Vanderbilt Follow-up - Teacher

  • Vanderbilt Assessment Follow-Up – Teacher Version

  • Today's Date:*
     - -

  • 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 last assessment scale was filled out.

  • Is this evaluation based on a time the child*

  • Part 1: Symptoms (Questions 1–18)

    Rating Scale:

    Never = 0
    Occasionally = 1
    Often = 2
    Very Often = 3

  • 1. Fails to give close attention to details or makes careless mistakes in schoolwork*
  • 2. Has difficulty sustaining attention to tasks or activities*
  • 3. Does not seem to listen when spoken to directly*
  • 4. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand)*
  • 5. Has difficulty organizing tasks and activities*
  • 6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort*
  • 7. Loses things necessary for tasks or activities (e.g., pencils, books, tools)*
  • 8. Is easily distracted by extraneous stimuli*
  • 9. Is forgetful in daily activities*
  • 10. Fidgets with hands or feet or squirms in seat*
  • 11. Leaves seat in classroom or in other situations in which remaining seated is expected*
  • 12. Runs about or climbs excessively in situations where it is inappropriate*
  • 13. Has difficulty playing or engaging in leisure activities quietly*
  • 14. Is “on the go” or often acts as if “driven by a motor”*
  • 15. Talks excessively*
  • 16. Blurts out answers before questions have been completed*
  • 17. Has difficulty waiting for his or her turn*
  • 18. Interrupts or intrudes on others (e.g., butts into conversations or games)*

  • Section 2: Performance – Items 19–26

    Rating Scale:

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

  • 19. Reading*
  • 20. Mathematics*
  • 21. Written expression*
  • 22. Relationship with peers*
  • 23. Following directions/rules*
  • 24. Disrupting class*
  • 25. Assignment completion*
  • 26. Organizational skills*

  • Side Effects: Has the child experienced any of the following side effects or problems in the past week?

  • Headache*
  • Stomachache*
  • Change in appetite (explain below)*
  • Trouble sleeping*
  • Irritability in the late morning, late afternoon, or evening (explain below)*
  • Socially withdrawn - decreased interaction with others*
  • Extreme sadness or unusual crying*
  • Dull, tired, listless behavior*
  • Tremors/feeling shaky*
  • Repetitive movements, tics, jerking, twitching, eye blinking (explain below)*
  • Picking at skin or fingers, nail biting, lip or cheek chewing (explain below)*
  • Sees or hears things that aren’t there*
  • Should be Empty: