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NICHQ Vanderbilt Assessment Scale PARENT Informant Today s Date Child s Name Date of Birth Parent s Name Parent s Phone Number Directions Each rating should be considered in the context of what is appropriate for the age of your child. When completing this form please think about your child s behaviors in the past 6 months. Is this evaluation based on a time when the child was on medication was not on medication Symptoms not sure Never Occasionally Often Very Often Does not pay attention to...details or makes careless mistakes with for example homework Has difficulty keeping attention to what needs to be done Does not seem to listen when spoken to directly Does not follow through when given directions and fails to finish activities not due to refusal or failure to understand Avoids dislikes or does not want to start tasks that require ongoing mental effort Loses things necessary for tasks or activities toys assignments pencils or books Is easily distracted by noises or other stimuli...Is forgetful in daily activities 10. Fidgets with hands or feet or squirms in seat 11. Leaves seat when remaining seated is expected 12. Runs about or climbs too much when remaining seated is expected 13. Has difficulty playing or beginning quiet play activities 14. Is on the go or often acts as if driven by a motor 15. Talks too much 16. Blurts out answers before questions have been completed 18. Interrupts or intrudes in on others conversations and/or activities 19. Argues with adults 20....Loses temper 21. Actively defies or refuses to go along with adults requests or rules 22. Deliberately annoys people 23. Blames others for his or her mistakes or misbehaviors 24. Is touchy or easily annoyed by others 25. Is angry or resentful 26. Is spiteful and wants to get even 27. Bullies threatens or intimidates others 28. Starts physical fights 29. Lies to get out of trouble or to avoid obligations i*e* cons others 30. Is truant from school skips school without permission 31. Is physically...cruel to people 32. Has stolen things that have value 34. Has used a weapon that can cause serious harm bat knife brick gun 36. Has deliberately set fires to cause damage Copyright 2002 American Academy of Pediatrics and National Initiative for Children s Healthcare Quality. Revised 1102 37. Has broken into someone else s home business or car 38 Has stayed out at night without permission 39. Has run away from home overnight 40. Has forced someone into sexual activity 41. Is fearful anxious or...worried 42. Is afraid to try new things for fear of making mistakes 43. Feels worthless or inferior 44. Blames self for problems feels guilty 45. Feels lonely unwanted or unloved complains that no one loves him or her 46. Is sad unhappy or depressed 47. Is self-conscious or easily embarrassed Excellent Above Average Somewhat of a Problem Problematic Performance 48. Overall school performance 49. Reading 50. Writing 51. Mathematics 52. Relationship with parents 55 Participation in organized...activities e*g* teams Comments For Office Use Only Total number of questions scored 2 or 3 in questions 1-9 Total Symptom Score for questions 1-18 Average Performance Score.

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Understanding the ADHD Assessment Printable Form

What is the ADHD assessment printable form

The ADHD assessment printable form is a structured tool designed to evaluate symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in individuals, primarily children. This form usually includes a series of questions and rating scales that help assess behavioral patterns over a specific period. Parents, teachers, and healthcare professionals can utilize this form to identify behaviors indicative of ADHD and to ensure a thorough evaluation.

Key features of the ADHD assessment printable form

The form typically features a series of standardized questions that cover various behavioral symptoms associated with ADHD. Users will find sections for reporting attention span, impulsivity, hyperactivity, and organizational skills. Additionally, the form may include options for parents and teachers to provide feedback on the child's daily functioning across multiple settings, making it comprehensive and insightful.

When to use the ADHD assessment printable form

This assessment form is useful in various situations, such as when a child is exhibiting symptoms that may suggest ADHD, or when seeking a formal evaluation by a healthcare professional. It is also beneficial for monitoring progress once a diagnosis is made, assisting in making informed decisions about treatment plans and educational interventions.

How to fill the ADHD assessment printable form

Filling out the ADHD assessment printable form involves carefully reviewing the questions and rating the frequency of observed behaviors. Parents and teachers should reflect on the child’s behavior over the past few months, considering different environments like home and school. Each item on the form will usually require responses based on a scale that indicates how often a particular behavior occurs, allowing for accurate assessment and comparison.

Best practices for accurate completion

To ensure the most accurate results, it is important to approach the ADHD assessment printable form with honesty and attention to detail. Users should consider each question in relation to the child's behavior across various situations and times. It can be helpful to collaborate with teachers or caregivers for a more rounded perspective. Additionally, taking time to fill out the form thoughtfully rather than in haste will lead to a more reliable evaluation.

Common errors and troubleshooting

Common errors when completing the ADHD assessment printable form include misunderstandings of question wording or providing inconsistent ratings across similar questions. To troubleshoot these issues, participants should read each question carefully and ensure that their answers reflect a consistent viewpoint of the child’s behavior. If there is uncertainty about a specific item, it is advisable to discuss it with professionals or others involved in the child’s care.

Frequently Asked Questions about vanderbilt adhd assessment pdf form

What is the purpose of the ADHD assessment printable form?

The purpose of the ADHD assessment printable form is to evaluate behavioral patterns associated with ADHD to assist in diagnosis and treatment planning.