Upload File

nichq vanderbilt assessment scale: teacher informant

  • Home
  • Documents
  • NICHQ Vanderbilt Assessment Scale: Teacher Informant
3
CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION ASSESSMENT AND DIAGNOSIS Page 1 of 3 Symptoms Never Occasionally Often Very Often 1. Fails to give 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 (school assignments, pencils, books) 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 in which remaining seated is expected 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 in line 18. Interrupts or intrudes in on others (eg, butts into conversations/games) NICHQ Vanderbilt Assessment Scale: Teacher Informant Child’s Name: Child’s Date of Birth: Teacher’s Name: Today’s Date: Class Time: Class Name/Period: Grade Level: 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 beginning of the school year. Please indicate the number of weeks or months you have been able to evaluate the behaviors: . For Office Use Only __________/9 For Office Use Only __________/9

Upload: others

Post on 17-Feb-2022

23 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: NICHQ Vanderbilt Assessment Scale: Teacher Informant

CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION

ASSESSMENT AND DIAGNOSIS Page 1 of 3

Symptoms Never Occasionally Often VeryOften

1. Failstogiveattentiontodetailsormakescarelessmistakesinschoolwork

2. Hasdifficultysustainingattentiontotasksoractivities

3. Doesnotseemtolistenwhenspokentodirectly

4. Doesnotfollowthroughoninstructionsandfailstofinishschoolwork (notduetooppositionalbehaviororfailuretounderstand)

5. Hasdifficultyorganizingtasksandactivities

6. Avoids,dislikes,orisreluctanttoengageintasksthatrequiresustained mentaleffort

7. Losesthingsnecessaryfortasksoractivities(schoolassignments, pencils,books)

8. Iseasilydistractedbyextraneousstimuli

9. Isforgetfulindailyactivities

10. Fidgetswithhandsorfeetorsquirmsinseat

11. Leavesseatinclassroomorinothersituationsinwhichremaining seatedisexpected

12. Runsaboutorclimbsexcessivelyinsituationsinwhichremaining seatedisexpected

13. Hasdifficultyplayingorengaginginleisureactivitiesquietly

14. Is“onthego”oroftenactsasif“drivenbyamotor”

15. Talksexcessively

16. Blurtsoutanswersbeforequestionshavebeencompleted

17. Hasdifficultywaitinginline

18. Interruptsorintrudesinonothers(eg,buttsintoconversations/games)

NICHQ Vanderbilt Assessment Scale: Teacher InformantChild’sName:

Child’sDateofBirth:

Teacher’sName:

Today’sDate:

ClassTime:

ClassName/Period:

GradeLevel:

Directions:Eachratingshouldbeconsideredinthecontextofwhatisappropriatefortheageofthechildyouareratingandshouldreflectthatchild’sbehaviorsincethebeginningoftheschoolyear.Pleaseindicatethenumberofweeksormonthsyouhavebeenabletoevaluatethebehaviors:.

ForOfficeUseOnly

__________/9

ForOfficeUseOnly

__________/9

Page 2: NICHQ Vanderbilt Assessment Scale: Teacher Informant

NICHQ Vanderbilt Assessment Scale: Teacher Informant

ASSESSMENT AND DIAGNOSIS Page 2 of 3

Symptoms(continued) Never Occasionally Often VeryOften

19. Losestemper

20. Activitydefiesorrefusestocomplywithadults’requestsorrules

21. Isangryorresentful

22. Isspitefulandvindictive

23. Bullies,threatens,orintimidatesothers

24. Initiatesphysicalfights

25. Liestoobtaingoodsforfavorsortoavoidobligations(eg,“cons”others)

26. Isphysicallycrueltopeople

27. Hasstolenitemsofnontrivialvalue

28. Deliberatelydestroysothers’property

29. Isfearful,anxious,orworried

30. Isself-consciousoreasilyembarrassed

31. Isafraidtotrynewthingsforfearofmakingmistakes

32. Feelsworthlessorinferior

33. Blamesselfforproblems;feelsguilty

34. Feelslonely,unwanted,orunloved;complainsthat“nooneloveshimorher”

35. Issad,unhappy,ordepressed

Somewhat Above ofa AcademicPerformance Excellent Average Average Problem Problematic

36. Reading

37. Mathematics

38. Writtenexpression

Somewhat Above ofa ClassroomBehavioralPerformance Excellent Average Average Problem Problematic

39. Relationshipwithpeers

40. Followingdirections

41. Disruptingclass

42. Assignmentcompletion

43. Organizationalskills

Comments:

Pleasereturnthisformto:

Mailingaddress:

Faxnumber:

ForOfficeUseOnly

__________/10

ForOfficeUseOnly

__________/7

ForOfficeUseOnly

5s:_________/3

ForOfficeUseOnly

4s:_________/3

ForOfficeUseOnly

5s:_________/5

ForOfficeUseOnly

4s:_________/5

Page 3: NICHQ Vanderbilt Assessment Scale: Teacher Informant

NICHQ Vanderbilt Assessment Scale: Teacher Informant

ASSESSMENT AND DIAGNOSIS Page 3 of 3

Therecommendationsinthispublicationdonotindicateanexclusivecourseoftreatmentorserveasastandardofmedicalcare.Variations,takingintoaccountindividualcircumstances,maybeappropriate.OriginaldocumentincludedaspartofCaring for Children With ADHD: A Resource Toolkit for Clinicians, 2ndEdition.Copyright©2012AmericanAcademyofPediatrics.AllRightsReserved.TheAmericanAcademyofPediatricsdoesnotrevieworendorseanymodificationsmadetothisdocumentandinnoeventshalltheAAPbeliableforanysuchchanges.

AdaptedfromtheVanderbiltRatingScalesdevelopedbyMarkL.Wolraich,MD.

ForOfficeUseOnly

Totalnumberofquestionsscored2or3inquestions1––9:_____________

Totalnumberofquestionsscored2or3inquestions10–—18:_____________

Totalnumberofquestionsscored2or3inquestions19–—28:_____________

Totalnumberofquestionsscored2or3inquestions29–—35:_____________

Totalnumberofquestionsscored4inquestions36–—38:_____________

Totalnumberofquestionsscored5inquestions36–—38:_____________

Totalnumberofquestionsscored4inquestions39–—43:_____________

Totalnumberofquestionsscored5inquestions39–—43:_____________


Chess Informant 100

Informant 2006-02

Chess Informant 101

Chess Informant 86

NICHQ Vanderbilt Assessment Follow-up: Teacher Informant · NICHQ Vanderbilt Assessment Follow-up: Teacher Informant MONITORING AND FOLLOW-UP Page 3 of 3 The recommendations in this

NICHQ Vanderbilt Assessment Follow-up: Teacher Informant · 2019-11-06 · NICHQ Vanderbilt Assessment Follow-up: Teacher Informant MONITORING AND FOLLOW-UP Page 2 of 3 Symptoms (continued)

NICHQ Vanderbilt ADHD Primary Care Initial Evaluation Form · 2017-04-11 · NICHQ Vanderbilt ADHD Primary Care Initial Evaluation Form ASSESSMENT AND DIAGNOSIS Page 3 of 3 The recommendations

Informant 2008-11

Chess Informant 10

Auto Informant

Chess Informant 07

Informant 2006-06

SEGUIMIENTO DE LA EVALUACIóN NICHQ VANDERBILT

sistema nichq vanderbilt de evaluación. cuestionario del ...med.stanford.edu/content/dam/sm/ppc/documents/DBP/...Decision support for clinicians page 1 of 4 sistema nichq vanderbilt

Chess Informant 74

seguimiento de la evaluación nichq vanderbilt ...med.stanford.edu/content/dam/sm/ppc/documents/DBP/ADHD_Vand… · Decision support for clinicians page 3 of 3 seguimiento de la evaluación

Chess Informant 70

ADHD Management Plan/Sample 1 · PDF fileD4 NICHQ Vanderbilt Assessment Scale—TEACHER Informant, continued Te acher’s Name: _____ Class Time

LCZH Informant 26

sistema nichq vanderbilt de evaluación. cuestionario para ... Specialized/files...Decision support for clinicians page 2 of 4 sistema nichq vanderbilt de evaluación. cuestionario

Informant 2009-06

Chess Informant 04

Boundless Informant

Chess Informant 08

NICHQ Vanderbilt Assessment Scale—PARENT Informantabout your child’s behaviors since the last assessment scale was filled out when rating his/her behaviors. Is this evaluation

PCPs need teachers to complete the NICHQ Vanderbilt Assessment Scale!

NICHQ Vanderbilt ADHD Primary Care Initial Evaluation Form · PDF fileNICHQ Vanderbilt ADHD Primary Care Initial Evaluation Form ASSESSMENT AND DIAGNOSIS Page 2 of 3 ADHD Diagnostic

Informant Accuracy

storage.googleapis.com · Teacher's Name: Today's Date: NICHQ Vanderbilt Assessment Scale— Class Time: Child's Name: TEACHER Informant Class Name/Period: Grade Level: Directions:

Global Informant

Informant 2007-02

1545 NICHQ Vanderbilt Parent Initial SPANISH

NICHQ Vanderbilt Assessment Scale—PARENT …...NICHQ Vanderbilt Assessment Scale—PARENT Informant To day’s Date: _____ Child’s Name: _____ Date of Birth: _____ Parent’s For

Informant 2004-08

sistema nichq vanderbilt de evaluación. cuestionario del ... · Decision support for clinicians page 2 of 4 sistema nichq vanderbilt de evaluación. cuestionario del maestro nichq