Wender Utah Rating Scale for ADHD

Name

First Name Last Name

Date

Overview:

The Wender Utah Rating Scale can be used to assess adults for Attention Deficit Hyperactivity Disorder with a subset of 25 questions associated with that diagnosis.

Wender Utah Rating Scale

61 questions answered by the adult patient recalling his or her childhood behavior
5 possible responses scored from O to 4 points

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
1. Active restless always on the go
2. Afraid of things
3. Concentration problems/easily distracted
4. Anxious worrying

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
5. Nervous, fidgety
6. Inattentive, daydreaming
7. Hot or short-tempered, low boiling point
8. Shy, sensitive

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
9. Temper outbursts, tantrums
10. Trouble with stick-to-it-tiveness, not following through, failing to finish things started
11. Stubborn, strong-willed
12. Sad or blue, depressed, unhappy

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
13. Incautious, dare-devilish, involved in pranks
14. Not getting a kick out of things, dissatisfied with life
15. Disobedient with parents, rebellious, sassy
16. low opinion of myself

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
17. Irritable
18. Outgoing, friendly, enjoyed company of people
19. Sloppy, disorganized
20. Moody, ups an downs

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
21. Angry
22. Friends, popular
23. Well-organized, tidy, neat
24. Acting without thinking, impulsive

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
25. Tendency to be immature
26. Guilty feelings, regretful
27. Losing control of myself
28. Tendency to be or act irrational

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
29. Unpopular with other children, didn't keep friends for long, didn't get along with other children
30. Poorly coordinated, did not participate in sports
31. Afraid of losing control of self
32. Well-coordinated, picked first in games

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
33. Tomboyish (for women only)
34. Running away from home
35. Getting into fights
36. Teasing other children

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
37. Leader, bossy
38. Difficulty getting awake
39. Follower, led around to much
40. Trouble seeing things from someone else's point of view

As a child I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
41.Trouble with authorities, trouble with school, visits to principal's office
42. Trouble with police, booked, convicted

Medical problems as a child:

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
43. Headaches
44. Stomachaches
45. Constipation
46. Diarrhea
47. Food Allergies
48. Other allergies
49. Bedwetting

As a child in school I was (or had):

	Not at all or very slightly	Mildly	Moderately	Quite a bit	Very much
50. Overall a good student, fast
51. Overall a poor student, slow learner
52. Slow in learning to read
53. Slow reader
54. Trouble reversing letters
55. Problems with spelling
56. Trouble with mathematics or numbers
57. Bad handwriting
58. Able to read pretty well but never really enjoyed reading
59. Not achieving up to potential
60. Repeating grades
61. Suspended or expelled

My signature below attests that I or my patient representative completed this scale.

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Date

References:

Ward MF Wender PH Reimherr FW. The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood Attention Deficit Hyperactivity Disorder. Am J Psychiatry. 1993; 150: 885-890.