ADHD Evaluation / Assessment Tools

ADHD Evaluation / Assessment ToolsWe offer this set of tools to help caregivers in the assessment and management of children, adolescents, and adults affected by ADHD.

These forms may be downloaded and printed; you may bring completed forms with you to your visit, or mail them (in advance) to our office:

Chiropractic Neurology Center
9302 N. Meridian St., Suite 170
Indianapolis, IN 46280

Please do NOT email them since they may contain confidential (protected) medical information.

Assessment Tool Name
PDF Format
(*.requires Adobe Reader)

 

MS Word Document
(*.doc format)

Vanderbilt Assessment Scale – Parent Informant

This is a 55-item rating scale that has two components: symptom assessment and impairment of performance at home, in school, and in social settings. This rating scale is widely used by healthcare professionals to screen for symptoms of ADHD, oppositional defiant disorder, conduct disorder, and anxiety and depression in children.

Vanderbilt Assessment Scale – Teacher Informant

This is a 43-item rating scale that has two components: symptom assessment and impairment of performance in school. This rating scale is widely used by healthcare professionals to screen for symptoms of ADHD, oppositional defiant disorder, conduct disorder, and anxiety and depression in children.

SNAP-IV Teacher and Parent 18-Item Rating Scale

This is an 18-item norm-referenced checklist that is designed to determine if symptoms of ADHD are present. This checklist can be completed by either a parent or other caregiver or an educator for use by a healthcare provider in performing an assessment.

SNAP-IV-C Rating Scale (80-Items Revised)

The SNAP-IV-C Rating Scale is a revision of the SNAP Questionnaire. It contains 80 items that can be completed by parents, teachers, or other caregivers for use by a healthcare provider in performing an assessment. The items from the DSM-IV criteria for ADHD and Oppositional Defiant Disorder are included. In addition, the SNAP-IV-C contains 10 items from the SKAMP.These 10 items are classroom manifestations of inattention, hyperactivity, and impulsivity (i.e., getting started, staying on task, interactions with others, completing work, and shifting activities). The SKAMP may be used to estimate severity of impairment in the classroom.There are additional items from other DSM-IV disorders such as Conduct Disorder, Intermittent Explosive Disorder, Tourette’s Disorder, Stereotypic Movement Disorder, Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, Narcolepsy, Manic Episode, Major Depressive Episode, Dysthymic Disorder, etc.

ADHD Symptom Checklist Child / Adolescent Version

This is a 21-item checklist that is designed to determine if symptoms of ADHD are present—in what settings symptoms appear, when symptoms began and whether the child is impaired as a resultof having such symptoms.This checklist can be completed by a parent or other caregiver or an educator for use by a healthcare provider in performing an assessment.
Versión Española

ADHD Symptom Checklist Adult Version-Self-Report

This is a 21-item checklist that is designed to determine if symptoms of ADHD are present—in what settings such symptoms appear, when symptoms began and whether the adult is impaired as a result of having such symptoms. This is the self-report version to be completed by the person suspected of having ADHD.
Versión Española

ADHD Symptom Checklist Adult Version – Observer Report

This is a 21-item checklist that is designed to determine if symptoms of ADHD are present—in what settings such symptoms appear, when symptoms began and whether the adult is impaired as a result of having such symptoms. This is the observer report version to be completed by someone who knows the adult suspected of having ADHD.
Versión Española

Childhood Disorders Checklist

This is a listing of disorders described in the Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition (DSM IV). This checklist can be completed by a parent or other caregiver for use by a healthcare provider in performing an assessment.

Child and Adolescent Developmental History Form

This form asks about the child or adolescent’s history and includes questions about family composition, current concerns, developmental and medical information, family information, school information, child management techniques used in the home and the child’s strengths and accomplishments. This form can be completed by a parent or other caregiver for use by a healthcare provider in performing an assessment.

Novotni Social Skills Checklist – Self-Report Version

This checklist was designed by Michele Novotni, Ph.D. to evaluate social traits and social skills of adolescents and adults. The social skills that are evaluated include: basic manners, verbal communication skills, nonverbal communication skills, communication road blocks, organizational skills-trustworthiness, self-control, knowledge of social interaction, relationship skills and self-care. This form can be completed by an adolescent or adult.

Novotni Social Skills Checklist – Observer-Report Version

This checklist was designed by Michele Novotni, Ph.D. to evaluate social traits and social skills of adolescents and adults. The social skills that are evaluated include: basic manners, verbal communication skills, nonverbal communication skills, communication road blocks, organizational skills-trustworthiness, self-control, knowledge of social interaction, relationship skills and self-care. This observer form can be completed by an adolescent or adult.

ADHD Monitoring System (Instructions and Weekly Monitoring Form)

The ADHD Monitoring System was designed by David Rabiner, Ph.D. to carefully track a student’s progress in school so that caregivers will be alerted when any adjustments or modifications to treatment need to be made.This packet contains a monitoring form and the instructions needed to interpret the information this form provides.

ADHD Monitoring System (Weekly Monitoring Form only)

This packet contains a monitoring form only. For information about interpreting this form, please download the Instructions and Weekly Monitoring Form version above.
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For more information about Chiropractic Neurology Center and the conditions we treat, or to schedule an appointment for consultation, contact us.