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Using Environmental Distractors in the Diagnosis of ADHD


Using Environmental Distractors in the Diagnosis of ADHD

Hanoch Cassuto et al. Front Hum Neurosci.


This study examined the effect of the incorporation of environmental distractors in computerized continuous performance test (CPT) on the ability of the test in distinguishing ADHD from non-ADHD children. It was hypothesized that children with ADHD would display more distractibility than controls while performing CPT as measured by omission errors in the presence of pure visual, pure auditory, and a combination of visual and auditory distracting stimuli. Participants were 663 children aged 7-12 years, of them 345 diagnosed with ADHD and 318 without ADHD. Results showed that ADHD children demonstrated more omission errors than their healthy peers in all CPT conditions (no distractors, pure visual or auditory distractors and combined distractors). However, ADHD and non-ADHD children differed in their reaction to distracting stimuli; while all types of distracting stimuli increased the rate of omission errors in ADHD children, only combined visual and auditory distractors increased it in non-ADHD children. Given the low ecological validity of many CPT, these findings suggest that incorporating distractors in CPT improves the ability to distinguish ADHD from non-ADHD children.

Keywords: ADHD; CPT; auditory; diagnosis; distractibility; validity; visual.


Figure 1
Figure 1
Definition of the time line- Target and non-target stimuli were presented for 500, 1000, or 3000 ms. Each stimulus was followed by avoid period of the same duration. The stimulus remained on the screen for the full duration regardless the response. Distracting stimuli were not synchronized with target/non-targel's onset and could be generated during target/non-target stimulus or during the void period.
Figure 2
Figure 2
MOXO-CPT target and non-target stimuli.
Figure 3
Figure 3
MOXO-CPT visual distractors.

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