Is the Test of Variables of Attention Reliable for the Diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD)?

Abstract

The diagnosis of attention-deficit hyperactivity disorder (ADHD) is occasionally biased by the subjectivity of symptoms and reports of parents and teachers. The advent of continuous performance tests raised expectations that the diagnosis of ADHD will be more standardized and accurate. In this study, the authors looked for the validity of the ADHD scores obtained by the Test of Variables of Attention in 230 children who were referred to their ADHD clinic between 2005 and 2007. Based on clinical evaluations, 179 children were diagnosed with affirmed or suspected ADHD. Among the 179 children with ADHD, the Test of Variables of Attention was suggestive of ADHD in 163 participants (91.1% sensitivity), but it was also suggestive for ADHD in 78.4% of the children without ADHD. With a low specificity of 21.6%, the authors feel that the Test of Variables of Attention is not reliable enough to serve as a screening diagnostic tool for ADHD.

Keywords

attention-deficit hyperactivity disorder (ADHD)continuous performance test

Get full access to this article

View all access options for this article.

References

Biederman

Faraone

. Attention-deficit hyperactivity disorder. Lancet. 2005;366(9481):237–248.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

World Health Organization The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva, Switzerland: World Health Organization; 1993.

Polanczyk

de Lima

Horta

Biederman

Rohde

. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942–948.

Cantwell

. Diagnostic evaluation of the hyperactive child. In: Cantwell

DP, ed

. The Hyperactive Child: Diagnosis, Management, Current Research. New York, NY: Spectrum; 1975:17–50.

Barkley

. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. New York, NY: Guilford; 1990.

Barkley

. The ecological validity of laboratory and analogue assessment methods of ADHD symptoms. J Abnorm Child Psychol. 1991;19(2):149–178.

Corkum

Siegel

. Is the Continuous Performance Task a valuable research tool for use with children with attention-deficit-hyperactivity disorder? J Child Psychol Psychiatry. 1993;34(7):1217–1239.

Aylward

Verhulst

Bell

. Individual and combined effects of attention deficits and learning disabilities on computerized ADHD assessment. J Psychoeducational Assess. 1990;8(4):497–508.

10.

Shapiro

Garfinkel

. The occurrence of behavior disorders in children: the interdependence of attention deficit and conduct disorder. J Am Acad Child Adolesc Psychiatry. 1986;25(6):809–819.

11.

Golden

. Are tests of working memory and inattention diagnostically useful in children with ADHD? The ADHD Report. 1996;4(5):6–8.

12.

Greenberg

Waldman

. Developmental normative data on the Test of Variables of Attention (TOVA) . J Child Psychol Psychiatry. 1993;34(6):1019–1030.

13.

Forbes

. Clinical utility of the Test of Variables of Attention (TOVA) in the diagnosis of attention-deficit/hyperactivity disorders. J Clin Psychol. 1998;54(4):461–476.

14.

Schatz

Ballantyne

Trauner

. Sensitivity and specificity of a computerized test of attention in the diagnosis of attention-deficit/hyperactivity disorder. Assessment. 2001;8(4):357–365.

15.

Rappley

. Clinical practice: attention deficit-hyperactivity disorder. N Eng J Med. 2005;352(2):165–173.

16.

American Academy of Pediatrics: Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit hyperactivity disorder. Pediatrics. 2000;105(5):1158–1170.

17.

Halperin

Matier

Bedi

Sharma

Newcorn

. Specificity of inattention, impulsivity, and hyperactivity to the diagnosis of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1992;31(2):190–196.

18.

Willmott

Ponsford

. Efficacy of methylphenidate in the rehabilitation of attention following traumatic brain injury: a randomised, crossover, double blind, placebo controlled inpatient trial. J Neurol Neurosurg Psychiatry. 2009;80(5):552–557.

19.

Silver

McAllister

Arciniegas

. Depression and cognitive complaints following mild traumatic brain injury. Am J Psychiatry. 2009;166(6):653–661.

20.

Forlini

Racine

. Disagreements with implications: diverging discourses on the ethics of non-medical use of methylphenidate for performance enhancement. BMC Med Ethics. 2009;10-9(6):1–13.

21.

Goez

Back-Bennet

Zelnik

. Differential stimulant response on attention in children with comorbid anxiety and oppositional defiant disorder. J Child Neurol. 2007;22(5):538–542.