Wender Utah Rating Scale (WURS-25)
Retrospective assessment of childhood ADHD symptoms for adult diagnosis.
Last reviewed: May 2026
The WURS-25 was developed by Ward, Wender, and Reimherr (1993) to address a core requirement of ADHD diagnosis: evidence of childhood-onset symptoms. Since DSM-5 requires that symptoms were present before age 12, clinicians need a way to assess childhood ADHD in adults who may not have been diagnosed as children.
Scoring & Interpretation
Each item scored 0 (Not at all / Very slightly) to 4 (Very much). Total score: sum of 25 items, range 0–100. A cut-off of 46 correctly identified 86% of ADHD patients and 99% of controls in the validation study.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 0–20 | Low | Childhood ADHD symptoms unlikely |
| 21–45 | Borderline | Some childhood difficulties — gather corroborative history |
| 46–100 | Elevated | Consistent with childhood ADHD — supports current diagnosis |
Sensitivity 86%, specificity 99% at cut-off of 46 (Ward et al., 1993). Internal consistency: α = 0.95. Discriminates ADHD patients from controls (d = 2.1) and from depression-only patients (d = 1.4). Validated in 15+ languages.
When to Use This vs Alternatives
Use ASRS when…
You need to assess CURRENT ADHD symptoms. The ASRS measures symptom frequency over the past 6 months; the WURS-25 measures CHILDHOOD symptoms recalled retrospectively. Use both together for the full diagnostic picture (current + developmental history).
View ASRS →Use WFIRS-S when…
You need to document current functional impairment. The WFIRS-S measures how ADHD affects life NOW; the WURS-25 establishes that difficulties were present IN CHILDHOOD. Different time frames, complementary purposes.
View WFIRS-S →Use ADHD-FIS when…
You're monitoring treatment progress. The WURS-25 is a one-time assessment (childhood history doesn't change); the ADHD-FIS is for repeated measurement of current impairment over time.
View ADHD-FIS →See It in Action
- 1Total score with validated cut-off threshold (46)
- 2Above/below cut-off clinical indicator
- 3Individual question responses with scoring badges
- 4One-click PDF export and email delivery
What It Measures
The WURS-25 was developed by Ward, Wender, and Reimherr (1993) to address a core requirement of ADHD diagnosis: evidence of childhood-onset symptoms. Since DSM-5 requires that symptoms were present before age 12, clinicians need a way to assess childhood ADHD in adults who may not have been diagnosed as children. The WURS-25 asks adults to retrospectively rate 25 behaviours from their childhood, covering attention difficulties, hyperactivity, impulsivity, academic problems, and emotional dysregulation.
When to Use the WURS-25
Use the WURS-25 after current ADHD symptoms are confirmed (e. g., positive ASRS screen). Administer to establish the developmental history required for DSM-5 diagnosis. Particularly important for late-diagnosed adults who were not assessed in childhood — the WURS-25 provides structured evidence of childhood symptom presence.
Who It's For
Adults aged 18+ recalling their childhood behaviours (up to age 12). Self-report. Validated in clinical populations seeking ADHD evaluation. Note: retrospective self-report has inherent limitations — corroborative information (school reports, parent recall) strengthens the assessment.
Frequently Asked Questions
What is the WURS-25?
The WURS-25 (Wender Utah Rating Scale) is a 25-item self-report questionnaire that asks adults to retrospectively rate their childhood behaviours (before age 12). It assesses whether ADHD symptoms were present in childhood — a requirement for adult ADHD diagnosis under DSM-5.
What is the WURS-25 cut-off score?
A total score of 46 or above (out of 100) is the validated cut-off for childhood ADHD. This threshold correctly identifies 86% of ADHD patients (sensitivity) and 99% of controls (specificity) in the original validation study.
Why is childhood history important for adult ADHD diagnosis?
DSM-5 requires that several ADHD symptoms were present before age 12 for a valid adult diagnosis. The WURS-25 provides structured evidence of childhood symptoms, particularly important for adults who were never assessed as children and may not have school reports available.
Use the WURS-25 in your practice
Available on the Starter plan. Instant scoring, severity bands, and PDF reports included. Patients complete it on their phone or computer. Scored the moment they hit submit.