CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION

Scoring Instructions for NICHQ Vanderbilt Assessment Scales

Baseline Assessment The initial scales have symptom screens for 3 other comorbidities:
The validation studies for the NICHQ Vanderbilt Assessment Scales oppositional-defiant disorder, conduct disorder, and anxiety/
were for the 6– to 12-year-old age group. However, to the extent depression. (The initial teacher scale also screens for learning
that they collect information to establish Diagnostic and Statistical disabilities.) These are screened by the number of positive
Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, they are responses in each of the segments. The specific item sets and
applicable to other groups, particularly preschoolers, where they numbers of positives required for each comorbid symptom screen
have identified that DSM-5 criteria are still appropriate. set are detailed below and on the next page.
These scales should not be used alone to make a diagnosis of ADHD The second section of the scale has a set of performance
without confirming and elaborating the information with interviews measures, scored 1 to 5, with 4 and 5 being somewhat of a problem/
with at least the primary caregivers (usually parents) and patients. problematic. To meet criteria for ADHD there must be at least 2
You must take into consideration information from multiple sources. items of the performance set in which the child scores a 4, or 1 item
Scores of 2 or 3 on a single symptom question reflect often-occurring of the performance set in which the child scores a 5; ie, there must
behaviors. Scores of 4 or 5 on performance questions reflect problems be impairment, not just symptoms, to meet diagnostic criteria. The
in performance. sheet has a place to record the number of positives (4s, 5s).
The initial assessment scales, parent and teacher, have 2 components: Scoring to Monitor Symptom and Performance Improvement
symptom assessment and impairment in performance. On both For the purposes of tracking symptoms and symptom severity,
parent and teacher initial scales, the symptom assessment screens calculate the mean response for each subsegment of the ADHD
for symptoms that meet criteria for inattentive (items 1––9) and symptom assessment screen items (inattentive 9 and hyperactive
hyperactive (items 10––18) attention-deficit/hyperactivity disorder 9). To calculate the mean responses, first total the responses (0s,
(ADHD). 1s, 2s, and 3s) from each item within the inattentive subsegment
Scoring for Diagnostic Purposes (items 1––9) and divide by the number of items that received a
To meet DSM-5 criteria for the diagnosis, one must have at least response. For example, if a parent only provided responses to
6 positive responses to the inattentive 9 or hyperactive 9 core 7 of the first 9 items, the responses would be totaled and divided
symptoms, or both. A positive response is a 2 or 3 (often, very by 7. Follow the same calculation instructions for the hyperactive
often) (you could draw a line straight down the page and count the subsegment (items 10––18).
positive answers in each subsegment). There is a place to record the
number of positives in each subsegment.

Parent Assessment Scale Teacher Assessment Scale

Predominantly Inattentive subtype Predominantly Inattentive subtype

• Must score a 2 or 3 on 6 out of 9 items on questions 1––9.
AND • Must score a 2 or 3 on 6 out of 9 items on questions 1––9.
AND

• Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 48––54. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 36––43.
Predominantly Hyperactive/Impulsive subtype Predominantly Hyperactive/Impulsive subtype

•
Must score a 2 or 3 on 6 out of 9 items on questions 10––18.
AND • Must score a 2 or 3 on 6 out of 9 items on questions 10––18.
AND
•
Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 48––54. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 36––43.
ADHD Combined Inattention/Hyperactivity ADHD Combined Inattention/Hyperactivity
•
Requires the criteria on Inattentive AND
Hyperactive/Impulsive subtypes • Requires the criteria on Inattentive AND
Hyperactive/Impulsive subtypes
Oppositional-Defiant Disorder Oppositional-Defiant/Conduct Disorder

•
Must score a 2 or 3 on 4 out of 8 behaviors on questions 19––26.
AND • Must score a 2 or 3 on 3 out of 10 items on questions 19––28.
AND
•
Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 48––54. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 36––43.
Conduct Disorder

•
Must score a 2 or 3 on 3 out of 14 behaviors on questions 27––40.
AND
•
Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 48––54.

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 Scoring Instructions for NICHQ Vanderbilt Assessment Scales

Parent Assessment Scale Teacher Assessment Scale

Anxiety/Depression Anxiety/Depression

• Must score a 2 or 3 on 3 out of 7 behaviors on questions 41––47.
AND • Must score a 2 or 3 on 3 out of 7 items on questions 29––35.
AND

• Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 48––54. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 36––43.
Learning Disabilities

• Must score a 4 on both, or 5 on 1, of questions 36 and 38.

Follow-up Assessment aforementioned comorbidities, as measures of improvement over

time with treatment.
Scoring for Diagnostic Purposes
The parent and teacher follow-up scales have the first 18 core Scoring to Monitor Symptom and Performance Improvement
ADHD symptoms and the comorbid symptoms oppositional-defiant To determine the score for follow-up, calculate the mean response
(parent) and oppositional-defiant/conduct (teacher) disorders. for each of the ADHD subsegments. Compare the mean response
The Performance section has the same performance items and from the follow-up inattentive subsegment (items 1––9) to the mean
impairment assessment as the initial scales; it is followed by a side- response from the inattentive subsegment that was calculated at
effect reporting scale that can be used to assess and monitor the baseline assessment. Conduct the same comparison for the mean
presence of adverse reactions to prescribed medications, if any. responses for the hyperactive subsegment (items 10––18) taken at
Scoring the follow-up scales involves tracking inattentive follow-up and baseline.
(items 1––9) and hyperactive (items 10––18) ADHD, as well as the

Parent Assessment Scale Teacher Assessment Scale

Predominantly Inattentive subtype Predominantly Inattentive subtype

• Must score a 2 or 3 on 6 out of 9 items on questions 1––9.
AND • Must score a 2 or 3 on 6 out of 9 items on questions 1––9.
AND

• Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 27––33. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 29––36.
Predominantly Hyperactive/Impulsive subtype Predominantly Hyperactive/Impulsive subtype

•
Must score a 2 or 3 on 6 out of 9 items on questions 10––18.
AND • Must score a 2 or 3 on 6 out of 9 items on questions 10––18.
AND
•
Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 27––33. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 29––36.
ADHD Combined Inattention/Hyperactivity ADHD Combined Inattention/Hyperactivity
•
Requires the criteria on Inattentive AND
Hyperactive/Impulsive subtypes • Requires the criteria on Inattentive AND
Hyperactive/Impulsive subtypes
Oppositional-Defiant Disorder Oppositional-Defiant/Conduct Disorder

•
Must score a 2 or 3 on 4 out of 8 behaviors on questions 19––26.
AND • Must score a 2 or 3 on 3 out of 10 items on questions 19––28.
AND
•
Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 27––33. • Score a 4 on at least 2, or 5 on at least 1, of the performance
questions 29––36.

The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Original document included as part of Caring for Children With ADHD: A Resource
Toolkit for Clinicians, 2nd Edition. Copyright © 2012 American Academy of Pediatrics, Updated August 2014. All Rights Reserved. The American Academy of Pediatrics does not review or endorse any modifications made to this document and in no event shall the AAP be liable for any such
changes.

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