Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that afflicts children and adults. Children and adults with ADHD have difficulty sustaining attention and completing everyday tasks that others handle with ease, have difficulty staying involved in sedentary projects and act impulsively. These neurological challenges undermine effectiveness at school or work and can sabotage education, family and career. Various medical and psychiatric problems can mimic ADHD, so the first step to an effective ADHD intervention is an accurate diagnosis. To this end, several tests are available to assist parents, afflicted adults, teachers and practitioners to identify ADHD symptoms and to form an objective behaviorally based diagnosis.
Online Tests
Several websites provide online questionnaires or rating scales that allow people to rate themselves or their child. Typically, these online tests ask yes-no questions or ask the respondent to give a numeric rating to identify the presence or absence of ADHD symptoms. Items usually asses attentional capacity, inattention, gross and fine motor hyperactivity, impulsiveness, difficulties planning and organizing, mood swings and emotional lability, problems with temper or irritability and racing thoughts.
Examples of tests for adults are at Psych Central and New York University Medical Center, and an example of a children's test can be found at New Ideas. These tests do not provide definitive diagnoses. Rather, online tests are best viewed as screening tools that can help you decide if ADHD might be an issue that merits further diagnostic clarification with your doctor, psychologist or counselor.
Paper and Pencil Tests
Several standardized paper and pencil behavior rating tests are used by counselors, doctors, researchers and clinicians to aid in the diagnostic process. One of the most widely used tests is the Child Behavior Checklist (CBCL), developed by psychologist Thomas Achenbach. Various versions of this scale are available for children and young adults of different age ranges: children between 1.5 to 5 years; children 6 to 10 years; youth 11 to 18 years; and young adults from 18 to 30. These tests evaluate a variety of behavior problems and provide behavioral subscales, including a subscale that evaluates attention and thought problems that are consistent with a diagnosis of ADHD.
The Conners Comprehensive Behavior Rating Scale is another standardized rating scale that provides a broad spectrum of rating scales. It includes subscales for hyperactivity, impulsivity and ADHD. The advantage of comprehensive scales is that they evaluate for the presence of ADHD symptoms, and they also evaluate for the presence of other disorders that might contribute to ADHD symptoms. Anxiety, depression, mania and other psychiatric and behavioral problems can present as ADHD or might co-occur and merit diagnostic attention and treatment. Adults and children with ADHD are prone to have other co-morbid conditions, as indicated for example at Archives of Disease.
Behavioral Tests
The tests described above all involve self-report or rating of behavioral symptoms. The best of these tests---the Conners and the CBCL---are standardized, supported by research and substantiated with age and sex-based norms. Nonetheless, questionnaires and rating scales are vulnerable to distortions and reporter bias.
Several ADHD tests are based on actual performance, and therefore provide a more direct, objective assessment of the underlying ADHD processes. The Test of Variables of Attention (TOVA) is a computer-based performance test that has child or adult respondents participate in a repetitive task that requires vigilance and quick yet thoughtful reactions. The TOVA measures various aspects of attentional processes including response time, impulsivity, inattention and inconsistency in attention.
The Attentional Capactiy Test (ACT) measures childrens' and adults' attentional capacity or working memory. The respondent is presented with increasingly complex and demanding auditory attention tasks that require the ability to sustain attention while ignoring distractions. As a performance-based test, the ACT directly measures attentional processes and does not rely on self-reports or observer ratings.
