Vanderbilt ADHD Teacher Rating Scale (Initial)
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.
Child's Name
*
First Name
Last Name
Teacher's Name
*
First Name
Last Name
Today's Date
*
-
Month
-
Day
Year
Date
School:
*
Grade Level/Subject:
*
Class Time:
*
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
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Behavior:
Fails to give attention to details or makes careless mistakes in schoolwork.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Has difficulty sustaining attention to tasks or activities.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Dos not seem to listen when spoken to directly.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Doe not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand).
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Has difficulty organizing tasks and activities.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Loses things necessary for tasks or activities (school assignments, pencils, books).
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is easily distracted by extraneous stimuli.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is forgetful in daily activities.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
fidgets with hands and feet or squirms in seat.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Leaves seat in classroom or in other situations in which remaining seated is expected.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Runs about or climbs excessively in situations in which remaining seated is expected.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Has difficulty playing or engaging in leisure activities quietly.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is "on the go" or often acts as if "driven by a motor".
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Talks excessively.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Blurts out answers before questions have been completed.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Has difficulty waiting in line.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Interrupts or intrudes in on others (e.g., butts into conversations or games).
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Loses temper.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Actively defies or refuses to comply with adult's requests or rules.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is angry or resentful.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is spiteful and vindictive.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Bullies, threatens, or intimidates others.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Initiates physical fights.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Lies to obtain goods for favors or to avoid obligations (i.e., "cons" others)
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is physically cruel to people.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Has stolen items of nontrivial value.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Deliberately destroys others' property.
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is fearful, anxious, or worried
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is self-conscious or easily embarrassed
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is afraid to try new things for fear of making mistakes
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Feels worthless or inferior
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Blames self for problems; feels guilty
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Feels lonely, unwanted, or unloved; complains hat "no one loves him or her"
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
Is sad, unhappy, or depressed
*
Never (0)
Occasionally (1)
Often (2)
Very Often (3)
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Academic & Social Performance
Reading
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Mathematics
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Written expression
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Relationship with peers
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Following directions
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Disrupting class
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Assignment completion
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
Organizational skills
*
Excellent (1)
Above Average (2)
Average (3)
Somewhat of a problem (4)
Problematic (5)
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Symptom
Has the child experienced any of the following side effects or problems in the past week?
Headache
*
None
Mild
Moderate
Severe
Stomachache
*
None
Mild
Moderate
Severe
Change of appetite - explain below
*
None
Mild
Moderate
Severe
Explain question above if applicable.
Trouble sleeping
*
None
Mild
Moderate
Severe
Irritability in the late morning, late afternoon, or evening
*
None
Mild
Moderate
Severe
Explain question above if applicable.
Socially withdrawn - decreased interaction with others
*
None
Mild
Moderate
Severe
Extreme sadness or unusual crying
*
None
Mild
Moderate
Severe
Dull, tired, listless behavior
*
None
Mild
Moderate
Severe
Tremors/feeling shaky
*
None
Mild
Moderate
Severe
Repetitive movements, tics, jerking, twitching, eye blinking - explain below
*
None
Mild
Moderate
Severe
Explain question above if applicable.
Picking at skin or fingers, nail biting, lip or cheek chewing - explain below
*
None
Mild
Moderate
Severe
Explain question above if applicable.
Sees or hears things that aren't there
*
None
Mild
Moderate
Severe
Explain/Comments:
Submit
Should be Empty: