Vanderbilt Teacher Rating Scale

1
Today's Date:* This field is required.
Date
Month
Day
Year
2
Child's Name:* This field is required.
3
Child's Date of Birth:* This field is required.
Date
Month
Day
Year
4
Teacher's Name:* This field is required.
5
Subjects taught by the teacher:* This field is required.
6
At what time of day do you typically teach these subjects? Check ALL that apply:* This field is required.
Early morning
Late morning
Early afternoon
Late afternoon
Other
7
Is this evaluation based on a time when the child:* This field is required.
was on medication
was not on medication
not sure
8
Interpretation of average scores below

Average Score Interpretation

0 Never

1 Occasionally

2 Often

3 Very often
9
Average Score on Inattentive Subtype Questions (Items 1-9)
10
Average Score on Hyperactive/Impulsive Subtype Questions (Items 10-18)
11
Average Score on Oppositional-Defiant/Conduct Disorder Questions (Items 19-28)
12
Average Score on Anxiety/Depression Questions (Items 29-35)
13
Interpretation of performance scores below

Average Score Interpretation

1 Excellent

2 Above Average

3 Average

4 Somewhat of a Problem

5 Problematic
14
Average Score on Performance Questions (Items 36-43):
15
DIRECTIONS: In the next 35 items, please select the option that best reflects how often you've observed each symptom or behavior in the child over the past month.
16
1. Fails to give attention to details or makes careless mistakes in schoolwork.* This field is required.
Never
Occasionally
Often
Very Often
17
2. Has difficulty sustaining attention to tasks or activities.* This field is required.
Never
Occasionally
Often
Very Often
18
3. Does not seem to listen when spoken to directly.* This field is required.
Never
Occasionally
Often
Very Often
19
4. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand).* This field is required.
Never
Occasionally
Often
Very Often
20
5. Has difficulty organizing tasks and activities.* This field is required.
Never
Occasionally
Often
Very Often
21
6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.* This field is required.
Never
Occasionally
Often
Very Often
22
7. Loses things necessary for tasks or activities (school assignments, pencils, or books).* This field is required.
Never
Occasionally
Often
Very Often
23
8. Is easily distracted by extraneous stimuli.* This field is required.
Never
Occasionally
Often
Very Often
24
9. Is forgetful in daily activities.* This field is required.
Never
Occasionally
Often
Very Often
25
10. Fidgets with hands or feet or squirms in seat.* This field is required.
Never
Occasionally
Often
Very Often
26
11. Leaves seat in classroom or in other situations in which remaining seated is expected.* This field is required.
Never
Occasionally
Often
Very Often
27
12. Runs about or climbs excessively in situations in which remaining seated is expected.* This field is required.
Never
Occasionally
Often
Very Often
28
13. Has difficulty playing or engaging in leisure activities quietly.* This field is required.
Never
Occasionally
Often
Very Often
29
14. Is “on the go” or often acts as if “driven by a motor”.* This field is required.
Never
Occasionally
Often
Very Often
30
15. Talks excessively.* This field is required.
Never
Occasionally
Often
Very Often
31
16. Blurts out answers before questions have been completed.* This field is required.
Never
Occasionally
Often
Very Often
32
17. Has difficulty waiting in line.* This field is required.
Never
Occasionally
Often
Very Often
33
18. Interrupts or intrudes on others (eg, butts into conversations/games).* This field is required.
Never
Occasionally
Often
Very Often
34
19. Loses temper.* This field is required.
Never
Occasionally
Often
Very Often
35
20. Actively defies or refuses to comply with adult’s requests or rules.* This field is required.
Never
Occasionally
Often
Very Often
36
21. Is angry or resentful.* This field is required.
Never
Occasionally
Often
Very Often
37
22. Is spiteful and vindictive.* This field is required.
Never
Occasionally
Often
Very Often
38
23. Bullies, threatens, or intimidates others.* This field is required.
Never
Occasionally
Often
Very Often
39
24. Initiates physical fights.* This field is required.
Never
Occasionally
Often
Very Often
40
25. Lies to obtain goods for favors or to avoid obligations (eg, “cons” others).* This field is required.
Never
Occasionally
Often
Very Often
41
26. Is physically cruel to people.* This field is required.
Never
Occasionally
Often
Very Often
42
27. Has stolen items of nontrivial value.* This field is required.
Never
Occasionally
Often
Very Often
43
28. Deliberately destroys others’ property.* This field is required.
Never
Occasionally
Often
Very Often
44
29. Is fearful, anxious, or worried.* This field is required.
Never
Occasionally
Often
Very Often
45
30. Is self-conscious or easily embarrassed.* This field is required.
Never
Occasionally
Often
Very Often
46
31. Is afraid to try new things for fear of making mistakes.* This field is required.
Never
Occasionally
Often
Very Often
47
32. Feels worthless or inferior.* This field is required.
Never
Occasionally
Often
Very Often
48
33. Blames self for problems; feels guilty.* This field is required.
Never
Occasionally
Often
Very Often
49
34. Feels lonely, unwanted, or unloved; complains that “no one loves him or her”.* This field is required.
Never
Occasionally
Often
Very Often
50
35. Is sad, unhappy, or depressed.* This field is required.
Never
Occasionally
Often
Very Often
51
DIRECTONS: In the next 3 items, please rate child's academic performance.
52
36. Reading
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
53
37. Mathematics
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
54
38. Written expression
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
55
DIRECTONS: In the next 5 items, please rate child's behavior, relationships & organization skills in school & classroom setting.
56
39. Relationship with peers
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
57
40. Following directions
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
58
41. Disrupting class
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
59
42. Assignment completion
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
60
43. Organizational skills
Excellent
Above Average
Average
Somewhat of a Problem
Problematic
61
Additional CommentsUse this space to provide any further comments that may be relevant to the child's behavior, academic performance, emotional health or psychological well-being. Your insights are invaluable and will help us offer the best possible care and support for the child.
Should be Empty:

Average Score	Interpretation
0	Never
1	Occasionally
2	Often
3	Very often

Average Score	Interpretation
1	Excellent
2	Above Average
3	Average
4	Somewhat of a Problem
5	Problematic