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Test of Variables of
Attention
(TOVA)
A Computerized Assessment
to assist in the diagnosis of ADHD
Frequently Asked Questions (FAQ)
Below
One of the evaluation procedures
used for diagnosing ADHD is the Test of Variables of Attention
(TOVA), a computerized Continual
Performance Test (CPT) used to help identify factors related to problems with
attention and impulsivity. In some ways it is like a "stress test for the
brain." The TOVA helps the clinician see how a person does in a boring task that
requires vigilance.
The TOVA can be used as young as
age 4, although beginning at age 6 is more practical. It is also normed for
adults through age 70.
The visual version of
the TOVA uses only two symbols. No
reading skill is needed. The person being tested is to push the button on the
microswitch when they see the target, and "pass" when they see the non-target.
The images flash on the screen for just a moment, about 2 seconds apart. There
are 648 decisions to be made during the 22 minute test.
Target
Non-target
The Auditory version
of the TOVA uses two tones. The higher tone is the target tone, and the lower
tone is the non-target tone. Again, the tones are presented in a random
sequence, one every two seconds for the duration of the test.
The TOVA is a 22 minute test that
helps determine how well one can focus on a simple task that requires constant
attention. The test is done in both a visual version as well as an auditory
version. The TOVA addresses several factors:
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Variability- the evenness
of a person's response times.
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Response Time- how fast the
person responds
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Errors of Commission-a
measure of impulsivity
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Errors of Omission -a
measure of inattentiveness
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Anticipatory Errors (pushing the button before you see the target)
measure problems with holding back as required, versus "jumping the
gun."
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Post commission response time (do you slow down or speed up after errors)
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Response data by quarters
so can tell how well one does over time
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Low brain stimulation task for first half
of the test, and a high brain stimulation task for second half of the test
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Compares the person to
others by age and sex.
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Uses micro-switch accurate to 1/1000 of a second
to measure response time
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Provides the counselor an
opportunity to observe vigilance on a boring task
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Has an ADHD score in the visual
mode that compares to those who have been diagnosed with ADHD
No one test, checklist or brief
interview is adequate to evaluate for ADHD or any other disorder for that
matter. The total pattern of problems, as well as the disabling quality of the
problems is important in order to get an accurate diagnosis. It also
assists in identifying areas to observe for improvement when medication is
administered. The TOVA can be administered after giving medication to monitor
medication improvements.
The TOVA alone does not determine
ADHD. But it can help confirm the diagnosis, and help more clearly see
the type of problems that a person with ADHD has.
A video about the
TOVA can be seen here.
video
How many sessions are needed to
complete the TOVA? A minimum of three (3) sessions are required to
adequately complete the TOVA.
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The first session
is to understand your unique situation, and identify the exact purpose of
giving the TOVA. An introduction and trials of the TOVA are also given.
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The second session
is usually the visual version of the TOVA. A brief verbal interpretation is
shared with the client and/or family. I usually gather more information, and
will often give feedback regarding questionnaires that have been completed.
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The third session
is usually the auditory version of the TOVA. At this point a summary of
the testing to date is shared with the client and/or family. A brief
discussion about implications of the testing is discussed, such as further
counseling, referral for medication, or parenting strategies that might be
helpful.
How much does it
cost. There is a charge for three visits, plus an $80.00 additional
fee.
What is this
$80.00 fee for? The additional $80.00 fee covers administrative fees
for the TOVA, time spent outside the session interpreting the results, and
time writing a report. Most insurance companies will not cover this fee.
This test needs to be paid prior to the report being given.
Is there a special time of the day
to take the test? The test is administered only in the morning.
The reason for this is that all of the comparative data was completed on other
people in the morning. Generally, people with ADHD perform less well as the day
progresses.
Is there
anything else I should do before the test? It is always a good idea
to get a good nights rest before the test, as well as have a good breakfast.
However, please do not eat or drink anything that might have caffeine in it.
Caffeine can effect the results of the TOVA.
Do I get to
watch my child take the test? No other family member is in the room while
the test is being given. This is to avoid unnecessary distractions. Also there
are some family members who cannot resist coaching or commenting during the
test.
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Swank Counseling
