The NICHQ Vanderbilt Assessment Scales are ADHD rating forms that a parent and a teacher fill in for children 6 to 12. They count symptoms in two domains, inattention and hyperactivity-impulsivity, rate how the child is doing at school and at home, and screen for conditions that often come with ADHD. See how to score the parent and teacher forms, what six of nine means, and how the follow-up forms track treatment, then record the result with the free template.
Vanderbilt result template
FreeVANDERBILT ADHD RATINGS Date of review: [Date] Child: [Name or ID; age and school grade] Reason: [First ADHD evaluation, medication follow-up, or a concern raised by school or family] Edition: [First edition 2002 or third edition 2019; initial or follow-up forms] WHO COMPLETED WHICH FORM Parent form: [Who filled it in, their relationship to the child, and the date returned] Teacher form: [Teacher's name and subject, and how many weeks or months they have known the child] Other raters: [Second parent, another teacher, a coach, or none] Medication during the rating period: [On medication, off medication, or not sure, for each form] SYMPTOM COUNTS Inattentive: [Parent count of 9 and teacher count of 9, items rated often or very often] Hyperactive-impulsive: [Parent count of 9 and teacher count of 9] Tracking figures: [Mean rating 0 to 3 for each domain on each form, or total symptom score 0 to 54] PERFORMANCE Parent ratings at 4 or 5: [Which areas: schoolwork, reading, writing, math, family, friends, activities; or none] Teacher ratings at 4 or 5: [Which areas: reading, writing, math, classroom behavior, peers; or none] Impairment: [Rule met or not met, on which form] CO-OCCURRING SCREENS Oppositional and conduct: [Positive or negative on each form] Anxiety and depression: [Positive or negative on each form] Learning: [Any teacher academic rating of 5, or none] SIDE EFFECTS Reported: [Follow-up forms only: each side effect and its severity, or none] Growth and vitals: [Weight, height, heart rate, blood pressure, and change since the last visit] PARENT AND TEACHER AGREEMENT Agree on: [Domains and behaviors both raters report] Differ on: [Where the forms differ and the likely reason, such as structure at school or homework at home] IMPRESSION Criteria: [Inattentive, hyperactive-impulsive, or combined presentation met; or not met] History: [Symptoms before age 12, settings, impairment, and other causes considered] PLAN Treatment: [Medication and dose, parent training, behavior plan, or watch and repeat] School: [Classroom supports, learning assessment, or education plan requested] Next forms: [When the parent and teacher follow-up forms are due] Clinician: [Name, credentials]
Use it for
A parent and a teacher each fill in the initial form on their own, on the official edition. The parent rates the past six months; the teacher rates what they have seen in class.
Avoid: Letting the parent fill in the teacher form, or skipping it. A second setting is part of the diagnosis.
On each form, count the inattentive items rated often or very often, then the hyperactive-impulsive items. Six of nine in a domain meets the count.
Avoid: Adding the 18 ratings and reading the total as a result. The total and the means track change; they don’t decide criteria.
The performance ratings show whether the symptoms cause problems. Without impairment, a symptom count doesn’t meet criteria.
Avoid: Calling it ADHD on six of nine when every performance rating is 3 or better.
The initial forms also screen for oppositional, conduct, and anxiety or depression symptoms, and the third edition teacher form for learning problems. A positive screen calls for a closer look.
Avoid: Treating a positive screen as a second diagnosis. It needs its own assessment.
The diagnosis needs symptoms in two or more settings. The two forms put home and school side by side.
Avoid: Averaging the two forms into one count. Each form is one setting.
The follow-up forms track the core symptoms, performance, and side effects after treatment starts or changes.
Avoid: Comparing a teacher’s follow-up with the parent’s baseline. Track each rater against their own first form.
Each one follows the recording template. Use them to judge how much to write.
Pediatric practice, ADHD evaluation visit, parent and teacher initial forms returned the week before
8-year-old girl in grade 3. Third edition initial forms. Parent form from her mother. Teacher form from her homeroom teacher, who has taught her for 10 weeks. No medication during either rating period.
Inattentive: mother 7 of 9, teacher 7 of 9. Hyperactive-impulsive: mother 2 of 9, teacher 1 of 9. Inattentive means 2.1 on the parent form and 2.2 on the teacher form.
Teacher: reading rated 5, writing and organization 4; behavior in class and with peers 2. Mother: schoolwork and reading 4; family life and friendships 3. Impairment rule met on both forms.
Oppositional, conduct, and anxiety and depression screens negative on both forms. The teacher’s reading rating of 5 flags a possible learning problem.
Both describe the same child: she drifts off during instructions, loses her things, and rarely finishes work on her own, with little restlessness. Her mother adds that homework takes 2 hours with reminders at every step. Report cards since grade 1 mention daydreaming and unfinished work.
Inattentive presentation met on both forms, with impairment at home and at school and symptoms since grade 1. Hearing and vision normal at her spring checkup; sleeps 10 hours without snoring. No anxiety or low mood in the interview. Impression: ADHD, predominantly inattentive presentation. Her reading problems may be more than inattention, so a reading assessment is requested.
Options discussed with her mother and with her; they chose medication alongside school supports. Methylphenidate extended-release 18 mg each morning. No fainting, chest pain with exercise, or family history of sudden death; heart rate 88, blood pressure 98/62, weight 26 kg, height 128 cm. Letter to the school asking for a reading assessment and classroom supports: written instructions, a seat near the teacher, and work in short parts. Parent training program details given. Follow-up forms from her mother and teacher in 4 weeks, then a visit to review the dose.
Pediatric practice, follow-up visit 6 weeks after starting lisdexamfetamine, parent and teacher follow-up forms
10-year-old boy in grade 5, combined presentation diagnosed in the spring. Third edition follow-up forms from his father and his main classroom teacher, both rated while on medication. Lisdexamfetamine 30 mg each morning for 6 weeks.
Inattentive: father 3 of 9, teacher 2 of 9, down from 8 and 7 at baseline. Hyperactive-impulsive: father 2 of 9, teacher 1 of 9, down from 7 and 8. Teacher’s means: inattentive 2.4 to 1.0, hyperactive-impulsive 2.6 to 0.8.
Teacher: no ratings of 4 or 5, where math and organization were both 4 at baseline. Father: schoolwork 3, down from 5; family life and friendships 2.
Father rates loss of appetite as moderate: he eats little at lunch, and his teacher says most of it comes home. Trouble falling asleep, mild in the first week, has settled. No headaches, stomachaches, tics, or late-day irritability. Weight 31.2 kg, down 1.2 kg since starting; height 140 cm. Heart rate 94, blood pressure 104/66.
Both report clear gains: he finishes classwork, waits his turn, and the calls home from school have stopped. His father sees symptoms return after about 6 p.m., during homework.
ADHD, combined presentation. Neither domain meets the symptom count on either form now: a good response to lisdexamfetamine 30 mg, with appetite loss and a 1.2 kg weight loss in 6 weeks.
Keep 30 mg, taken with a full breakfast before school. High-calorie snack after school and a later evening meal; homework moved earlier in the afternoon. Weight check in 4 weeks; if it’s still falling, discuss a lower dose or another medicine. Follow-up forms from his father and teacher before the next visit in 3 months.
The Vanderbilt has no total that diagnoses. Count the items rated often or very often in each domain, on each form.
Seven of nine inattentive items with no performance rating at 4 or 5 doesn’t meet criteria. Record the performance ratings every time.
One form is one setting. Get the teacher’s form, or another adult’s outside the home, before diagnosing.
The 2002 and 2019 editions use different impairment rules. Score with the rules of the edition you gave, and say which it was.
A fall in symptoms is half the result. Record appetite, sleep, mood, and weight with it.
Vero Scribe records the Vanderbilt result in your template from the visit, with the family’s consent, or from your dictation: the counts on each form, the performance ratings, the side effects, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Count, don’t add. On each form, count the inattentive items rated 2 or 3, often or very often, then the hyperactive-impulsive items. Six or more of nine in a domain meets the symptom count. Then check the performance ratings: in the third edition, a 4 on at least two items or a 5 on at least one shows impairment. Score the parent and teacher forms separately.
There’s no single score. A form supports ADHD when six or more of the nine items in a domain are rated often or very often and the performance ratings show impairment. Inattention alone points to the predominantly inattentive presentation, hyperactivity-impulsivity alone to the hyperactive-impulsive presentation, and both to combined. The diagnosis also needs symptoms in two settings, starting before age 12, and other causes ruled out.
Both carry the same 18 core ADHD symptoms and a set of performance ratings. The parent form rates the past six months and screens oppositional behavior, conduct problems, and anxiety and depression separately. The teacher form rates the classroom, screens oppositional and conduct behavior together, and in the third edition flags possible learning problems from the academic ratings. You need both: the diagnosis needs symptoms in more than one setting.
A shorter form that parents and teachers fill in once treatment starts. It has the 18 core symptoms, the performance ratings, and a side effect checklist rated by severity, without the co-occurring screens. Compare each domain’s count and mean with that rater’s baseline, and record side effects such as poor appetite or trouble sleeping.
It was validated in children 6 to 12. Because it follows DSM-5 criteria rather than age norms, the third edition’s instructions say it can also help gather information for preschoolers and teenagers. From age 17, DSM-5 needs five symptoms in a domain rather than six.
The Vanderbilt counts DSM-5 symptoms, and its first edition is free to download. The Conners rating scales are sold by their publisher and compare a child with others of the same age and sex, as T-scores. For adults, clinicians use self-report screens such as the ASRS instead.
Parents and teachers fill in the forms, and anyone in the care team can hand them out or send them. A clinician scores and reads them, and the diagnosis comes from a clinician’s assessment, such as by a pediatrician, family physician, psychiatrist, or psychologist.
NICHQ posts the 2002 first edition as a free download and asks that publications citing it credit NICHQ. The current third edition is part of the AAP’s ADHD toolkit, sold by the AAP, and building it into an electronic record needs an institutional license. The scales are copyrighted by the AAP and NICHQ, so get the forms from those sources. 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.
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 26-item parent and teacher rating of ADHD and oppositional symptoms, scored as subscale averages from 0 to 3.
A 41-item child and parent anxiety screen for ages 8 to 18: total 0 to 82, cutoff 25, with five subscales.
For younger children: milestones, ASQ-3 and M-CHAT-R/F results, and referrals.
The checkup where school concerns often first come up, with growth and development.
What a diagnosis needs beyond the forms: onset, settings, and impairment.
Pediatric visit notes drafted from the visit, for your review.
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.
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