NICHQ Vanderbilt Assessment Scale: Report

Gurman Kaur Chawla, 2337524

Department of Psychology CHRIST (Deemed to be University) Bangalore, India

MPS 352
Dr. Uma Krishnan

22 July, 2024
 Introduction to the Test

The NICHQ Vanderbilt Assessment Scale is a widely used, standardized tool

designed to assess symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and
related disorders in children aged 6 to 12. Developed by the National Institute for Children's
Health Quality (NICHQ), it provides a comprehensive evaluation of ADHD symptoms, as
well as co-occurring conditions such as oppositional defiant disorder, conduct disorder,
anxiety, and depression. It examines whether ADHD is affecting a child’s academic
performance as well as their general behaviour.

The scale has a total of 55 questions, and includes all 18 of the DSM criteria for
ADHD. It is available in both parent and teacher versions, allowing for a comprehensive
evaluation of the child's behavior in different environments. By providing a standardized and
reliable measure, the Vanderbilt Assessment Scale aids in the diagnosis, treatment planning,
and monitoring of ADHD and related conditions.

Specifically, this scale covers the dimensions of:

 Predominantly Inattentive Subtype

 Predominantly Hyperactive/Impulsive subtype
 ADHD Combined Inattention/Hyperactivity
 Oppositional-defiant/conduct disorder screen
 Anxiety/depression

History and Test development

The Vanderbilt Assessment Scale has its roots in the work of Dr. Mark L. Wolraich at
the Oklahoma Health Sciences Center. His research on ADHD led to the development of the
initial Vanderbilt ADHD Diagnostic Rating Scale (VADRS). The NICHQ subsequently
adopted and refined the scale, resulting in the creation of the Vanderbilt Assessment Scale.

The scale has undergone several revisions and updates to enhance its psychometric
properties and clinical utility. The most recent edition incorporates the latest diagnostic
criteria for ADHD and related disorders, ensuring its alignment with current clinical practice.

Psychometric properties
 Concurrent validity has been established through comparing parent rating with teacher
ratings and those independently diagnosed with ADHD (Mark et al., 2003). Confirmatory
factor analysis confirmed four factors that fit with the theoretical formulation of inattention,
hyperactivity/impulsivity, ODD-CD, and anxiety-depression subscales.

Becker et al. (2011) validated the subscales but reformulated the scoring method for
the comorbid sub-scales by using the total sum of scores. In this scoring system the total sum
of the subscales (rather than when a parents rates either 2 or 3 on the Likert scale), ODD is
ruled out at <10, CD at <4, Anxiety at <5 and Depression at <5. Nevertheless, the overall
scale was validated and found to have high reliability and clinical utility.

Test administration

The administration of the NICHQ Vanderbilt Assessment Scale involves completing

the information of the patient/client and reading relevant instructions. After this, ratings will
be obtained from both parents/caregivers and teachers, who independently assess the child's
behaviour over a specified period. Each informant responds to items that quantify the
frequency and severity of ADHD-related behaviours on a Likert-type scale. The combined
scores from these ratings provide a comprehensive evaluation of the child's symptomatology
across different settings.

Instructions for Caregivers/Parents

Each rating should be considered in the context of what is appropriate for the age of
your child. When completing this form, please think about your child’s behaviors in the past
6 months

Scoring

Scoring of the scale involves calculating summary scores based on the responses from
parents and teachers, which can then be interpreted according to established guidelines.

Scores are presented for the three subtypes of ADHD:

  Predominately Inattentive Subtype. A child meets the diagnostic criteria if they
have six or more “Often” or “Very Often” on items 1 to 9, plus a performance
problem (scores of 1 or 2) on questions 48 to 55.
 Predominately Hyperactive/Impulsive Subtype. A child meets diagnostic criteria if
they have six or more “Often” or “Very Often” on items 10 through 18, plus a
performance problem (scores of 1 or 2) on questions 48 to 55.
 Combined Subtype. A child meets the diagnostic criteria if they meet the above
criteria for both Inattentive and Hyperactive/Impulsive subtypes.

Percentiles are presented (based upon the age of the child) comparing the respondent’s
scores to those of a community sample of 1,570 parents in the USA (Anderson et al., 2022). A
percentile of 50 indicates average (and healthy) functioning, and higher percentiles indicate
more reported difficulties. For example, a percentile of 90 indicates the parent reports more
problems for their child that 90 percent of other parents.

In addition to the ADHD scales, scores are presented for frequently comorbid difficulties.
Children with scores below the clinical cutoff are highly unlikely to meet the diagnostic
criteria for that disorder. Children above the cutoff on the ODD, CD, Anxiety/Depression
sub-scales should be further evaluated, as these sub-scales are only designed as a cursory
screening measure for such problems.

Oppositional Defiant Disorder is covered in items 19 to 26. To be above the clinical cutoff
score of 2 or 3 on 4 (or more) out of 8 behaviors on questions 19–26 AND score a 1 or 2 on
any of the performance questions 48–55.

Conduct Disorder is covered in items 27 to 40. To be above the clinical cutoff scores a 2
or 3 on 3 (or more) out of 14 behaviors on questions 27–40 AND score a 1 or 2 on any of the
performance questions 48–55

Anxiety/ Depression is covered in items 41 to 47. To be above the clinical cutoff scores a
2 or 3 on 3 (or more) out of 7 behaviors on questions 41–47 AND score a 1 or 2 on any of the
performance questions 48–55.

Clinicians use these scores to inform diagnostic decisions, treatment planning, and
monitoring of intervention outcomes.
 References

Anderson, N. P., Feldman, J. A., Kolko, D. J., Pilkonis, P. A., & Lindhiem, O. (2022).
National Norms for the Vanderbilt ADHD Diagnostic Parent Rating Scale in
Children. Journal of Pediatric Psychology, 47(6), 652–661.
https://doi.org/10.1093/jpepsy/jsab132

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 and Behavioral Pediatrics, 33(3),
221. https://doi.org/10.1097/dbp.0b013e318245615b

Wolraich, M, Lambert, W., Doffing, M., Bickman, L., Simmons, T., Worley, K., (2003).
Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a
Referred Population, Journal of Pediatric Psychology, Volume 28, Issue 8, 1, Pages
559–568. https://doi.org/10.1093/jpepsy/jsg046

Wolraich, M. L., Hannah, J. N., Baumgaertel, A., & Feurer, I. D. (1998). Examination of
DSM-IV critieria for attention deficit/hyperactivity disorder in a county-wide sample.
Journal of Developmental and Behavioral Pediatrics, 19, 162–
168. https://doi.org/10.1097/00004703-199806000-00003
 Psychological Assessment Report

Demographic details

Name: A.B.

Date: 15/07/2024

Age: 5 years, 4 months

Gender: Female

Ethnic Background: Indian

Rater’s Name: GKC

Purpose of Testing: The present test was administered for academic purposes

Test Administered: NICHQ Vanderbilt Assessment Scale- Parent

Background Information

The client is a 5 old year girl child, currently enrolled in 1st grade in Mother’s
International School, New Delhi. She comes from a nuclear family and his grandmother from
a middle-income socioeconomic status. Her father is an IT professional at an MNC and her
mother is self employed as a tuition teacher. The child performs decently in school and
finishes her homework on time. She also takes part in extracurricular activities like skating
and dance classes. The child adheres to parental directives and the mother is responsible for
the disciplining of the child. There is no history of neurodevelopmental delays among the
family members.

Behavioural Observation

The rapport formation with the child was very easy during the interview. Throughout
the assessment, the child sat quietly and paid attention but at some points asked her mother
things about the test. She also looked tensed when her mother was answering questions
relating to her performance. She also got up sometimes and went to his grandmother living in
the same house. But overall, attention could be focused and did not create disturbance.
Test findings

Domain Required Score Obtained Score Remarks

Predominantly Score a 2 or 3 on 6 out Scored 2 or 3 on Symptoms of

Inattentive Subtype of 9 items (1-9) 0 out of 9 items Predominantly
& (1-9) Inattentive
Score 4 on at least 2 & Subtype Absent
items or 5 on any of the Scored 4 or 5 on
performance questions no items (48-55)
48-55

Predominantly Score a 2 or 3 on 6 out Scored 2 or 3 on Symptoms of

Hyperactive/Inattentive of 9 items (10-18) 0 out of 9 items Predominantly
& (10-18) Hyperactive/
Score 4 or 5 on any of & Impulsive
the Performance Scored 4 or 5 on subtype absent
questions 48-55 no items (48-55)

ADHD Combined Requires the above Criteria not met Symptoms of

Inattention/Hyperactivity criteria on both ADHD
inattention and Combined Type
hyperactivity/impulsivity absent

Oppositional-Defiant Must score a 2 or 3 on 4 Scored 2 on one Symptoms of

Disorder Screen out of 8 behaviors on item out of 8 Oppositional -
questions 19–26 items (19-26) Defiant Disorder
& & absent
Score a 4 or 5 on any of Scored 4 or 5 on
the Performance no items (48-55)
questions 48–55

Anxiety/Depression Must score a 2 or 3 on 3 Scored 0 on all Symptoms of

Screen out of 7 behaviors on the 7 items (41- Anxiety/
questions 41–47 47) Depression
& & absent
Score a 4 or 5 on any of Scored 4 or 5 on
the Performance no items (48-55)
questions 48–55

The client scored a 0 or 1 in most of the questions and does not show any
manifestations of symptoms of ADHD except for one item- is touchy or easily annoyed by
others. This could be because she lives with adults and is not used to any peer interaction at
home. Apart from that, in the performance subscale, all the items were marked above average
except for participation in group activities which was marked average as she enjoys solitary
activities like skating more than team work.

Impressions

According to the NICHQ Vanderbilt ADHD Assessment - PARENT Format, it is

suggested that the child does not manifest any symptoms of any subtype of ADHD. She also
does not meet the criteria of ODD, CD and Anxiety/ Depression. She just gets often annoyed
by others because she thinks they do not follow her way of working but otherwise is mostly
attentive and follows instructions. Thus, she does not require a diagnosis of ADHD.

Recommendations

Client A.B. shows no clinical symptoms of ADHD, ODD, CD and Anxiety and
Depression. Thus there are no recommendations as such but for a child showing symptoms
and reaching the symptoms, certain recommendations include

Follow up ADHD Assessment

A subsequent ADHD follow up assessment using the follow-up sheet in the

questionnaire is advised to corroborate the provisional diagnosis with the symptoms found of
either subtype or with that of performance.

VADTRS Assessment

Additional evaluation by the teacher of the client using the Teacher Rating form will
help understand the manifestations of the symptoms at school with peers and authority
figures, academic performances, reading and writing outside of home.

Executive Function Training with Play Therapy

This technique will help mitigate both inattentive and hyperactive behaviours in a
childlike initiating and completing tasks on time along with better attention and memory.

Social Skills and Organisational Skills Training

 Training in organisational and social skills will help improve social interaction with
peers, siblings and family and managing their functional problems like writing school exams
or completing daily tasks on time.

Behavioural Parent Training

This approach will include psychosocial and behavioural techniques instructing

parents on maintaining a positive environment at school and fostering a positive parent-child
relationship. It will help teach parents skills of reinforcement, punishment and other
behavioural techniques to deal with the maladaptive behaviour of the child and encourage
appropriate behaviours.