Vanderbilt Screening for Teacher

ADD/ADHD Vanderbilt Screening—TEACHER Informant

Instruction: 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 Name

First Name

Last Name

Symptoms

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

1) Fails to give attention to details or makes careless mistakes in schoolwork

Never Very often

2) Has difficulty sustaining attention to tasks or activities

Never Very often

3) Does not seem to listen when spoken to directly

Never Very often

4) Does not follow through when given directions and fails to finish activities (not due to refusal or failure to understand)

Never Very often

5) Has difficulty organizing tasks and activities

Never Very often

6) Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort

Never Very often

7) Loses things necessary for tasks or activities (school assignments, pencils, or books)

Never Very often

8) Is easily distracted by noises or other stimuli

Never Very often

9) Is forgetful in daily activities

Never Very often

10) Fidgets with hands or feet or squirms in seat

Never Very often

11) Leaves seat in classroom or in other situations in which remaining seated is expected

Never Very often

12) Runs about or climbs excessively in situations in which remaining seated is expected

Never Very often

13) Has difficulty playing or engaging in leisure activities quietly

Never Very often

14) Is “on the go” or often acts as if “driven by a motor”

Never Very often

15) Talks excessively

Never Very often

16) Blurts out answers before questions have been completed

Never Very often

17) Has difficulty waiting in line

Never Very often

18) Interrupts or intrudes on others (eg, butts into conversations/games)

Never Very often

19) Loses temper

Never Very often

20) Actively defies or refuses to comply with adult’s requests or rules

Never Very often

21) Is angry or resentful

Never Very often

22) Is spiteful and vindictive

Never Very often

23) Bullies, threatens, or intimidates others

Never Very often

24) Initiates physical fights

Never Very often

25) Lies to obtain goods for favors or to avoid obligations (eg, “cons” others)

Never Very often

26) Is physically cruel to people

Never Very often

27) Has stolen items of nontrivial value

Never Very often

28) Deliberately destroys others’ property

Never Very often

29) Is fearful, anxious, or worried

Never Very often

30) Is self-conscious or easily embarrassed

Never Very often

31) Is afraid to try new things for fear of making mistakes

Never Very often

32) Feels worthless or inferior

Never Very often

33) Blames self for problems; feels guilty

Never Very often

34) Feels lonely, unwanted, or unloved; complains that “no one loves him or her”

Never Very often

35) Is sad, unhappy, or depressed

Never Very often

Academic Performance

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

Classroom Behavioral Performance

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

Vanderbilt Screening for Teachers

ADD/ADHD Vanderbilt Screening—TEACHER Informant

Symptoms

Academic Performance

Classroom Behavioral Performance

Sometimes, it is not just a phase…