NICHQ Vanderbilt Assessment Scale - TEACHER Informant Teacher's Name:* First Last Class Time:*Class Name/Period:*Today's Date:* Date Format: MM slash DD slash YYYY Child's Name:* First Last 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:*Is this evaluation based on a time when the child:*was on medicationwas not on medicationnot sure?Symptoms1. Fails to give attention to details or makes careless mistakes in schoolwork.*0 - Never1 - Occasionally2 - Often3 - Very Often2. Has difficulty sustaining attention to tasks or activities.*0 - Never1 - Occasionally2 - Often3 - Very Often3. Does not seem to listen when spoken to directly.*0 - Never1 - Occasionally2 - Often3 - Very Often4. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand)*0 - Never1 - Occasionally2 - Often3 - Very Often5. Has difficulty organizing tasks and activities*0 - Never1 - Occasionally2 - Often3 - Very Often6. Avoids, dislikes, or does not want to start tasks that require ongoing mental effort*0 - Never1 - Occasionally2 - Often3 - Very Often7. Loses things necessary for tasks or activities (toys, assignments, pencils, or books)*0 - Never1 - Occasionally2 - Often3 - Very Often8. Is easily distracted by extraneous stimuli*0 - Never1 - Occasionally2 - Often3 - Very Often9. Is forgetful in daily activities.*0 - Never1 - Occasionally2 - Often3 - Very Often10. Fidgets with hands or feet or squirms in seat.*0 - Never1 - Occasionally2 - Often3 - Very Often11. Leaves seat in classroom or in other situations in which remaining seated is expected*0 - Never1 - Occasionally2 - Often3 - Very Often12. Runs about or climbs excessively in situations in which remaining seated is expected*0 - Never1 - Occasionally2 - Often3 - Very Often13. Has difficulty playing or engaging in leisure activities quietly*0 - Never1 - Occasionally2 - Often3 - Very Often14. Is “on the go” or often acts as if “driven by a motor”.*0 - Never1 - Occasionally2 - Often3 - Very Often15. Talks excessively*0 - Never1 - Occasionally2 - Often3 - Very Often16. Blurts out answers before questions have been completed.*0 - Never1 - Occasionally2 - Often3 - Very Often17. Has difficulty waiting in line*0 - Never1 - Occasionally2 - Often3 - Very Often18. Interrupts or intrudes on others (eg, butts into conversations/games)*0 - Never1 - Occasionally2 - Often3 - Very Often19. Loses temper*0 - Never1 - Occasionally2 - Often3 - Very Often20. Actively defies or refuses to go along with adults’ requests or rules.*0 - Never1 - Occasionally2 - Often3 - Very Often21. Is angry or resentfu*0 - Never1 - Occasionally2 - Often3 - Very Often22. Is spiteful and vindictive*0 - Never1 - Occasionally2 - Often3 - Very Often23. Bullies, threatens, or intimidates others*0 - Never1 - Occasionally2 - Often3 - Very Often24. Initiates physical fights*0 - Never1 - Occasionally2 - Often3 - Very Often25. Lies to obtain goods for favors or to avoid obligations (eg, “cons” others)*0 - Never1 - Occasionally2 - Often3 - Very Often26. Is physically cruel to people*0 - Never1 - Occasionally2 - Often3 - Very Often27. Has stolen items of nontrivial value*0 - Never1 - Occasionally2 - Often3 - Very Often28. Deliberately destroys others’ property*0 - Never1 - Occasionally2 - Often3 - Very Often29. Is fearful, anxious, or worried*0 - Never1 - Occasionally2 - Often3 - Very Often30. Is self-conscious or easily embarrassed*0 - Never1 - Occasionally2 - Often3 - Very Often31. Is afraid to try new things for fear of making mistakes*0 - Never1 - Occasionally2 - Often3 - Very Often32. Feels worthless or inferior*0 - Never1 - Occasionally2 - Often3 - Very Often33. Blames self for problems; feels guilty*0 - Never1 - Occasionally2 - Often3 - Very Often34. Feels lonely, unwanted, or unloved; complains that “no one loves him or her”*0 - Never1 - Occasionally2 - Often3 - Very Often35. Is sad, unhappy, or depressed*0 - Never1 - Occasionally2 - Often3 - Very OftenAcademic Performance36. Reading*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic37. Mathematics*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic38. Written expression*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - ProblematicClassroom Behavioral Performance39. Relationship with peers*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic40. Following directions*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic41. Disrupting class*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic42. Assignment completion*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - Problematic43. Organizational skills*1 - Excellent2 - Above Average3 - Average4 - Somewhat of a Problem5 - ProblematicComments: