• Home
  • About Us
    • Founding Philosophy
    • Office Information
    • Our Providers >
      • Dr. Eric Siegel M.D.
      • Katherine Leezer, APRN
      • Jennifer Seib, APRN
      • Wendy Warren, PA-C
    • Our Staff
    • Location
    • Take a Tour of Our Office
  • Parents
    • Updates >
      • Patient Portal Information
    • Medication Doses
    • Resources >
      • Community Resources
    • Vaccine Information & Well Check Schedule >
      • General Immunization Information
    • Brighten Your Day
  • New Patients
  • Forms & Policies
    • Forms for New Patients
    • ADHD Screening
    • Social Development Screening
  • Teens
    • Teen Online Resources
    • Frequently Asked Questions >
      • Teen Health Blog
    • Compass
    • View From the Mountaintop
  • Contact Us
  • World Change
Picture

The NICHQ Vanderbilt Assessment Scales were developed through the Attention Deficit Hyperactivity Disorder (ADHD) Learning Collaborative project. These scales are used for helping healthcare professionals diagnose ADHD.
The Vanderbilt ADHD rating scale is an initial assessment tool, for use with children ages 6-12.  The tool contains rating scales for symptoms of disorders and for impairments in academic and behavioral performance.  Although this tool is not intended for diagnosis, it is widely used to provide information about symptom presence and severity, as well as the child’s performance in the classroom, home, and social settings. The Vanderbilt Scale takes approximately 10 minutes to complete (the Parent Form has 55 items; the Teacher Form has 43 items).

Parent Initial Assessment

Download and fill this along with the Teacher Assessment and bring them to the physician office.
NICHQ Parent Initial Assessment
File Size: 595 kb
File Type: pdf
Download File

Teacher Initial Assessment

Give this form to your child's teacher and bring the completed form with you to your physician appointment.
NICHQ Teacher Initial Assessment
File Size: 246 kb
File Type: pdf
Download File


Parent Follow-Up

Complete this form prior to your child's follow-up appointment.  Please bring the Teacher Follow-Up form with you as well.
NICHQ Parent Follow-Up
File Size: 245 kb
File Type: pdf
Download File

Teacher Follow-Up

Have your child's teacher fill out this form and bring it with you to your follow-up appointment.
NICHQ Teacher Follow-Up
File Size: 245 kb
File Type: pdf
Download File

Picture
Contact Us   ·   Site Map   ·   Teens
Welcome to Shelby Pediatrics - A piece of home for your children, a peace of mind for you.