoff. A teacher inattention average of 2.0 is over the parent cutoff but well under the teacher’s.
A rating of quite a bit or very much counts as the symptom being present, which sets the form beside the DSM-5 symptom counts.
Avoid: Treating six of nine as a diagnosis. DSM-5 also needs impairment, onset before age 12, two settings, and other causes ruled out.
Parents and teachers often rate the same child differently. Where they differ is part of the result.
Avoid: Averaging the two raters into one figure for diagnosis. Each form is one setting.
Repeat the form with the same raters and the same window after treatment starts or changes. The averages show small changes well.
Avoid: Setting a new teacher’s ratings against last year’s teacher without saying so. A change of rater can move the average on its own.
Each one follows the recording template. Use them to judge how much to write.
Family practice, visit to review forms sent home and to school after his teacher raised concerns at a parent-teacher meeting
9-year-old boy in grade 4. Ratings from his father and from his homeroom teacher, who has taught him since September. Both asked to describe the past month. No medicines.
Inattention: father 2.22, teacher 2.33, both moderate. Hyperactivity-impulsivity: father 1.00, teacher 0.89, both not clinically significant. Combined: 1.61 on both forms. Oppositional: father 0.75, teacher 0.25. The father’s inattention average is above the parent cutoff of 1.78; the teacher’s is below the teacher cutoff of 2.56.
Inattention: father 7 of 9, teacher 8 of 9. Hyperactivity-impulsivity: father 1, teacher 0. Oppositional: 0 on both. No blank items.
Close agreement. Both describe a quiet boy who loses track halfway through instructions, leaves worksheets unfinished, and forgets what to bring home. His teacher sees careless errors in math that he can fix when she points them out. His father says a page of homework takes an hour with him sitting beside him.
Inattentive pattern on both forms, with few hyperactive or oppositional symptoms. Report cards from grades 2 and 3 mention daydreaming and work left unfinished. He worries before tests, so anxiety needs a closer look. Hearing and vision normal at his check-up in the spring; sleeps about 10 hours and doesn’t snore.
Full ADHD assessment booked for a longer visit in 2 weeks: DSM-5 interview with both parents and with him, developmental and school history, and an anxiety screen. Asked the school whether a learning assessment for math is possible. No treatment started today.
Pediatric clinic, review 8 weeks after starting mixed amphetamine salts extended-release, both forms returned before the visit
11-year-old girl in grade 6 with ADHD, combined presentation, diagnosed in August. Ratings from her mother and her main classroom teacher, both describing the past 4 weeks. Mixed amphetamine salts extended-release 10 mg for 4 weeks, then 15 mg for the last 4.
Inattention: mother 1.22, teacher 1.11. Hyperactivity-impulsivity: mother 1.00, teacher 0.78. Oppositional: mother 1.00, teacher 0.38. All in the not clinically significant band except the mother’s oppositional average, at the bottom of the mild band. Combined: mother 1.11, teacher 0.94.
Inattention: mother 2 of 9, teacher 1 of 9. Hyperactivity-impulsivity: mother 1, teacher 0. Oppositional: mother 1 of 8, teacher 0.
September 8 baseline, before medicine: inattention mother 2.33, teacher 2.67; hyperactivity-impulsivity mother 2.11, teacher 2.22; oppositional mother 1.63, teacher 0.88. Inattention has fallen by 1.11 on her mother’s form and 1.56 on her teacher’s. Across both raters and all 26 items the average is now 0.92, under the “just a little” level.
Her teacher says she now starts work without reminders and has stopped calling out in class. Her mother agrees about mornings but says arguments over homework after 5 p.m. remain, which fits the medicine wearing off.
Good response to 15 mg, with ratings back in range at school and mostly at home. Lunch appetite lower; weight 36.4 kg, down 0.4 kg. Sleep unchanged. Heart rate 90, blood pressure 102/64.
Continue 15 mg with breakfast. Homework moved to straight after school, with a snack. Parent training group details given for the evening arguments. Weight check in 6 weeks. Both forms again in 3 months, describing the same 4-week window.
Parents and teachers have different cutoffs. An inattention average of 2.0 is over the parent cutoff of 1.78 but under the teacher cutoff of 2.56.
The SNAP-IV is scored as an average for each subscale. A total of all 26 ratings mixes ADHD and oppositional items and means nothing on its own.
High averages show a pattern of symptoms. The diagnosis needs the history, impairment, onset before 12, and symptoms in two settings.
Items 19 to 26 often explain the conflict at home and change the plan. Score them on every form.
Ratings on medicine differ from ratings off it. Write down the time window and the treatment for each form.
Vero Scribe records the SNAP-IV result in your template from the visit, with the family’s consent, or from your dictation: each rater’s subscale averages, the item counts, how home and school compare, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Each item is rated 0 for not at all, 1 for just a little, 2 for quite a bit, and 3 for very much. Add the ratings in each subscale and divide by its number of items: items 1 to 9 for inattention, 10 to 18 for hyperactivity-impulsivity, and 19 to 26 for oppositional behavior. Each average runs from 0 to 3. Score the parent and teacher forms separately.
No single score does. Swanson’s tentative cutoffs for the inattention average are 1.78 for parents and 2.56 for teachers; for hyperactivity-impulsivity, 1.44 and 1.78; for the combined 18 items, 1.67 and 2.00. The scoring guide that comes with the 26-item form bands each ADHD subscale total as under 13 of 27 not clinically significant, 13 to 17 mild, 18 to 22 moderate, and 23 to 27 severe. A high result supports a full ADHD assessment; the diagnosis comes from the clinician.
Each cutoff marks roughly the top 5% of ratings from that kind of rater, and parents and teachers rate differently. Teachers need a higher inattention average to reach the cutoff, 2.56 against 1.78, while for oppositional behavior the teacher cutoff is lower, 1.38 against 1.88. Read each form against its own rater’s cutoff.
Both rate the 18 DSM ADHD symptoms on parent and teacher forms. The SNAP-IV-26 uses one form for both raters, scores each subscale as an average, and carries the same eight oppositional items for each rater. The Vanderbilt counts symptoms rated often or very often, adds performance ratings that show impairment, and screens for anxiety, depression, and conduct problems. The SNAP-IV’s averages make small changes easy to see at medication reviews; the Vanderbilt’s performance items help show impairment at a first evaluation.
The full SNAP-IV-C has 90 items: the ADHD and oppositional items, items taken from older Conners scales, items on conditions that overlap with or mimic ADHD, and 10 classroom items from the SKAMP scale. The 26-item version keeps the 18 ADHD and 8 oppositional items, and the 18-item version keeps only the ADHD items. All three score the ADHD subscales the same way.
It’s used for school-age children and teenagers, roughly 6 to 18. A 2008 school-district study published parent and teacher norms for children from kindergarten to grade 5, so the norms are firmest for younger school-age children.
Ask the same parent and teacher to rate the same window at baseline and after each change, and compare each subscale average with that rater’s baseline. The suggested targets are under 13 of 27 on each ADHD subscale, an average below 1.44, and under 8 of 24 on oppositional, below 1.00. In the MTA study, an average at the “just a little” level across parent and teacher ratings marked a successful outcome.
A parent or caregiver and a teacher fill in the form, and anyone in the care team can hand it out. A clinician scores and reads it, and the diagnosis comes from a clinician’s assessment, such as by a pediatrician, family physician, psychiatrist, or psychologist.
Yes, it’s free to use in practice. Dr. Swanson posted the form and its scoring instructions free online, and CADDRA posts the 26-item form as a free printable PDF, linked from this page. No licence for building it into other products is published, so this page doesn’t reproduce the items. The recording template on this page is free to copy or download.
A 20-question parent checklist that screens toddlers for autism from 16 to 30 months, scored 0 to 20, with a Follow-Up interview.
Parent and teacher ADHD rating forms for ages 6 to 12: six of nine symptoms in a domain, with impaired performance, meets the count.
The PHQ-9 modified for teens 11 to 17: nine symptoms scored 0 to 27, plus a past-year question and two suicide questions.
A 41-item child and parent anxiety screen for ages 8 to 18: total 0 to 82, cutoff 25, with five subscales.
For classroom supports once the assessment points to ADHD.
For younger children: milestones by domain, screening results, and referrals.
Notes for well visits, ADHD reviews, and school concerns, drafted from the visit.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
No credit card required. 10 free actions every month.