NICHQ Vanderbilt Assessment Follow-up—PARENT Informant

Please correct the errors described below.

Directions: Each rating should be considered in the context of what is appropriate for the age of your child. Please think about your child’s behaviors since the last assessment scale was filled out when rating his/her behaviors.



Frequency Code: 1 = Excellent; 2 = Above Average; 3 = Average; 4 = Somewhat of a Problem; 5 = Problematic

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Copyright ©2002 American Academy of Pediatrics and National Initiative for Children’s
Healthcare Quality
Adapted from the Vanderbilt Rating Scales developed by Mark L. Wolraich, MD.
Revised - 0303

NICHQ Vanderbilt Assessment Follow-up—PARENT Informant, continued

Side Effects: Has your child experienced any of the following side effects or problems in the past week?

Are these side effects currently a problem?
Legend: None; Mild; Moderate; Severe

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