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Parent Follow-up Vanderbilt Assessment Scale

ECR :

Client's Name : Today's Date :

Recent Behavior
Please circle the number of the phrase that best describes
your child’s behaviors in the past week.

1 - does not pay attention to details or makes careless mistakes (homework, duties) RarelySometimesOftenVery Often

2 - has difficulty keeping attention to what needs to be done RarelySometimesOftenVery Often

3 - does not seem to listen when spoken to directly RarelySometimesOftenVery Often

4 - does not follow through when given directions, fails to finish activities RarelySometimesOftenVery Often

5 - has difficulty organizing tasks and activities RarelySometimesOftenVery Often

6 - avoids, dislikes or does not want to start tasks that require ongoing mental effort RarelySometimesOftenVery Often

7 - loses things necessary for tasks or activities (toys, pencils, assignments, books) RarelySometimesOftenVery Often

8 - is easily distracted by noises or other stimuli RarelySometimesOftenVery Often

9 - is forgetful in daily activities RarelySometimesOftenVery Often

10 - fidgets with hands or feet or squirms in seat RarelySometimesOftenVery Often

11 - leaves seat when remaining seated is expected RarelySometimesOftenVery Often

12 - runs about or climbs too much when remaining seated is expected RarelySometimesOftenVery Often

13 - has difficulty playing quietly or beginning quiet activities RarelySometimesOftenVery Often

14 - is “on the go” or often acts as if “driven by a motor” RarelySometimesOftenVery Often

15 - talks too much RarelySometimesOftenVery Often

16 - blurts out answers before questions have been completed RarelySometimesOftenVery Often

17 - has difficulty waiting his or her turn RarelySometimesOftenVery Often

18 - interrupts or intrudes on others’ conversations or activities RarelySometimesOftenVery Often

19 - argues with adults RarelySometimesOftenVery Often

20 - loses temper RarelySometimesOftenVery Often

21 - actively defies or refuses to go along with adults’ requests or rules RarelySometimesOftenVery Often

22 - deliberately annoys people RarelySometimesOftenVery Often

23 - blames others for his or her mistakes or misbehaviors RarelySometimesOftenVery Often

24 - is touchy or easily annoyed by others RarelySometimesOftenVery Often

25 - is angry or resentful RarelySometimesOftenVery Often

26 - is spiteful and wants to get even RarelySometimesOftenVery Often

27 - is fearful, anxious or worried RarelySometimesOftenVery Often

28 - is afraid to try new things for fear of making mistakes RarelySometimesOftenVery Often

29 - feels worthless or inferior RarelySometimesOftenVery Often

30 - blames self for problems, feels guilty RarelySometimesOftenVery Often

31 - feels lonely, unwanted or unloved; complains “no one loves me” RarelySometimesOftenVery Often

32 - is sad, unhappy or depressed RarelySometimesOftenVery Often

33 - is self-conscious or easily embarrassed RarelySometimesOftenVery Often

Current medications & Reason: Max Dose Date taken

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September 3, 2021 12:43 pm PDT

Parent Follow-up Vanderbilt Assessment Scale Uploaded by Adam Falk - adam.falk@options.org IP 100.42.162.250