Wender Scale

Wender Utah Rating Scale*

For the Attention Deficit Hyperactivity Disorder
Date*

MonthDayYear
Date
Patient Name*

First NameLast Name
Instructions: For each of the 25 items, check the box that best describes your behavior

As a child I was (or had):*

	0 - Not at all or very slightly	1 - Mildly	2 - Moderately	3 - Quite a bit	4 - Very much
1. Concentration problems, easily distracted
2. Anxious, worrying
3. Nervous, fidgety
4. Inattentive, daydreaming
5. Hot/short-tempered, low boiling point
6. Temper outbursts, tantrums
7. Trouble with stick-to-it-tiveness, not following through, failing to finish things started
8. Stubborn, strong-willed
9. Sad or blue, depressed, unhappy
10. Disobedient with parents, rebellious, sassy
11. Low opinion of myself
12. Irritable
13. Moody, ups and downs
14. Angry
15. Acting without thinking, impulsive
16. Tendency to be immature
17. Guilty feelings, regretful
18. Losing control of myself
19. Tendency to be or act irrational
20. Unpopular with other children, didn't keep friends for long, didn't get along with other children
21. Trouble seeing things from someone else's point of view
22. Trouble with authorities, trouble with school, visits to principal's office
23. Overall a poor student, slow learner
24. Trouble with mathematics or numbers
25. Not achieving up to potential

Wender Utah Rating Scale*