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.

Signature

Clear

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.