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Unlike many other medical conditions, there is no one single test that can definitely prove whether or not your child has attention deficit hyperactivity disorder. However, there are several ways to objectively measure the severity of inattention and impulsivity in a child.  In our clinic, we use a unique test called Test of Variables of Attention (TOVA).  This simple 21-minute-long test is actually a computer game designed to measure the response of children to visual and auditory stimuli.  Their measurements are compared to the scores of people without ADHD who have taken the TOVA. 

To minimize the effects of culture and language differences, the TOVA uses geometric stimuli, and has two test conditions: target frequent and target infrequent.  The first part of the test, the target infrequent part, is a repetitive task designed to measure inattention.  Atarget is presented randomly and infrequently, and the child taking the test needs to pay close attention in order to spot the infrequent targets correctly. If the child fails to respond to the target, a measure of inattention is taken.  The next part of the test, the target frequent part, is designed to measure impulsivity.  The targets are presented more often and the child is expected to show restraint and avoid responding to non-targets.  If the child responds to a non-target, a measure of impulsivity is taken.  The variables measured by the TOVA are consistency (variability of response time), response time, errors of omission (inattention) impulsivity (commission), post-commission response times, and an ADHD score that is compared to an age/gender-specific ADHD group.

There are several benefits to having your child evaluated with a TOVA.

Diagnostic accuracy

The TOVA allows us to evaluate a child more accurately, because of the objective information given on impulsivity and inattention, which is difficult to obtain from history and behavior ratings.  On its own, TOVA has correctly identified 86% of ADHD cases. It is important to remember that it is not the test that makes a diagnosis; only a clinician can. Also, it is crucial to understand that the diagnosis of ADHD is only descriptive and does not explain its causes.

Objective results

The TOVA allows us to objectively measure parameters of inattention and impulsivity. This gives you, the parents, a clearer picture of where your child is at as far as his or her inattention and impulsivity.

Facilitation of ADHD management

With periodic retesting, we can objectively measure how well your child responds to a particular treatment plan.

As with other tests for ADHD, the TOVA is most useful in the context of complete ADHD testing. There are many other disorders and health problems that share the same symptoms as ADHD, and it is important that we cover all possibilities. Whether or not your child has poor performance on a TOVA, he or she will still need to go through other tests for us to accurately determine what us causing the problem in the first place.


TOVA website