NICHQ Vanderbilt Assessment Scale for Teachers

What is the NICHQ Vanderbilt Assessment Scale (Teacher Informant)?

The NICHQ Vanderbilt Assessment Scales were developed as part of a broader initiative in behavioral pediatrics in 2002 (National Institute for Children’s Health Quality, 2024). Although often associated with the National Institute for Children’s Health Quality (NICHQ), the scales are adaptations of earlier Vanderbilt scales created by Dr. Mark L. Wolraich et al. (2013) at Vanderbilt University. NICHQ contributed to the widespread dissemination of these tools through its ADHD toolkit.

The purpose of the assessment scale is to support the diagnostic process by determining whether ADHD is impacting a child’s academic performance and general behavior (Becker et al., 2012). This evaluation-based tool includes questionnaire items related to symptoms of ADHD as well as potential comorbid conditions such as anxiety, depression, impulsivity, defiance, and impatience.

Two versions of the scale are available: one designed for teachers and one for parents. This guide focuses on the Vanderbilt Assessment Teacher Informant version, a 43-item questionnaire used to gather observations from educators.

How to use the NICHQ Vanderbilt Assessment Scale

Here's how to use this template:

Step 1: Check if the teacher has been nominated to report on a certain child

Before administering the NICHQ Vanderbilt Assessment Scale (Teacher Informant version), it is essential to confirm that the teacher has obtained permission from the child’s parents or legal guardians to report on the child’s behavior. This ensures ethical use of the tool, as teachers are not the child's primary caregivers.

Step 2: Have the teacher answer the questionnaire

Once consent is verified, the healthcare provider may issue the assessment scale to the teacher. The teacher may complete the form during the appointment, at home, or electronically with an electronic signature if needed.

The teacher will rate the student using the following scales:

• Items 1–35: Rated on a scale of 0 to 3 (Never to Very Often)
• Items 36–43: Rated on a scale of 1 to 5 (Excellent to Problematic)

All responses should reflect behavior appropriate for the child's age.

Step 3: Record the scores

Upon receiving the completed assessment, the healthcare provider should document the following:

• Total number of items scored 2 or 3 in questions 1–9
• Total number of items scored 2 or 3 in questions 10–18
• Total symptom score for questions 1–18
• Total number of items scored 2 or 3 in questions 19–28
• Total number of items scored 2 or 3 in questions 29–35
• Total number of items scored 4 or 5 in questions 36–43
• Average performance score

Predominantly inattentive subtype

• Score 2 or 3 on at least 6 of the 9 items in questions 1–9 AND
• Score 4 or 5 on any Performance question (36–43)

Predominantly hyperactive/impulsive subtype

• Score 2 or 3 on at least 6 of the 9 items in questions 10–18 AND
• Score 4 or 5 on any Performance question (36–43)

ADHD combined inattention/hyperactivity

• Meet the criteria for both inattentive and hyperactive/impulsive subtypes

To meet the diagnostic criteria, a minimum of six positive responses (scores of 2 or 3) must be recorded in either the inattentive or hyperactive/impulsive symptom categories, or both.

The first part of the scale also has symptom screens of the following:

Oppositional-defiant/conduct disorder screen:

• Must score a 2 or 3 on 3 out of 10 items in questions 19–28 AND
• Score 4 or 5 on any Performance question (36–43)

Anxiety/depression screen:

• Score 2 or 3 on at least 3 of the 10 items in questions 19–28 AND
• Score 4 or 5 on any Performance question (36–43)

These comorbid problems are screened by counting the number of positive responses in each section.

Performance set (items 36–43):

To meet diagnostic criteria, at least one item in this set must score a 4 or 5. The Average Performance Score can be calculated by summing the item scores and dividing by the number of items rated.

Step 4: Make a diagnosis and create a care plan

Based on the results of the assessment and additional evaluation in accordance with DSM criteria, the healthcare provider determines whether an ADHD diagnosis is warranted. If diagnosed, a personalized treatment plan should be developed to support the child's specific needs. For example, interventions might target areas such as managing distractibility, improving attention, organizing tasks, enhancing peer relationships (peers), or addressing impulsivity.

Step 5: If a follow-up is needed, issue the follow-up form to the teacher

If follow-up is indicated—especially when monitoring medication efficacy or behavioral interventions—the healthcare provider may reissue the follow-up version of the Vanderbilt ADHD scale.

The follow-up version contains 26 items. The teacher will again rate the child and report on any observed problems such as headaches, sleep disturbances, or fatigue.

After receiving the completed follow-up form, the healthcare provider should document:

• Total symptom score for questions 1–18
• Average performance score for questions 19–26 (calculated as the sum of ratings divided by the number of Performance items answered)

When does one typically use the NICHQ Vanderbilt Assessment?

The NICHQ Vanderbilt Assessment Scale (Teacher Informant version) is typically administered to teachers after they have obtained parental permission to provide observations to a department of pediatric service, psychologist, or other qualified healthcare provider for the purpose of screening a student for ADHD.

Following diagnosis and the development of a treatment plan, the pediatrician or psychologist may reissue the assessment to monitor the student’s progress over time. This is particularly useful if the teacher initiates further communication to discuss the student’s ADHD and its impact in the classroom.

Teachers may complete the assessment during an appointment or after taking it back to the school setting, where they can observe the student further to ensure informed and accurate ratings.

Ideally, the teacher should observe the student over a period of several weeks or months. This allows sufficient time to gather meaningful data and provide ratings that accurately reflect the student’s typical behavior in the school environment.

The following healthcare practitioners can use the NICHQ Vanderbilt Assessment Scale for Teachers for their respective practices:

• Pediatricians
• Psychiatrists
• Psychotherapists

Benefits

This assessment offers several practical benefits for pediatricians, psychologists, and educators working with children suspected of having ADHD.

First, the questionnaire is designed to examine various aspects of a child’s school life. The teacher’s ratings provide valuable insights into how the child functions in a classroom setting, helping professionals determine whether an ADHD diagnosis is appropriate.

Second, the information gathered through the assessment supports the creation of a personalized care plan for the student. The teacher’s responses highlight specific areas of need, enabling healthcare providers and educators to collaborate on strategies that support the child’s learning and social development.

Additionally, the assessment fosters continuity of care. Teachers can use a follow-up version of the questionnaire to report on the child’s progress over time. This ongoing feedback enables clinicians to assess whether interventions are effective and whether adjustments to the care plan are necessary.

Finally, the process of completing the assessment encourages teachers to observe their students more closely and reflect on their needs. If a diagnosis is made, the insights gained can guide teachers in adapting their teaching approaches and classroom management strategies, helping ensure that ADHD does not unduly hinder the child’s academic success or peer relationships.

References

Becker, S. P., Langberg, J. M., Vaughn, A. J., & Epstein, J. N. (2012). Clinical utility of the Vanderbilt ADHD Diagnostic Parent Rating Scale comorbidity screening scales. Journal of Developmental & Behavioral Pediatrics, 33(3), 221–228. https://doi.org/10.1097/dbp.0b013e318245615b

National Institute for Children’s Health Quality. (2024, September 12). NICHQ Vanderbilt Assessment Scales — The National Institute for Children’s Health Quality. The National Institute for Children’s Health Quality. https://nichq.org/downloadable/nichq-vanderbilt-assessment-scales/

Wolraich, M. L., Bard, D. E., Neas, B., Doffing, M., & Beck, L. (2013). The psychometric properties of the Vanderbilt Attention-Deficit Hyperactivity Disorder Diagnostic Teacher Rating Scale in a community population. Journal of Developmental & Behavioral Pediatrics, 34(2), 83–93. https://doi.org/10.1097/dbp.0b013e31827d55c3