Wender Utah ADHD Rating Scale

Facilitates diagnosis of attention deficit hyperactivity disorder in adults based on childhood symptoms.

In the text below the calculator there is more information about the scale, a table with the complete 61-item version and a summary of the original study.


The Wender Utah ADHD rating scale evaluates adults with suspicion of attention deficit hyperactivity disorder based on symptoms that they might have experienced during childhood.

This form uses the condensed, 25-item version of the scale, the one with the most relevant items for ADHD.

The scale is self-report and the patient is asked to remember childhood behaviour and feelings.


ADHD is generally a condition with early onset. 60% of children with ADHD continue to display symptoms throughout adult life.

The cut off score is considered to be at 46 points for the 25-item scale.

In the original study, 86% of patients with ADHD, 99% of normal persons and 81% of depressed subjects were diagnosed accurately (positive or negative) using this cut off value.


As a child I was (or had):
1Easily distracted
2Anxious worrying
3Nervous fidgety
4Inattentive daydreaming
5Hot- or short-tempered
6Temper outbursts tantrums
7Trouble not finishing things
8Stubborn strong-willed
9Sad or blue depressed
10Disobedient with parents
11Low opinion of myself
12Irritable
13Moody ups and downs
14Angry
15Impulsive, acting without thinking
16Tendency to be immature
17Guilty feelings regretful
18Losing control of myself
19Tendency to be or act irrational
20Unpopular, not very friendly
21Trouble seeing someone else`s view
22Trouble with authorities
23Overall a poor student
24Trouble with math or numbers
25Not achieving up to potential
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WURS explained

This is a scale used in the diagnosis of attention deficit hyperactivity disorder based on behaviour and feelings experienced during childhood.

The self-report questionnaire consists of 61-items, 25 of which are highly relevant items for ADHD (thus used in the scale for ADHD) and can help link childhood symptoms with patterns of behaviour in adulthood.

The scale is however limited by the capacity of the patient to recall memories from childhood.

Each of the questions in the retrospective scale has 4 answer choices, awarded points from 0 to 4:

■ Not at all or slightly (0 points);

■ Mildly (1 point);

■ Moderately (2 points);

■ Quite a bit (3 points);

■ Very much (4 points).

 

61-item Wender Utah Rating Scale

The WURS model is based on the DSM criteria of attention deficit diagnosis. These are seven classes (that are contained in the full 61-item version):

■ Attention difficulties;

■ Hyperactivity/restlessness;

■ Temper;

■ Affective liability;

■ Emotional over-reactivity;

■ Disorganization;

■ Impulsivity.

The administration of the scale can help clinicians understand the mechanisms of adult attention deficit with hyperactivity disorder. The scale has shown good psychometric properties in various populations and demographics.

The following table introduces the full version, which can also be downloaded as pdf and printed for patients to use or for notes during the evaluation.

1 Active restless always on the go 32 Well-coordinated picked first in games
2 Afraid of things 33 Tomboyish (for women only)
3 Easily distracted with concentration problems 34 Running away from home
4 Anxious worrying 35 Getting into fights
5 Nervous fidgety 36 Teasing other children
6 Inattentive daydreaming 37 Leader bossy
7 Hot- or short-tempered 38 Difficulty getting awake
8 Shy sensitive 39 Follower led around too much
9 Temper outbursts tantrums 40 Trouble seeing things from someone else's point of view
10 Trouble with stick-to-it-tiveness not finishing things 41 Trouble with authorities
11 Stubborn strong-willed 42 Trouble with police
12 Sad or blue depressed 43 Headaches
13 Incautious. dare-devilish 44 Stomach aches
14 Dissatisfied with life 45 Constipation
15 Disobedient with parents 46 Diarrhea
16 Low opinion of myself 47 Food allergies
17 Irritable 48 Other allergies
18 Outgoing, friendly 49 Bedwetting
19 Sloppy disorganized 50 Overall a good student fast learner
20 Moody ups and downs 51 Overall a poor student slow learner
21 Angry 52 Slow in learning to read
22 Friends popular 53 Slow reader
23 Well-organized tidy neat 54 Trouble reversing letters
24 Impulsive, acting without thinking 55 Problems with spelling
25 Tendency to be immature 56 Trouble with mathematics or numbers
26 Guilty feelings regretful 57 Bad handwriting
27 Losing control of myself 58 Able to read pretty well but not really enjoying it
28 Tendency to be or act irrational 59 Not achieving up to potential
29 Unpopular, not very friendly 60 Repeating grades
30 Poorly coordinated 61 Suspended or expelled
31 Afraid of losing control of self -
 

Result interpretation

The results range between 0 and 100 when the 25-item scale is used and a cut-off at 46 points was provided. This means that patients who score 46 or above are likely to be diagnosed with attention deficit hyperactivity disorder.

In the original study: 86% of patients with ADHD, 99% of normal persons and 81% of depressed subjects were accurately diagnosed using this cut off value.

Because adult ADHD is mostly a condition with early onset and 60% of children with ADHD continue to display symptoms in adulthood, investigation of childhood symptoms has real value in diagnosis.

It is important to note that there is also a strong genetic determinism with this mental health condition likely to be inherited.

 

About the study

The scale was designed following a study by Ward, Wender and Reimherr in 1993. The complete 61-item Wender Utah Rating Scale (WURS) helps distinguish adults who could have been diagnosed with ADHD as children.

The scale was administered to 81 subjects already diagnosed with attention deficit hyperactivity disorder, 100 subjects that didn’t present any mental health conditions and 70 subjects diagnosed with unipolar depression.

The difference between the mean total scores of the patients with attention deficit hyperactivity disorder and the normal subjects was also highly significant.

The results from the scale were compared with results from the Parents' Rating Scale. A subscale with the most relevant 25-items for ADHD was also published.

The WURS is recommended as a sensitive scale for the identification of childhood ADHD and in the assessment of patients with ambiguous adult psychopathology.

 

ADHD symptoms

Adults who suffer from attention deficit disorders may also experience symptoms pertaining to other mental health conditions such as anxiety, depression or substance abuse.

The manifestations of this mental disorder may not be as obvious in adults as they are in children but there are patterns of behaviour which indicate an attention deficit, such as:

■ Task (anticipatory) avoidance;

■ Impatience;

■ Irritability;

■ Inability to concentrate;

■ Pseudo efficiency;

■ Juggling activities and mixing professional with personal life;

■ Improper reactions to interpersonal problems;

■ Susceptibility to substance abuse.

 

Original source

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(6):885-90.

Other references

1. Stein MA, Sandoval R, Szumowski E, Roizen N, Reinecke MA, Blondis TA, Klein Z. Psychometric characteristics of the Wender Utah Rating Scale (WURS): reliability and factor structure for men and women. Psychopharmacol Bull. 1995; 31(2):425-33.

2. McCann BS, Scheele L, Ward N, Roy-Byrne P. Discriminant validity of the Wender Utah Rating Scale for attention-deficit/hyperactivity disorder in adults. J Neuropsychiatry Clin Neurosci. 2000; 12(2):240-5.


App Version: 1.0.1

Coded By: MDApp

Specialty: Psychiatry

System: Nervous

Objective: Diagnosis

Type: Scale

No. Of Items: 25

Year Of Study: 1993

Abbreviation: WURS

Article By: Denise Nedea

Published On: June 29, 2017 · 02:25 PM

Last Checked: June 29, 2017

Next Review: June 29, 2018