I write in response to the question/comment about the TOVA test, and medication
therapy.

I will make a few comments and discuss some information:

Their is no "test" for ADHD/ADD. The TOVA [test of variables of attention]
is one of a number of computerized tests, known as continuous performance tests
[CPT]. These tests often provide measures of an individual's ability to attend
to a boring task, and also to a stimulating task over a specific time period.

The tester, through observing the testee's responses, gets an idea of the
individuals ability to attend over time, their consistency of responding, their
accuracy of "correct" and "incorrect" responses, their variability of
responding, their tendency to respond in impulsively, and their ability to sit
during the test.

The individuals scores on the CPT are then compared to normed groups of
similar age children [or adults] who have been diagnosed as ADHD, or who have
been labelled "normal".

The TOVA and the other CPTs [continuous performance tests] do not provide a
diagnosis.
Also, these instruments are tools. The TOVA's results, although relatively
valid, do not provide 100% accurate measures. There is some degree and
possibility of error with all of these tests.

CPTs are not meant to be used as stand-alone tests. CPTs and the TOVA
are best used as one component of a thorough and comprehensive assessment.
A full assessment should include a full interview and history taking with the
parents, and also a meeting with the child.
In my opinion, a full assessment should also include a thorough medical
checkup and blood-work - for example, low iron levels and/or low thyroid [TSH]
levels may mimic ADD symptoms.

Also, some children who are diagnosed with "ADD" actually are experiencing
problems with their vision. Again, this and many other factors [allergies,
lead toxicity] should be ruled out.

With regard to medication - most individuals, whether they have "ADHD/ADD" or
not, will be able to focus and attend better with psycho-stimulant medication.
Improvement on the TOVA while on medication, compared to while not on
medication, is not in and of itself, a certain indicator for "ADHD".

I would be happy to respond further.

Rafael Richman, Ph.D.
Psychologist, Machon Etgar ADHD clinic
Psychotherapist in private practise
Jerusalem




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