Wender Utah Rating Scale - 25 items (WURS-25)
What it is
The WURS-25 is a 25-item retrospective self-report measure used to assess childhood ADHD symptoms in adults. It asks individuals to reflect on their behaviour and experiences during childhood (approximately ages 6–10), helping clinicians determine whether ADHD may have been present from an early age — a key diagnostic criterion for adult ADHD under most classification systems.
The WURS-25 is a shortened version of the original 61-item Wender Utah Rating Scale. The 25 items were selected because they showed the greatest mean difference between adults with ADHD and controls.
How is it used
- Suitable for adults aged 18 and over
- Takes approximately 10–15 minutes to complete
- Used as part of a broader ADHD assessment, alongside current symptom measures and clinical interview
- Provides a retrospective account of childhood symptoms rather than current functioning
- Supports differential diagnosis, particularly when distinguishing ADHD from mood or anxiety disorders
What do the scores mean?
Each of the 25 items is rated on a five-point scale from 0 (not at all or very slightly) to 4 (very much), giving a total score range of 0 to 100. Higher scores reflect a greater retrospective report of childhood ADHD symptoms.
Two established cut-off scores are commonly used:
- Score of 36 or above: Identifies adults with a childhood history of ADHD symptoms, with 96% sensitivity and 96% specificity in the original validation (Ward et al., 1993)
- Score of 46 or above: A more conservative threshold that improves specificity, correctly identifying 86% of adults with ADHD and 99% of healthy controls, and 81% of adults with depression
The higher threshold (46+) is often preferred in clinical settings where distinguishing ADHD from depression or anxiety is important, as lower scores in those groups may still fall above the 36 cut-off.
Results should not be used in isolation — the retrospective nature of the WURS-25 means memory limitations and response bias should always be considered.
Developer
The WURS was developed by Paul H. Wender and colleagues. The 25-item version was validated by Ward, Wender, and Reimherr (1993).
References:
Ward, M. F., Wender, P. H., & Reimherr, F. W. (1993). The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. American Journal of Psychiatry, 150(6), 885–890.
Reimherr, F. W., Marchant, B. K., Gift, T. E., Steans, T. A., & Wender, P. H. (2022). ADHD and the Utah criteria. Neuropsychiatric Disease and Treatment, 1853–1874.