NICHQ Vanderbilt Assessment Scale—TEACHER …

NICHQ Vanderbilt Assessment scale teacher InformantTeacher s Name: _____ Class Time: _____ Class Name/Period: _____ Today s Date: _____ Child s Name: _____ 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: this evaluation based on a time when the child was on medication was not on medication not sure?SymptomsNeverOccasionallyOftenVery to give attention to details or makes careless mistakes in schoolwork0123 difficulty sustaining attention to tasks or not seem to listen when spoken to not follow through on instructions and fails to finish schoolwork0123(not due to oppositional behavior or failure to understand) difficulty organizing tasks and , dislikes, or is reluctant to engage in tasks that require sustained0123mental things necessary for tasks or activities (school assignments,0123pencils, or books) easily distracted by extraneous forgetful in daily activities012310.

Symptoms (continued) Never Occasionally Often Very Often 32. Feels worthless or inferior 0 1 2 3 33. Blames self for problems; feels guilty 0 1 2 3

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