ADHD Assessment - Top Tier Psychiatry

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Adult ADHD Self-Assessment

Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Please give this completed checklist to your healthcare professional to discuss during your appointment.

	Never	Rarely	Sometimes	Often	Very often
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
3. How often do you have problems remembering appointments or obligations?
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
7. How often do you make careless mistakes when you have to work on a boring or difficult project?
8. How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
10. How often do you misplace or have difficulty finding things at home or at work?
11. How often are you distracted by activity or noise around you?
12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
13. How often do you feel restless or fidgety?
14. How often do you have difficulty unwinding and relaxing when you have time to yourself?
15. How often do you find yourself talking too much when you are in social situations?
16. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
17. How often do you have difficulty waiting your turn in situations when turn taking is required?
18. How often do you interrupt others when they are busy?

How old were you when these problems first began to occur?

This Part must be filled out by a parent or teacher.

Who is filling out the form?

Parent

Teacher

Introduction

The Vanderbilt ADHD Diagnostic Rating Scale (VADRS) is an assessment tool specifically designed to evaluate symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. Rooted in the criteria established by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), this scale serves a critical role in both clinical and research settings for the identification and understanding of ADHD behaviors. The scale is distinguished by its comprehensive approach, incorporating inputs from both parents and teachers to provide a multifaceted view of the child's behavior across different environments.

Structured into two main parts, the Vanderbilt Scale assesses core ADHD symptoms, including inattention, hyperactivity, and impulsivity, as well as additional domains relevant to childhood behavior disorders such as oppositional-defiant behavior, conduct disorder, and anxiety/depression. This broad scope allows for a thorough evaluation of the child's symptoms in relation to ADHD and co-occurring conditions, facilitating a more nuanced diagnostic process.

The Vanderbilt ADHD Diagnostic Rating Scale's emphasis on multi-informant input enhances its diagnostic accuracy, enabling healthcare professionals to make informed decisions regarding diagnosis and treatment planning. Its structured format and alignment with DSM-IV criteria contribute to its utility as a reliable tool for identifying ADHD and associated behavioral issues in pediatric populations.

Instructions

Consider the context of what is appropriate for the age of your child. How would you rate your child’s behaviors in the following areas over the past 6 months:

	Never	Occasionally	Often	Very Often
1. Does not pay attention to details or makes careless mistakes with, for example, homework
2. Has difficulty keeping attention to what needs to be done
3. Does not seem to listen when spoken to directly
4. Does not follow through when given directions and fails to finish activities (not due to refusal or failure to understand)
5. Has difficulty organizing tasks and activities
6. Avoids, dislikes, or does not want to start tasks that require ongoing mental effort
7. Loses things necessary for tasks or activities (toys, assignments, pencils, or books)
8. Is easily distracted by noises or other stimuli
9. 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
17. Has difficulty waiting his or her turn
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
33. Deliberately destroys others’ property34. Has used a weapon that can cause serious harm (bat, knife, brick, gun)
34. Has used a weapon that can cause serious harm (bat, knife, brick, gun)
35. Is physically cruel to animals
36. Has deliberately set fires to cause damage
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	Average	Somewhat of a Problem	Problematic
48. Overall school performance
49. Reading
50. Writing
51. Mathematics
52. Relationship with parents
53. Relationship with siblings
54. Relationship with peers
55. Participation in organized activities

Introduction

Direction

Each rating should be considered in the context of what is appropriate for the age of the child you are rating and should reflect that child’s behavior since the beginning of the school year.

Please indicate the number of weeks or months you have been able to evaluate the behaviors:

Is this evaluation based on a time when the child

was on medication

was not on medication

not sure?

Symptoms

	Never	Occasionally	Often	Very Often
1. Fails to give attention to details or makes careless mistakes in schoolwork
2. Has difficulty sustaining attention to tasks or activities
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand)
5. Has difficulty organizing tasks and activities
6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
7. Loses things necessary for tasks or activities (school assignments, pencils,or books)
8. Is easily distracted by extraneous stimuli
9. Is forgetful in daily activities
10. Fidgets with hands or feet or squirms in seat
11. Leaves seat in classroom or in other situations in which remaining seated is expected
12. Runs about or climbs excessively in situations in which remaining seated is expected
13. Has difficulty playing or engaging in leisure activities quietly
14. Is “on the go”or often acts as if “driven by a motor”
15. Talks excessively
16. Blurts out answers before questions have been completed
17. Has difficulty waiting in line
18. Interrupts or intrudes on others (eg,butts into conversations/games)
19. Loses temper
20. Actively defies or refuses to comply with adult’s requests or rules
21. Is angry or resentful
22. Is spiteful and vindictive
23. Bullies, threatens, or intimidates others
24. Initiates physical fights
25. Lies to obtain goods for favors or to avoid obligations (eg,“cons”others)
26. Is physically cruel to people
27. Has stolen items ofnontrivial value
28. Deliberately destroys others’property
29. Is fearful,anxious,or worried
30. Is self-conscious or easily embarrassed
31. Is afraid to try new things for fear ofmaking mistakes
32. Feels worthless or inferior
33.Blames selffor problems;feels guilty
34. Feels lonely,unwanted,or unloved;complains that “no one loves him or her”
35. Is sad, unhappy, or depressed

Classroom Behavioral Performance