This document contains a parent rating scale for assessing symptoms of ADHD in children. It consists of 45 questions about inattentive, hyperactive, and impulsive behaviors rated on a 4-point scale. It also includes 7 questions about a child's academic performance and relationships rated on a 5-point scale. The final section provides instructions on how to score the checklist to determine if a child meets criteria for the inattentive, hyperactive/impulsive, or combined subtypes of ADHD.
1 of 2
Downloaded 35 times
More Related Content
Vanderbilt parent adhd
1. CHILD STUDY CENTER
Department of Pediatrics
University of Oklahoma Health Sciences Center Vanderbilt ADHD Diagnostic Parent Rating Scale
Parents Name: ____________________ Todays Date: ___________ Childs Name: ______________________ Age: ____
Directions: Each rating should be considered in the context of what is appropriate for the age of your child and
should reflect that childs behavior in the last 6 months.
Is this evaluation based on a time when the child was on medication was not on medication not sure?
BEHAVIOR: never occasionally often very often
1. Does not pay attention to details or makes careless mistakes; 0 1 2 3
for example, homework.
2. Has difficulty attending to what needs to be done. 0 1 2 3
3. Does not seem to listen when spoken to directly. 0 1 2 3
4. Does not follow through when given directions and fails to finish things. 0 1 2 3
5. Has difficulty organizing tasks and activities. 0 1 2 3
6. Avoids, dislikes, or does not want to start tasks that require ongoing mental effort. 0 1 2 3
7. Loses things needed for tasks or activities (assignments, pencils, or books). 0 1 2 3
8. Is easily distracted by noises or other things. 0 1 2 3
9. Is forgetful in daily activities. 0 1 2 3
10. Fidgets with hands or feet or squirms in seat. 0 1 2 3
11. Leaves seat when he/she is supposed to stay in his/her seat. 0 1 2 3
12. Runs about or climbs too much when he/she is supposed to stay seated. 0 1 2 3
13. Has difficulty playing or starting quiet games. 0 1 2 3
14. Is on the go or often acts as if driven by a motor. 0 1 2 3
15. Talks too much. 0 1 2 3
16. Blurts out answers before questions have been completed. 0 1 2 3
17. Has difficulty waiting for his/her turn. 0 1 2 3
18. Interrupts or bothers others when they are talking or playing games. 0 1 2 3
19. Argues with adults. 0 1 2 3
20. Loses temper. 0 1 2 3
21. Actively disobeys or refuses to follow an adults requests or rules. 0 1 2 3
22. Bothers people on purpose. 0 1 2 3
23. Blames others for his/her mistakes or misbehaviors. 0 1 2 3
24. Is touchy or easily annoyed by others. 0 1 2 3
25. Is angry or bitter. 0 1 2 3
26. Is hateful and wants to get even. 0 1 2 3
27. Bullies, threatens, or scares others. 0 1 2 3
28. Starts physical fights. 0 1 2 3
29. Lies to get out of trouble or to avoid jobs (i.e., cons others). 0 1 2 3
30. Skips school without permission. 0 1 2 3
31. Is physically unkind to people. 0 1 2 3
32. Has stolen things that have value. 0 1 2 3
33. Destroys others property on purpose. 0 1 2 3
34. Is physically mean to animals. 0 1 2 3
35. Has set fires on purpose to cause damage. 0 1 2 3
36. Has broken into someone elses home, business or car. 0 1 2 3
37. Has stayed out at night without permission. 0 1 2 3
38. Has run away from home overnight. 0 1 2 3
39. Is fearful, anxious, or worried. 0 1 2 3
40. Is afraid to try new things for fear of making mistakes. 0 1 2 3
41. Feels useless or inferior. 0 1 2 3
42. Blames self for problems, feels at fault. 0 1 2 3
43. Feels lonely, unwanted, or unloved; complains that no one loves him/her. 0 1 2 3
44. Is sad, unhappy, or depressed. 0 1 2 3
45. Feels different and easily embarrassed. 0 1 2 3
PERFORMANCE: Above Somewhat
How is your child doing? Excellent Average Average of a Problem Problematic
1. Rate how your child is doing in school overall. 1 2 3 4 5
2. How is your child doing in reading? 1 2 3 4 5
3. How is your child doing in writing? 1 2 3 4 5
4. How is your child doing in math? 1 2 3 4 5
5. How does your child get along with you? 1 2 3 4 5
6. How does your child get along with brothers and sisters? 1 2 3 4 5
7. How does your child get along with others his/her own age? 1 2 3 4 5
8. How does your child do in activities such as games or team play? 1 2 3 4 5
If more than six items from questions 1 - 9 or 10 -18 are rated 2 or 3,
how old was your child when you first noticed these behaviors? _______
2. How to score the parent checklist
A. For questions 19, add up the number of questions where the teacher circled a 2 or 3.
B. For questions 1018, add up the number of questions where the teacher circled a 2 or 3.
C. For questions 3643, add up the number of questions where the teacher circled a 4 or 5.
ADHD Predominantly Inattentive subtype (1 and 2):
At least 6 of questions 19 must score a 2 or 3 and
At least 1 of questions 3643 must score a 4 or 5
ADHD Predominantly Hyperactive/Impulsive subtype
At least 6 of questions 1018 must score a 2 or 3 and
At least 1 of questions 3643 must score a 4 or 5
ADHD Combined Inattention/Hyperactivity subtype
At least 6 of questions 19 must score a 2 or 3 and
At least 6 of questions 1018 must score a 2 or 3 and
At least 1 of questions 3643 must score a 4 or 5