NICHQ Vanderbilt-Teacher.fm 2025

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  1. Click ‘Get Form’ to open the NICHQ Vanderbilt-Teacher.fm in the editor.
  2. Begin by entering the Teacher’s Name, Class Time, Class Name/Period, Today’s Date, Child’s Name, and Grade Level in the designated fields at the top of the form.
  3. In the Directions section, note how long you have been evaluating the child's behaviors and indicate whether this evaluation is based on a time when the child was on medication or not.
  4. Proceed to rate each symptom listed from 0 (Never) to 3 (Very Often) based on your observations since the beginning of the school year. Ensure you consider age-appropriate behavior for accurate ratings.
  5. For Academic Performance and Classroom Behavioral Performance sections, select ratings from 1 (Excellent) to 5 (Problematic) for each subject area and behavioral aspect.
  6. Finally, complete any comments you wish to add and review all entries before saving or sharing your completed form.

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The Vanderbilt Scales for ASD (See Appendix B) is an early screening measure utilizing graded parental ratings of early core symptoms of ASD. The measure consists of 12 yes/no questions and 11 graded response questions. Item examples: Is your child using phrases to communicate?
[HE0569] NICHQ Vanderbilt Assessment Scale: Parent Informant This tool is a validated, parent-completed questionnaire that obtains information needed for diagnosis from a parent about core symptoms of ADHD and areas of functional impairment.
Parents and teachers usually fill out the scales for children. Older children complete their own rating scale. Adults answer a questionnaire about themselves and may ask a spouse, co-worker, or close friend to do one as well.
The standard fee for an assessment is $6,000. Additional costs may be incurred for neuropsychological testing or polygraph examination. Any sub-specialty consultations needed within Vanderbilt are charged in addition to the standard fee and are billed separately. What costs are not covered in my evaluation?
To meet criteria for ADHD there must be at least 2 items of the performance set in which the child scores a 4, or 1 item of the performance set in which the child scores a 5; ie, there must be impairment, not just symptoms, to meet diagnostic criteria. The sheet has a place to record the number of positives (4s, 5s).
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The Vanderbilt ADHD Diagnostic Parent Rating Scale is used to help in the diagnostic process of Attention Deficit/Hyperactivity Disorder (ADHD) in children between the ages of 6 and 12. It has a total of 55 questions, includes all 18 of the DSM criteria for ADHD and should be completed by a parent of the child.
A meta analysis conducted by Bard, who extrapolated data, demonstrated that the test-retest reliability exceeded . 80 for all summed scale scores in elementary school children populations with a time span of about a year.

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