The NICHQ Vanderbilt Assessment Scale for Parents

What is the NICHQ Vanderbilt Assessment Scale?

Diagnosing attention deficit hyperactivity disorder (ADHD) in children can help address challenges early and provide appropriate interventions to improve a child's developmental journey.

The National Institute for Children's Health Quality developed the first edition of the Vanderbilt Assessment Scale in 2002 to assess ADHD in children and help with the diagnosis. This scale is based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV TR),  which outlines standardized criteria for diagnosing ADHD (Narad et al., 2015).

The NICHQ Vanderbilt Assessment Scale (Parent Informant) assessment attempts to pinpoint whether ADHD affects a child's behaviors and performance. It has a questionnaire with items related to possible anxiety, depression, impatience, defiance, and more. It comes in two versions: one for teachers and one for parents.

How to use the NICHQ Vanderbilt Assessment Scale for Parents

Health care professionals can use the NICHQ Vanderbilt Assessment Scale for Parents to determine if the child meets diagnostic criteria. Here are the procedures:

Step 1: Issue this to the parents reporting on their children

When parents/guardians express concerns about their child's potential ADHD during an appointment, provide them with the NICHQ Vanderbilt Assessment Scale. Before making a diagnosis, parents must complete and submit the scale to ensure a more informed assessment.

Step 2: Have the parents answer the questionnaire

After receiving the assessment scale, parents can complete it immediately, bring it to the next appointment, or submit it online. Considering their child's age, they'll rate items 1-47 from Never to Very Often and 48-55 from Excellent to Problematic. All of these revolve around

Here are some items/statements they need to rate:

• Blames others for his or her mistakes or misbehaviors
• Has difficulty organizing tasks and activities
• Avoids, dislikes, or does not want to start tasks that require ongoing mental effort
• Has difficulty playing or beginning quiet play activities
• Has used a weapon that can cause serious harm (bat, knife, brick, gun)
• Has difficulty waiting his or her turn
• Does not pay attention to details or makes careless mistakes with, for example, homework
• Overall school performance

Step 3: Record the scores

Once the parents have given you a fully-accomplished assessment scale, it's time to record the scores. Calculate the total number of questions scored 2 or 3 in questions 1–9 and 10–18 to determine the Total Symptom Score for questions 1–18. Then, determine the combined count of questions rated 2 or 3 in the following ranges: questions 19–26, 27–40, and 41–47.

The second part of the scale, the Performance Set (Items 48-55), has a different rating range. To meet the criteria for ADHD diagnosis, at least one item from this set must score a 4 or 5. You can record the scores for that. There's even an Average Performance Score, calculated by adding and dividing the scores by the number of Performance Set items rated.

Step 4: Diagnose and prepare a care plan

Next is making a diagnosis (depending on the results) and a care plan. Remember that this tool shouldn't be the sole assessment to make to diagnose ADHD. It's best to cover all bases before making a diagnosis. And make sure to tailor the care plan to the child, basing it on the ratings in the questionnaire and results from other tests.

Step 5: Issue a follow-up (if needed), then plan accordingly based on results

For ongoing monitoring, reissue the assessment, especially if the child is on medication, to track improvements and evaluate the effectiveness of the care plan. Informants complete a shorter version with 26 items, noting any associated problems. Provide the total Symptom Score for questions 1–18 and calculate the Average Performance Score for questions 19–26 by adding and dividing by the number of Performance criteria answered.

The questionnaire has a section for indicating a parent's phone number, so it would be best to have them write it down so you can contact them for required follow-ups.

When does one typically use the NICHQ Vanderbilt Assessment Scale for Parents?

This is usually issued when parents visit their child's pediatrician or psychologist to discuss any suspicions they might have about their child having ADHD. Specifically, it is used during:

• Diagnosis: Healthcare professionals use it to assess ADHD symptoms in children, aiding in the diagnostic process.
• Treatment planning: This helps formulate tailored treatment plans by providing a comprehensive overview of the child's symptoms and behaviors.
• Monitoring progress: Allows for ongoing evaluation of the effectiveness of interventions and adjustments to the treatment plan as needed.

Remember, relying solely on the assessment scale for diagnosis isn't sufficient. It should be complemented with information from multiple sources.

From home to the classroom: Vanderbilt assessment for teachers

As children transition from home to the classroom, teachers play a crucial role in recognizing and supporting those with ADHD. Their understanding and insight can make all the difference, as they provide the daily structure and guidance essential for these children's success. With the Vanderbilt Assessment, teachers acquire a practical understanding and create inclusive learning environments tailored to each child's unique needs.

Assessment and scoring for Vanderbilt Assessment for Teachers is similar to that for parents. However, there are just some slight differences. The 43-item questionnaire for a teacher informant is divided into symptoms and performance items (categorized into academic performance and classroom behavioral performance). Meanwhile, the follow-up questionnaire for teacher informants comprises 26 items, divided into symptoms questions (1-18) and performance items (19-26).

Assessing the scale

Before making a diagnosis, you must also take note of the following designations (National Institute for Children's Health Quality, 2002):

• Predominantly inattentive subtype: To meet the criteria for the Predominantly Inattentive subtype, a child must score 2 or 3 on at least 6 out of 9 items from questions 1–9 and also score 4 or 5 on at least one performance question from 48–55 (Q36-43 for teacher informant).
• Predominantly hyperactive/impulsive subtype: For the predominantly hyperactive/impulsive subtype, score 2 or 3 on 6 of 9 items (Q10–18) and 4 or 5 on any performance questions from 48–55 (Q36-43 for teacher informant).
• ADHD combined inattention/hyperactivity: Requires the above criteria on both inattention and hyperactivity/impulsivity.

To meet the diagnosis criteria, they must have at least six positive responses to either the inattentive nine, hyperactive nine core symptoms, or both. Remember that a positive response is a 2 or 3.

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

• Oppositional-defiant disorder screen: Achieve a score of 2 or 3 on at least 4 out of 8 specified behaviors (Q19–26) and a 4 or 5 on any of the Performance questions (Q48–55).
• Conduct disorder screen: Attain a score of 2 or 3 on at least 3 out of 14 designated behaviors (Q27–40), along with a 4 or 5 on any of the Performance questions (Q48–55).

The two scales mentioned earlier are combined for the teacher informant questionnaire, where a child must achieve a 2 or 3 on 3 out of 10 items (Q19–28) and a 4 or 5 on any performance question (Q36–43).

• Anxiety/depression Screen: Obtain a score of 2 or 3 on at least 3 out of 7 identified behaviors (Q41–47), and achieve a 4 or 5 on any of the performance questions (Q48–55). For the teacher informant questionnaire, the child must score 2 or 3 on 3 out of 7 items (Q29–35) and achieve a 4 or 5 on any performance question (Q36–43).

Recognizing ADHD behaviors in children can make a difference in their lives.

What are the benefits of using the NICHQ Vanderbilt Assessment Scale?

The printable Vanderbilt Assessment Scale offers many benefits to parents.

Here are some benefits that parents can get:

• The assessment offers parents clarity and understanding regarding their child's ADHD-related behaviors and challenges.
• Parents can make informed decisions about their child's education and treatment options using the Vanderbilt Assessment.
• It bridges gaps between parents and teachers, fostering collaboration and support for the child's well-being.

References

Narad, M. E., Garner, A. A., Peugh, J. L., Tamm, L., Antonini, T. N., Kingery, K. M., Simon, J. O., & Epstein, J. N. (2015). Parent-teacher agreement on ADHD symptoms across development. Psychological Assessment, 27(1), 239–248. https://doi.org/10.1037/a0037864

National Institute for Children's Health Quality. (2002). NICHQ Vanderbilt Assessment Scales. https://nichq.org/sites/default/files/resource-file/NICHQ-Vanderbilt-Assessment-Scales.pdf