How is the Vanderbilt Attention Deficit Hyperactivity Disorder (ADHD) form scored?

Scoring the Vanderbilt ADHD Form

The Vanderbilt ADHD Rating Scale is scored by counting symptoms rated as "often" or "very often" (scores of 2 or 3) on the inattention and hyperactivity-impulsivity subscales, with a diagnosis requiring at least 6 symptoms in one or both domains plus documented impairment in at least one performance area. 1

Symptom Scoring Method

• Count only items rated as "often" (2) or "very often" (3) as positive symptoms when determining if diagnostic thresholds are met 2
• The inattention subscale contains 9 items corresponding to DSM-5 criteria for inattentive symptoms 3, 2
• The hyperactivity-impulsivity subscale contains 9 items corresponding to DSM-5 criteria for hyperactive-impulsive symptoms 3, 2

Diagnostic Thresholds

• Predominantly Inattentive Presentation: 6 or more inattention symptoms rated "often/very often" AND fewer than 6 hyperactivity-impulsivity symptoms 4, 5
• Predominantly Hyperactive-Impulsive Presentation: 6 or more hyperactivity-impulsivity symptoms rated "often/very often" AND fewer than 6 inattention symptoms 4, 5
• Combined Presentation: 6 or more symptoms in BOTH inattention AND hyperactivity-impulsivity domains 4, 5

Performance/Impairment Assessment

• The performance section must show impairment (rated as "problematic" or "somewhat of a problem") in at least one domain (academic performance, classroom behavior, peer relationships, organizational skills, or assignment completion) to meet diagnostic criteria 1
• This impairment requirement is essential because DSM-5 criteria mandate functional impairment across multiple settings, not just symptom presence 1

Critical Implementation Points

• Collect Vanderbilt scales from BOTH parents AND teachers to obtain comprehensive behavioral information from multiple sources, as recommended by the American Academy of Pediatrics 1
• The scale serves as a screening and documentation tool, NOT a standalone diagnostic instrument—diagnosis requires comprehensive clinical evaluation including interview, review of school records, and ruling out alternative explanations 1
• Expect relatively low agreement between parent and teacher ratings (correlation coefficients around 0.14), which is normal and reflects different behavioral presentations across settings 6, 2

Comorbidity Screening

• The Vanderbilt includes subscales for oppositional defiant disorder (ODD), conduct problems, and anxiety/depression that are scored similarly (counting "often/very often" responses) 3, 2
• A cutoff score of 7.5 for the sum of parent and teacher reading performance items has excellent utility for ruling out comorbid reading and spelling learning disorders, though math learning disorders cannot be effectively ruled out using the Vanderbilt 7
• Clinicians may under-recognize ODD even when rating scales are positive, so pay particular attention to these subscales when present 6

Psychometric Reliability

• The Vanderbilt demonstrates robust test-retest reliability exceeding 0.80 for all subscales over 2-week intervals 1, 8
• Internal consistency is excellent with KR20 coefficients ranging from 0.88-0.91 for binary scoring 1, 2
• When combined with teacher ratings and structured interview, the scale achieves sensitivity of 0.80, specificity of 0.75, and negative predictive value of 0.98 1, 2