Wender Utah Rating Scale

This Rating Scale is used in determining if adults are likely to have ADD/ADHD.

Wender Utah Rating Scale

Attention Deficit Hyperactivity Disorder in Adults, Paul Wender M.D.,1995.

 

Name_____________________  
Completed by_______________

As a Child I Was (or Had):

Not at all or slightly

Moder-
ately

Mildly

Quite a
Bit

 Very
Much
  1.Active, restless, always on the go
  2.Afraid of things
  3.Concentration problems, easily distracted
  4.Anxious, worrying
  5.Nervous, fidgety
  6.Inattentive, daydreaming
  7.Hot or short temp, low boiling point
  8.Shy, sensitive
  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
13.Uncautious, 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
17.Irritable
18.Outgoing, friendly, enjoy company of people
19.Sloppy, disorganized
20.Moody, have ups + downs
21.Feel angry
22.Have friends, popular
23.Well organized, tidy, neat
24.Acting without thinking, impulsive
25.Tend to be immature
26.Feel guilty, regretful
27.Lose control of myself
28.Tend to be or act irrational
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
33.(for women only) Tomboyish
34.Ran away from home
35.Get in fights
36.Teased other children
37.Leader, bossy
38.Difficulty getting awake
39.Follower, lead around too much
40.Trouble seeing things from someone else's point of view
41.Trouble with authorities, trouble with school, visits to the principal's office
42.Trouble with the police, booked, convicted

Medical Problems as a Child

43.Headaches
44.Stomach aches
45.Constipation
46.Diarrhea
47.Food Allergies
48.Other Allergies
49.Bedwetting

As a Child in School


50.Overall a good student, fast
51.Overall a poor student, slow learner
52.Slow reader
53.Slow in learning to read
54.Trouble reversing letters
55.Trouble with spelling
56.Trouble with math or numbers
57.Bad handwriting
58.Though I could read pretty well, I never really enjoyed reading
59.Did not achieve up to potential
60.Repeated grades (which grades?)
61.Suspended or expelled (which grades?)

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