Wender Utah Rating Scale Scoring - there is more to know than you might think!
Scoring—and interpreting—the Wender Utah Rating Scale (WURS) is more complicated than online scoring calculators would lead you to believe.
Table of Contents
The Wender Utah Rating Scale (WURS) is a psychological assessment instrument that helps to identify possible ADHD in adults.
A WURS score by itself should not be used to diagnose ADHD.
Psychologists administer the WURS as one component of a comprehensive, multi-method assessment.1
When someone completes the Wender Utah Rating Scale (WURS) they indicate if they experienced signs or symptoms of educational, behavioral, and medical problems during childhood.
1. Eid, Michael, and Ed Diener (eds.). Handbook of Multimethod Measurement in Psychology. American Psychological Association, 2006.
You can also access the Wender Utah Rating Scale Handbook at: perma.cc/F4VS-TMU5.
The WURS Handbook is licensed under CC BY-4.0, which means you are free to copy and redistribute the Handbook in any medium or format, provided you:
Here is what you need to know about Wender Utah Rating Scale scoring:
(1) There are several WURS forms. WURS scoring differs depending on which WURS form you use. The most used forms are:
(a) WURS-61: the original Wender Utah Rating Scale.
(b) WURS-25: ADHD-specific items only, drawn from the WURS-61.
(c) WURS-45: Forty-five items drawn from the WURS-61.
The WURS-45 is the most psychometrically sound version because it includes only those WURS-61 items that load onto symptom clusters (factors) derived from factor analytic and related statistical analysis.
The WURS-45 also includes all the WURS-25 items, so you can calculate the WURS-25 score when you use the WURS-45 form.
In addition, if you ask people to complete the WURS-25 form, which includes only 25 items, most people realize that they are taking an "ADHD test"—the questionnaire's purpose is transparent. This leads some people to endorse more items at higher severity levels because (for a variety of reasons) they want an ADHD diagnosis.
→ However, the WURS-45 in the Handbook includes an introduction that states: "This scale assesses childhood symptoms and/or behaviors associated with persistence of ADHD into adulthood."
I created a WURS-45 without that statement:
I also removed asterisks next to many of the questions and a related notation at the end of the questionnaire which states: "*items scored in the WURS-25 **items with negative factor loading scores".
It is useful to know that information, but it is in the Handbook and incorporated into the WURS-45 Scoring Sheet, and it is not needed for individuals completing the instrument.
Be careful! Scoring and interpreting the Wender Utah Rating Scale for Adult ADHD is not as simple as it looks.
For example, consider the interpretation directions in the image above. You will find these instructions on one of the most popular free-to-download WURS-61 PDF forms on the internet.
The interpretation instructions above are not wrong, but they likely confuse many people.
For example, note that the form includes space to calculate two scores:
QUESTION #1: What is the difference between the "Wender Utah rating scale score" and the "Wender Utah rating scale subscore"?
ANSWER #1: Nothing. They are the same thing, at least for the purposes of scoring the Wender Utah Rating Scale as originally designed, i.e., to obtain the WURS-25 score.
QUESTION #2: Why is that potentially confusing?
ANSWER #2: Because, as written, these instructions imply that one should calculate two scores, one based on responses to all 61 items, the "Wender Utah rating scale score", and the second based on the 25 ADHD-specific items, the "Wender Utah rating scale subscore".
However, scoring all 61 items (maximum score = 244) does not produce a meaningful statistic, i.e., it does not tell you anything.
On the other hand, scoring the 25 ADHD-specific items does produce a meaningful statistic, the WURS-25 score, where ≥ 46 suggests ADHD. [I used the verb, suggests, on purpose because you should never diagnose adult ADHD based on a WURS score alone.]
Overall, the statements in the instructions are accurate, e.g., the classification statistics cited from the Ward et al. (1993) study (see Recommended Reading, below).
Note: I did not include a link to the "popular, free-to-download WURS-61 PDF" because I do not want to promote a form with confusing instructions. Instead, download the Wender Utah Rating Scale Handbook (manual) for comprehensive, evidence-based recommendations, and use the WURS-61 Scoring Sheet on pages 18–19.
Before using the WURS-45, please download the entire Wender Utah Rating Scale Handbook because you should read the Handbook before scoring and interpreting WURS-45 results.
→ Note that the WURS-45 in the Handbook includes an introduction that states: "This scale assesses childhood symptoms and/or behaviors associated with persistence of ADHD into adulthood." I created a WURS-45 without that statement:
I also removed the asterisks next to many of the questions and a related notation at the end of the questionnaire: "*items scored in the WURS-25 **items with negative factor loading scores" because that information is in the Handbook and the asterisks tend to distract or perplex test-takers.
Brevik, Erlend Joramo, Astri J. Lundervold, Jan Haavik, and Maj‐Britt Posserud. "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 and Behavior 10, no. 6 (Apr 2020): e01605.
Gift, Thomas E., Matthew L. Reimherr, Barrie K. Marchant, Tammy A. Steans, and Frederick W. Reimherr. "Wender Utah Rating Scale: Psychometrics, Clinical Utility and Implications Regarding the Elements of ADHD." Journal of Psychiatric Research 135 (2021): 181-188.
Marchant, Barrie K., Fred W. Reimherr, Diane Robison, Reid J. Robison, and Paul H. Wender. "Psychometric properties of the Wender-Reimherr Adult Attention Deficit Disorder Scale." Psychological Assessment 25, no. 3 (2013): 942.
Reimherr, Frederick W., Barrie K. Marchant, Thomas E. Gift, Tammy A. Steans, and Matthew L. Reimherr. "Psychometric Data and Versions of the Wender Utah Rating Scale including the WURS-25 & WURS-45." Data in Brief 37, art. no. 107232 (Aug 2021).
Reimherr, Frederick W., Barrie K. Marchant, Thomas E. Gift, Tammy A. Steans, Melissa Wilson, and Camille Pommerville. Handbook of Utah Scales for the Assessment and Treatment of ADHD in Adults. Version 1, 2022. https://perma.cc/F4VS-TMU5.
Ward, Mark F., Paul H. Wender, and Fred W. Reimherr. "The Wender Utah Rating Scale: An Aid in the Retrospective Diagnosis of Childhood Attention Deficit Hyperactivity Disorder." American Journal of Psychiatry 150, no. 6 (1993): 885-890.