| RPT |
|Wender Utah Rating Scale-25 (WURS-25)
| Gender: <.Patient_Gender.>
|
| WURS-25 Total Score = <-Total->
|
| WURS-25 scores range from 0-100
|
| Responses above the cutoff score of 46 (sensitivity &
| specificity = 96%; Ward et al., 1993) are consistent
| with an ADHD diagnosis.
|
|
|Questions and Answers:
|
| 1. concentration problems, easily distracted
| <*Answer_9306*>
| 2. anxious, worrying
| <*Answer_9307*>
| 3. nervous, fidgety
| <*Answer_9308*>
| 4. inattentive, daydreaming
| <*Answer_9309*>
| Date Given: <.Date_Given.>
| 5. hot- or short-tempered, low boiling point
| <*Answer_9310*>
| 6. temper outbursts, tantrums
| <*Answer_9311*>
| 7. trouble with stick-to-it-tiveness, not following through,
| failing to finish things started
| <*Answer_9312*>
| 8. stubborn, strong-willed
| <*Answer_9313*>
| 9. sad or blue, depressed, unhappy
| Clinician: <.Staff_Ordered_By.>
| <*Answer_9314*>
| 10. disobedient with parents, rebellious, sassy
| <*Answer_9315*>
| 11. low opinion of myself
| <*Answer_9316*>
| 12. irritable
| <*Answer_9317*>
| 13. moody, ups and downs
| <*Answer_9318*>
| 14. angry
| Location: <.Location.>
| <*Answer_9319*>
| 15. acting without thinking, impulsive
| <*Answer_9320*>
| 16. tendency to be immature
| <*Answer_9321*>
| 17. guilty feelings, regretful
| <*Answer_9322*>
| 18. losing control of myself
| <*Answer_9323*>
| 19. tendency to be or act irrational
|
| <*Answer_9324*>
| 20. unpopular with other children, didn't keep friends for long,
| didn't get along with other children
| <*Answer_9325*>
| 21. trouble seeing things from someone else's point of view
| <*Answer_9326*>
| 22. trouble with authorities, trouble with school, visits to
| principal's office
| <*Answer_9327*>
| 23. overall a poor student, slow learner
| Veteran: <.Patient_Name_Last_First.>
| <*Answer_9328*>
| 24. trouble with mathematics or numbers
| <*Answer_9329*>
| 25. not achieving up to potential
| <*Answer_9330*>
|
|Information contained in this note is based on a self-report assessment
|and is not sufficient to use alone for diagnostic purposes. Assessment
|results should be verified for accuracy and used in conjunction with
|other diagnostic activities.
| SSN: <.Patient_SSN.>
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
|
