Evidence-based assessment/Instruments/Vanderbilt ADHD Diagnostic Rating Scale

The Vanderbilt ADHD Diagnostic Rating Scale (VADRS) is a preliminary self-report instrument assessment tool for attention deficit hyperactivity disorder (ADHD) symptoms with children ages 6–12 and their effect on performance in academic and behavioral areas. This method of ADHD diagnostic self-report was developed by Mark Wolraich at the Oklahoma Health Sciences Center. Wolraich created the Vanderbilt diagnostic style because other assessments lacked common co-morbid conditions associated with ADHD. There are two versions available: a parent form that contains 55 questions, and a teacher form that contains 43 questions. The VADPRS (parent) was compared with the VADTRS (teacher) and C-DISC-IV ratings of children in clinical and nonclinical samples.

A shorter follow-up version of the Vanderbilt ADHD Diagnostic Rating Scale is also available for parents and teachers. The follow-up form contains 26 questions divided into two sections, one measuring the frequency of the child's ADHD symptoms, and one measuring his or her performance in school and interactions with siblings and peers. The follow-up form may be used as either a stand-alone screen for ADHD symptoms, or as a measure of a child's symptoms following pharmacological or behavioral interventions.

Scoring and interpretation
Both parent and teacher assessment scales have two components: symptom assessment and impairment in performance. The symptom assessment component screens for symptoms relevant to inattentive and hyperactive ADHD subtypes. To meet criteria for ADHD diagnoses, one must have 6 positive responses to either the core 9 inattentive symptoms or core 9 hyperactive symptoms, or both.

Both the parent and the teacher versions ask the respondent to rate the frequency of a child's behaviors on a 0-3 scale as follows: A positive response is either a score of 2 or 3 ("often" to "very often").
 * 0: "never";
 * 1: "occasionally";
 * 2: "often";
 * 3: "very often".

The final 8 questions of both versions ask the respondent to rate the child's performance in school and his or her interactions with others on a 1-5 scale, with 1-2 meaning "problematic", 3 meaning "average", and 4-5 meaning "above average".

To meet criteria for ADHD, there must be at least one score for the performance set that is either a 4 or 5, as these scores indicate impairment in performance.

Parent version
The parent version of the Vanderbilt ADHD Diagnostic Rating Scale contains 6 subscales. Behaviors are included in the total for each subscale if they are scored as a 2 or a 3. The rules for scoring are as follows:
 * ADHD inattentive type: Must score either a 2 or 3 on six or more items in questions 1-9, and score of 1 or 2 on any items in the performance section.
 * ADHD hyperactive/impulsive type: Must score either a 2 or 3 on six or more items in questions 10-18, and a score of 1 or 2 on any items in the performance section.
 * ADHD combined type: Meets criteria for both ADHD inattentive type and hyperactive/impulsive type.
 * Oppositional defiant disorder (ODD): Must score either a 2 or a 3 on four or more items in questions 19-26.
 * Conduct disorder: Must score either a 2 or 3 on three or more items in questions 27-40.
 * Anxiety/depression: Must score either a 2 or 3 on three or more items in questions 41-47.

The parent version showed diagnostic sensitivity of .80 and specificity of .75 for predicting diagnoses of ADHD in a community sample. The study used the C-DISC as a structured interview and also required teachers noting at least 4 symptoms to confirm the diagnosis. These yield a diagnostic likelihood ratio of 3.2 for positive scores (DLR+), and 0.75 for low risk scores (DLR-), with either 6+ inattention items or 6+ hyperactive/impulsive symptoms counting as a positive test result.

Teacher version
The teacher version of the Vanderbilt ADHD Diagnostic Rating Scale contains 5 subscales. Behaviors are included in the total for each subscale if they are scored as a 2 or a 3. A score of 1 or 2 on at least one question in the performance section indicates impairment. The rules for scoring are as follows:
 * ADHD inattentive type: Must score either a 2 or 3 on six or more items in questions 1-9.
 * ADHD hyperactive/impulsive type: Must score either a 2 or 3 on six or more items in questions 10-18.
 * ADHD combined type: Meets criteria for both ADHD inattentive type and hyperactive/impulsive type.
 * Oppositional defiant disorder (ODD): Must score either a 2 or a 3 on three or more items in questions 19-28.
 * Anxiety/depression: Must score either a 2 or 3 on three or more items in questions 29-35.

Downloads

 * Parent (55-item) version
 * VADRS (Parent version) - Automatically scored online version
 * VADRS (Parent version) - PDF
 * VADRS (Parent follow-up version) - PDF
 * VADRS (Parent version) - Scoring instructions - PDF


 * Teacher (43-item) version
 * VADRS (Teacher version) - PDF
 * VADRS (Teacher follow-up version) - PDF
 * VADRS (Teacher version) - Scoring instructions - PDF