A-30 Measures of Attention and Inhibitory Control: Comparing the TOVA to the NIH Toolbox Flanker Test in Children and Adolescents with ADHD

Abstract

Abstract Objective The Attention Comparison Score for the Test of Variables of Attention (TOVA) was developed as a “single score” method of differentiating individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) from controls (Leark, Greenburg, Kindschi, Dupuy & Hughes, 2008). Recent literature has documented that a more nuanced interpretation of TOVA scores, including the Attention Comparison Score, Commission Errors, and Omission Errors, can be more useful in describing the nature of impairment (e.g., sustained attention and/or inhibitory control) experienced by individuals diagnosed with ADHD (Winstone, Logid, Foley & Nicholls, 2019). The NIH Toolbox Cognition battery also assesses attention and inhibitory control by means of a Flanker Test. The current study examines whether the TOVA Attention Comparison Score predicts performance on the NIH Toolbox Flanker Test, and if adding TOVA Commission Error and Omission Error variables would predict greater amounts of variance on the Flanker Test in a pediatric sample. Method A sample of 64 pediatric patients (62.7% male, 37.3% female) diagnosed with ADHD aged 4–17 years (M = 11.25; SD = 3.74) was administered the NIH Toolbox Cognition Battery and TOVA as part of a comprehensive neuropsychological evaluation in a private practice in Scottsdale, Arizona. Results Our data found support that the more nuanced approach of adding commission and omission information better predicted Flanker scores than the Attention Comparison Score alone. Conclusion Based on the findings, clinicians utilizing the TOVA as a means of assessing for ADHD in pediatric populations should consider omission and commission errors to better understand attention and inhibitory control abilities.