Child And Adolescent Screening Checklist For Behavior Vanderbilt Assessment Scale Template (Page 4 of 4) in pdf

For Office Use Only

Total number of items scored 2 or 3 in items 1-9: _____ (ADHD, predominantly inattentive type—6 or more symptoms)

Total number of items scored 2 or 3 in items 10-18: _____ (ADHD, predominantly hyperactive-impulsive type—6 or more

symptoms)

Total number of items scored 2 or 3 for items 1-18:_____ (ADHD, combined type—6 or more symptoms of both types)

Total number of items scored 2 or 3 in items 19-26:_____ (oppositional defiant disorder screen—4 or more symptoms)

Total number of items scored 2 or 3 in items 27-40:_____ (conduct disorder screen—3 or more symptoms)

Total number of items scored 2 or 3 in items 41-47:_____ (anxiety/depression screen—3 or more symptoms)

Scoring Instructions for the Vanderbilt Assessment Scale—Parent Information

The Vanderbilt Assessment Scale has two components: symptom assessment and impairment of performance.

For the ADHD screen, the symptoms assessment component screens for symptoms that meet the criteria for

both inattentive (items 1-9) and hyperactive-impulsive ADHD (items 10-18).

To meet DSM-IV criteria for the diagnosis of ADHD, one must have at least 6 responses of "Often" or

"Very Often" (scored 2 or 3) to either the 9 inattentive or 9 hyperactive-impulsive items, or both and a score

of 4 or 5 on any of the Performance items (48-55). There is a place to record the number of symptoms that

meet this criteria in each subgroup.

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The Vanderbilt Assessment Scale also contains items that screen for 3 other co-morbidities:

• oppositional defiant disorder

• conduct disorder

•

anxiety/depression

For the oppositional defiant disorder screen there must be a score of 2 or 3 on 4 of the 8 items (19-26) on

the subscale and a score of 4 or 5 on any of the Performance items (48-55).

For the conduct disorder screen there must be a score of 2 or 3 on 3 out of the 14 items (27-40) on this

subscale and a score of 4 or 5 on any of the Performance items (48-55).

For the anxiety/depression screen there must be a score of 2 or 3 on 3 of the 7 items (41-47) and a score of

4 or 5 on any of the Performance items 48-55).

The Vanderbilt Assessment Scale should NOT be used alone to make a diagnosis. The practitioner must

consider information from other sources.

Vanderbilt Assessment Scale - Parent Information

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Child And Adolescent Screening Checklist For Behavior Vanderbilt Assessment Scale Template Page 4