The T.O.V.A. is widely recognized as one of the most useful measures of attention available. However, as with physiological measurements (e.g., assay of catecholamine metabolites, genetic testing, functional imaging), and other attention-sensitive tasks (P-300 tasks, n-back tasks, stop-signal tasks, gambling tasks, Posner’s Attention Network Test, the Test of Everyday Attention, and many measures of executive functioning), the behaviorally-defined DSM-IV criteria for ADHD are better predicted with the use of behavioral checklists that embed the DSM-IV diagnostic criteria themselves. This is a simple artifact of method variance, as the DSM criteria were themselves derived with the use of such instruments.

Objective measures play an increasingly important role in characterizing a patient’s unique expression of attention and behavior, eliminate rater bias, and are much more sensitivity to subtle treatment effects than questionnaires or diagnostic checklists. Tasks such as the T.O.V.A. are understood to more closely reflect underlying neurological processes that control attention, help to distinguish between potential subtypes, and play a critical role in differential diagnosis of attention problems and other phenotypically similar diagnoses.

Ultimately, your choice of additional measures for a study depends upon your research question. We find that a wide-scope clinical measure such as the Behavior Assessment System for Children-Second Edition is a useful addition because it is helpful in considering the presence of co-morbid or “masking” disorders. You may also consider using the Vanderbilt Rating Scales, or other commonly used behavior rating scales as an adjunct to the T.O.V.A. Use of a DSM-IV symptom checklist is a simple, quick way help you better understand the diagnostic status of your sample. We also recommend the Behavioral Rating Scale of Executive Functioning (BRIEF) as a tool to obtain additional information about the real-world functioning of subjects. There are also other instruments to consider. Please feel free to contact the T.O.V.A. research team at research@tovacompany.com with questions.

We hope this information is useful in planning and implementing your study. Feel free to call or write any time if we can assist you in your work.

And thanks for being a T.O.V.A. research user!

The T.O.V.A. Team