Attention-Deficit/Hyperactivity Disorder (ADHD) is difficult to diagnose due to the subjectivity of its symptoms and lack of specific assessment measures. Computerized tests of attention have recently been used as objective measures that may assist in the diagnosis of the disorder. The present study evaluated consistency between the Conners Parent Rating Scale and the Test of Variables of Attention (TOVA), which is a computerized test of attention designed to identify symptoms associated with ADHD, in children clinically diagnosed with ADHD (n = 28) and controls (n = 20). Our results showed that both the Conners and the TOVA indicated significant problem areas suggestive of an attention deficit in approximately 85% of children who were clinically diagnosed with ADHD. However, the TOVA also found attentional problems in approximately 30% of control children, whereas none of the controls scored abnormally on the Conners. As computerized measures are administered more frequently, there may be a risk of overdiagnosis and treatment of "ADHD" in normal children. A combined approach using questionnaires, clinical evaluation, and computerized tests of attention in the assessment of possible ADHD may provide the most accurate means of diagnosis.
Achenbach, T. M.
, & Edelbrock, C. S. (1986). Child behavior checklist and youth self-report. Burlington, VT: Author.
2.
American Psychiatric Association
. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3.
Ballard, J. C.
(1996). Computerized assessment of sustained attention: A review of factors affecting vigilance performance.Journal of Clinical and Experimental Neuropsychology, 18, 843-863.
4.
Barkley, R. A.
(1991). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford.
5.
Breen, M. J.
, & Altepeter, T. S. (1990). Situational variability in boys and girls identified as ADHD. Journal of Clinical Psychology, 46, 486-490.
6.
Conners, C. K.
(1991). Conners' Rating Scales. North Tonawanda, NY: Multi-health Systems.
7.
Diller, L. H.
(1996). The run on Ritalin: Attention deficit disorder and stimulant treatment in the 1990s. Hastings Center Report, 25, 12-18.
8.
Dupuy, T.
, & Cenedela, M. (2000). Test of Variables of Attention: User's guide. Minneapolis, MN: Universal Attention Disorders.
9.
Dupuy, T. R.
, & Greenberg, L. M. (1993). TOVA manual. Minneapolis, MN: Lawrence M. Greenberg.
10.
Forbes, G. B.
(1998). Clinical utility of the Test of Variables of Attention (TOVA) in the diagnosis of attention-deficit/hyperactivity disorder. Journal of Clinical Psychology, 54, 461-476.
11.
Golden, J. C.
(1978). Stroop Color and Word Test. Chicago: Stoelting Co.
12.
Goldman, L. S.
, Genel, M., Bezman, R., & Slanetz, P. (1998). Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Journal of the American Medical Association, 279, 1100-1107.
13.
Gordon, M.
(1983). The Gordon Diagnostic System. DeWitt, NY: Gordon Systems.
14.
Greenberg, L. M.
, & Waldman, I. D. (1993). Developmental normative data on the Test of Variables of Attention. Journal of Child Psychology and Psychiatry, 34, 1019-1030.
15.
Grodzinsky, G. M.
, & Barkley, R. A. (1999). Predictive power of frontal lobe tests in the diagnosis of attention deficit hyperactivity disorder. The Clinical Neuropsychologist, 13, 12-21.
16.
Heaton, R.
, Chelune, G., Talley, J., Kay, G., & Curtiss, G. (1993). Wisconsin Card Sorting Test manual. Odessa, FL: Psychological Assessment Resources.
17.
Houghton, S.
, Douglas, G., West, J., Whiting, K., Wall, M., Langsford, S., Powell, L., & Carroll, A. (1999). Differential patterns of executive function in children with attention-deficit hyperactivity disorder according to gender and subtype. Journal of Child Neurology, 14, 801-805.
18.
Jensen, P. S.
, Martin, B. A., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065-1079.
19.
Johnson, T. M.
(1997). Evaluating the hyperactive child in your office: Is it ADHD?American Family Physician, 56, 155-160.
20.
Keith, R. W.
, & Engineer, P. (1991). Effects of methylphenidate on the auditory processing abilities of children with attention deficit-hyperactivity disorder. Journal of Learning Disabilities, 24, 630-636, 640-640.
21.
Lin-Dyken, D. C.
, & Wolraich, M. L. (1992). Attention-deficit hyperactivity disorder. In D. E. Greydanus & M. L. Wolraich (Eds.), Behavioral pediatrics (pp. 167-193). New York: Springer-Verlag.
22.
Losier, B.J.
, McGrath, P.J., & Klein, R. M. (1996). Error patterns on the continuous performance test in nonmedicated and medicated samples of children with and without ADHD: A meta-analytic review. Journal of Child Psychology and Psychiatry, 37, 971-987.
23.
McNicol, D.
(1972). A primer of signal detection theory. London: George Allen & Unwin Ltd.
24.
Mellor, D. J.
, Storer, S. P., & Brown, J. (1996). Attention deficit hyperactivity disorder: Perceptions, practice, and politics.Journal of Pediatric Child Health, 32, 218-222.
25.
Paulus, M. P.
, Geyer, M. A., & Braff, D. L. (1994). The assessment of sequential response organization in schizophrenic and control subjects. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 18, 1169-1185.
26.
Paulus, M. P.
, Geyer, M. A., & Braff, D. L. (1996). Use of methods from chaos theory to quantify a fundamental dysfunction in the behavioral organization of schizophrenic patients. American Journal of Psychiatry, 153, 714-717.
27.
Sattler, J. M.
(1992). Assessment of children (3rd ed.). San Diego, CA: Author.
28.
Schneider, S. C.
, & Tan, G. (1997). Attention-deficit hyperactivity disorder. Postgraduate Medicine, 101, 231-240.
29.
Searight, H. R.
, Nahlik, J. E., & Campbell, D. C. (1995). Attention deficit/hyperactivity disorder: Assessment, diagnosis, and management. The Journal of Family Practice, 40, 270-279.
30.
Swets, J. A.
(1996). Signal detection theory and ROC analysis in psychology and diagnostics. Mahwah, NJ: Erlbaum.
31.
Swets, J. A.
, & Pickett, R. M. (1982). Evaluation of diagnostic systems: Methods from signal detection theory. New York: Academic Press.
32.
Taylor, M. A.
(1997). Evaluation and management of attention-deficit hyperactivity disorder. American Family Physician, 55, 887-901.
33.
Teicher, M. H.
, Ito, Y., Glod, C. A., & Barber, N. I. (1996). Objective measurement of hyperactivity and attentional problems in ADHD.Journal of the American Academy of Child and Adolescent Psychiatry, 35, 334-342.
34.
Wechsler, D.
(1991). Wechsler Intelligence Scale for Children-Third edition (WISC-III). San Antonio, TX: The Psychological Corporation.
