What is the Vanderbilt ADHD Diagnostic Rating Scale (VADRS) and how does it work?

The VADRS is a relatively new instrument, created in 2003 by Mark L. Wolraich, MD, and colleagues. They noted that other behaviour rating scales, like Conners and the Child Behavior Checklist, deviated from the DSM-IV’s diagnostic criteria for ADHD in key ways. As a response, the authors developed the VADRS as a simple instrument for teachers and parents to identify core symptoms of ADHD aligned with standard diagnostic criteria. The version of the VADRS included in Creyos Health is designed for parents, and also known as the Vanderbilt ADHD Parent Rating Scale (VADPRS).

The scale includes 55 items covering the DSM-IV criteria for ADHD, criteria for oppositional defiant disorder (ODD), criteria for conduct disorder (CD), and criteria from the Pediatric Behavior Scale for anxiety and depression. Additional items cover performance in school and relationships with others. It takes about 10 minutes to complete. Parents rate the severity of each behaviour over the past 6 months on a 4-point scale from “never” to “very often,” then scores are tallied to provide guidance on whether or not the criteria for inattentive, hyperactive/impulsive, and combined types of ADHD have been met. Issues with oppositional-defiant disorder, conduct disorder, and anxiety/depression are also highlighted if cutoff scores are reached (see the National Institute for Children’s Health Quality for scoring details).

The Creyos Health version of the VADRS allows a parent to rate the behaviours of children aged 6 to 12, and automatically calculates scores related to ADHD and comorbid conditions. The Vanderbilt Scale joins the ASRS, which measures symptoms of adult ADHD.

The VADRS has proven to be a reliable tool with strong psychometric properties. Wolraich et al. (2003) concluded that the internal consistency and factor structure of the parent version of the VADRS are acceptable, and consistent with other measures of ADHD as well as DSM-IV criteria. As a result, the scale is widely used in both research and clinical settings.

Note that clinical judgment should always be used when interpreting an individual’s VADRS scores. It is a screening scale, not a diagnostic test. A trained clinician must follow up with patients who reach the cutoff score for ADHD subtypes or comorbid disorders.