Interactive Interpreter

Wender Utah Rating Scale for ADHD - 25 WURS-25

The WURS-25 (Wender Utah Rating Scale, 25-item) is a 25-item self-report questionnaire in which adults rate their own childhood behaviour to screen retrospectively for childhood ADHD. Items are rated 0–4 for a total of 0–100, and a score of 46 or higher is the validated positive screen from the original validation study; it supports, but does not replace, a full adult ADHD assessment.

  • Administer once during ADHD evaluation to capture childhood history, with re-use only if the initial assessment was incomplete or unclear.
  • Rarely repeated, as responses should not change over time
  • May be re-administered only if an initial assessment was incomplete or unclear

For professional reference, research, and education only. Not for diagnosis or medical advice.

WURS-25 Score Interpreter

  • Enter a total score to see its range.

  • 25 items rated 0 (not at all) to 4 (very much) about childhood; total 0–100. A retrospective screen, not a diagnosis.

    Total scoreInterpretation
    46+Positive screen (≥46)Consistent with probable childhood ADHD; integrate with developmental history and a full adult ADHD evaluation.
    0–45Below cutoff (<46)Below the validated cutoff. Does not rule out ADHD; recall of childhood can be incomplete.

    Ward MF, Wender PH, Reimherr FW (1993). Am J Psychiatry 150:885–890. Cutoff of 46 or higher.

The WURS-25 (Wender Utah Rating Scale, 25-item) is a self-report questionnaire in which adults rate their own childhood behaviour, used to screen retrospectively for childhood ADHD. Totals run 0 to 100, and a score of 46 or higher is the positive screen from the original validation study [1].

Why was the WURS-25 developed?

Diagnosing ADHD in adults requires establishing that symptoms were present in childhood. The WURS was developed to support this requirement by giving adults a structured way to report on early life behaviours.

The WURS-25 is made up of the 25 items of the 61-item WURS-61 that differed most between adults with ADHD and comparison adults [1].

The WURS-25 captures emotional and behavioural traits historically associated with the Utah Criteria for ADHD, which emphasize not only inattention and hyperactivity, but also mood lability, disorganization, impulsivity, and difficulty with self-regulation. Because retrospective reporting is inherently subjective, the WURS-25 should be interpreted within a multi-method diagnostic approach.

What does the WURS-25 measure?

The WURS-25 assesses retrospective childhood behaviours related to:

  • Inattention and distractibility
  • Hyperactivity and restlessness
  • Impulsivity
  • Emotional dysregulation
  • Irritability and temper
  • Academic difficulties
  • Social conflict or interpersonal challenges
  • Disorganization and forgetfulness

All items contribute to one total score; no subscales are used in standard scoring.

How do you give the WURS-25?

Adults complete the WURS-25 themselves, rating how much each item applied to them as a child from 0 (not at all) to 4 (very much). It is usually given once during an ADHD evaluation to capture childhood history.

  • Best administered as part of a comprehensive adult ADHD evaluation
  • Useful when childhood records or parental reports are unavailable
  • Should be contextualized rather than treated as historical fact
  • Some individuals may over- or under-report due to mood, insight, or self-concept
  • Can complement other measures such as the ASRS, CAARS, or structured interviews

How do you score and interpret the WURS-25?

Score range: 0–100 (sum of 25 items, each 0–4). Use the score interpreter above to check a total.

Higher scores reflect stronger recollections of childhood ADHD-related symptoms.

Validated cutoff:

  • ≥46 → Positive screen for probable childhood ADHD [1]

Important interpretation notes:

  • The WURS-25 cannot confirm childhood ADHD; its utility is in supporting diagnostic formulation
  • Retrospective self-report can be affected by memory bias, mood, or current functioning
  • Should be integrated with developmental history, collateral information (when available), and structured ADHD evaluation
  • High scores may reflect other childhood conditions (e.g., mood disorders, conduct-related issues)

Psychometric properties

Reliability

  • In 759 Italian undergraduates, the WURS showed good internal consistency (Cronbach's alpha .888) and satisfactory 1-week (r = .981) and 2-month (r = .924) retest reliability [3]
  • Mother and self-report totals agreed closely in the same study (intraclass r = .883) [3]

Validity

  • In the original study (81 adult outpatients with ADHD, 100 adults without ADHD and 70 outpatients with unipolar depression), a cutoff of 46 or higher correctly identified 86% of the adults with ADHD, 99% of the comparison adults and 81% of the depressed adults; scores correlated moderately with parents' childhood ratings [1]
  • In 646 adults with clinically diagnosed ADHD and 908 population controls, the WURS discriminated between the groups with an area under the curve of 0.956 [2]
  • In an adult community sample, the WURS factors related as strongly to other psychopathology as to ADHD, raising concerns about its specificity [4]

Limitations

  • Retrospective recall is vulnerable to bias
  • Emotional items may inflate scores in adults with depression, anxiety, or trauma histories; WURS factors were not specific to ADHD in one community study [4]
  • Not suitable as a stand-alone diagnostic tool
  • Does not assess current ADHD symptoms

For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.

Related

FAQ

  • What is the Wender Utah Rating Scale?

    The Wender Utah Rating Scale (WURS) is a self-report measure used in adult ADHD assessment to retrospectively evaluate the presence and severity of ADHD symptoms in childhood. Adults complete it to recall their behaviour and emotions before age 12.

  • How is the WURS-25 scored?

    The WURS-25 is a 25-item subset of the original 61-item scale, each rated 0 (not at all) to 4 (very much), producing a total score of 0–100. The validated cutoff is 46 or higher: in the original study it correctly identified 86% of adults with ADHD, 99% of non-clinical adults, and 81% of adults with unipolar depression.

  • Why is retrospective childhood data needed for adult ADHD diagnosis?

    DSM-5-TR requires that several inattentive or hyperactive-impulsive symptoms be present before age 12 to diagnose ADHD in adults. The WURS captures this developmental history through structured self-report when childhood records or informants aren't available.

  • How is the WURS different from the ASRS?

    The Adult ADHD Self-Report Scale (ASRS) measures current adult ADHD symptoms in the last 6 months; the WURS measures retrospective childhood symptoms. They are commonly used together, the ASRS for current presentation and the WURS for developmental history, as part of a comprehensive ADHD evaluation.

References

    1. 1.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):885-890.
    2. 2.Brevik EJ, Lundervold AJ, Haavik J, Posserud MB. Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. Brain Behav. 2020;10(6):e01605.
    3. 3.Fossati A, Di Ceglie A, Acquarini E, et al. The retrospective assessment of childhood attention deficit hyperactivity disorder in adults: reliability and validity of the Italian version of the Wender Utah Rating Scale. Compr Psychiatry. 2001;42(4):326-336.
    4. 4.Stanton K, Watson D. An Examination of the Structure and Construct Validity of the Wender Utah Rating Scale. J Pers Assess. 2016;98(5):545-552.

    © Ward, Wender & Reimherr (1993). All rights reserved.

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