I had my initial ADD assessment Monday and my counselor told me that he thought I did have A.D.H.D.

It sounds like the place I went to places a lot of merit in the "tova" test. Does anyone here know anything about this test? I will also take a MMPI test, which is like 1-2 hrs.of boredom from what I could extrapolate. A psychological test, of sorts? Does this sound pretty common? I am sure there are many avenues and approaches to testing, I am just curious.

I don't know protocol in the patient/physician portion of diagnosing this, but he (my assessor) did seem pretty thorough. I could tell when his questions were looking for mania and when he was curious as to traumatic incidents. Just want to hear from those who went through this themselves. I want to feel better, not administer myself with unnecessary amphetamines, as the vibe I got made me think the counselor I saw Ritalin as something from the stone-age.

An actual Doctor will have me take this "tova" test Friday.
Thanks in advance!
Larry

Hi Larry,

After my counselor took my history he administered the TOVA. The TOVA by itself shouldn't be used to rule in or out AD/HD, but it is a helpful tool. There can be false negatives, because the conditions of testing themself may be novel enough to the test taker that their brain focuses in or if they are of above average intelligence, they can often do acceptably on the first 3/4 of the test skewing the results to an inconclusive or negative result. That happened to me. I did fine on the first 3/4 and crashed and burned in the last quarter. Kept responding when there wasn't anything there indicating an impulse control issue. The psychologist factored in my IQ scores and it came back that I was AD/HD. My history also bore that out and my later improvement with meds was very positive.

Ritalin is methlyphenidate and is short acting 2-4 hours usually. Newer medications like Concerta (a long acting methlyphenidate 6 - 12 hours) and Adderall XL (also a long acting stimulent) and others give a more sustained benefit for many AD/HD folk and that may be why your counselor considered Ritalin from the stone-age.

Scattered

Okay,


I've posted this many times.According to Russ Barkley, "checklists trump tests " in diagnosing ADHD.

Where I work (community mental health center) there is some current controversy about the TOVA. When I saw Dr Barkley 2 years ago, he presented data that showed that all continuous performance tests (CPTS), which are the computer tests like the Test of Visual Accuity (TOVA), the Conners Continuous Performance Test (Conners CPT) and the Gordon Diagnostic Test, DON'T WORK WHEN USED BY THEMSELVES AS THE ONLY TEST MEASURE for diagnosing ADHD.

I've never liked it for the exact same reason it doesn't work (by itself). It has what's called a high rate of "false negative ( you really do have ADHD and it misses you)".

In fact, the first 2 or 3 kids I referred for testing,all of whom were severely hyperactive, all "passed" the test. What happens is that it becomes a brand new video game for some kids and they "hyperfocus" and do well.

Dr.Barkley pointed out a study in which 50% of people already diagnosed with ADHD passed the TOVA with no problem. That's no better than flipping a coin.


Now here's where things stand today. I have several colleagues whom I respect a great deal wanting to use it in a "blended" report;meaning they'll use checklists to go along with it.

I'm okay with it because I know they'll use some of the best checklists .The TOVA (and other CPT's ) are appropriate for research. I tend to put post medication checks under that banner and I'm okay with one of our psychiatrist's using it for that purpose.

Actually, the biggest struggle I have right now is getting some of my colleague's from another office to quit using IQ test subtest scatter for diagnosing ADHD.

We're trying to become an accredited internship site and will be doing a series of workshops in Oct. I've been asked to present on ADHD. The person who runs our internship program is one of the chief proponents of IQ subtest scatter. He's the one who asked me and will probably present on ADHD as well.

It remains to be seen if I get equal time or not .Either way, it will be fun for me. I ended up e-mailing someone on the subject of "checklists trump tests" and got a wonderful reply. I intend to use that, along with other material, to help educate them.

Good luck to you and thanks for raising the question.

take care
mctavish23 (Robert)

p.s.

I love the whole idea of "evidenced based practice" in which you have to show the research proves whatever technique or therapy, etc., you're using actually works for that particular problem.

I equate that with "Put up or shut up." :)

Thanks for your, as always, insightful reply, Mctavish. My counselor did mention that even if I did pass the tova, he would use my written tests and consultation as deciding factors whether to go ahead with medicinal treatment or not. He seems pretty on par with your post, so I feel like I am going to get a pretty academic and contrived assessment. I wanna educate before I medicate, so thanks again for your expertise on the subject.

I had one as part of my assessment. It was pretty much inconclusive: 50% probability of clinically significant attention problems. However, my IQ tests and checklists definitely indicated ADD and learning disabilities, so, guess what, I got the diagnosis.

Here is some info on the comparative effectiveness of the TOVA in testing on onpre diagnosed ADD:
http://www.crossroadsinstitute.org/newsletter/nlarticles/janfeb05/qeegsupportadhd.html
"Because all participants in this study were carefully diagnosed with ADHD using standard procedures, each participant would have received abnormal scores on each measure if the QEEG scan, ADDES, TOVA, and Conners' CPT were perfectly accurate diagnostic instruments. This, of course, was not the case. It is interesting to note, however, that more participants obtained abnormal results on the QEEG scan than on any of the other procedures. The rates of abnormal results were 80%, 78%, 72%, and 49% for the QEEG, ADDES, TOVA, and Conners' CPT, respectively. Thus, results of this study indicate that QEEG scan results show significant consistency with other well-established procedures used in diagnosing ADHD, and that it is as least as accurate as these other procedures. "