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An annotated bibliography of research studies using the T.O.V.A.

Aggarwal, A., & Lillystone, D. (2000). A follow-up pilot study of objective measures in children with attention deficit hyperactivity disorder. Journal of Paediatrics & Child Health, 36(2), 134-138. OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is a common childhood problem requiring stimulant medications in a significant proportion of cases. The aim of this pilot study was to assess the effects of prolonged stimulant medication therapy on a continuous performance test, the Test of Variables of Attention (TOVA), which measures objectively features of ADHD. METHODS: Eighteen children aged 8 to 16 years who were diagnosed with ADHD, based on the Diagnostic and Statistical Manual of Mental Disorders 4th edn criteria, were included in the study. Assessment on a continuous performance test (TOVA) was performed initially and the children were administered stimulant medications for at least 12 months. The medications were stopped for 1 week, followed by a repeat TOVA assessment which was compared to the initial TOVA assessment. RESULTS: Follow up TOVA scores showed a significant improvement in mean commission errors (impulsivity) after the stimulant medication therapy. No significant improvement was found in omission errors (inattention), response time and variability. There was a significant positive correlation between commission and omission scores (P value 0.0001). CONCLUSIONS: The results of this pilot study indicate that there is objective improvement in impulsivity in children with ADHD after a prolonged period of stimulant medication therapy. The study suggests that it would be useful to perform formal studies to investigate this further and also to assess the role of continuous performance test (TOVA) as a method for monitoring the need for ongoing therapy.

Alhambra, M. A., Fowler, T. P., & Alhambra, A. A. (1995). EEG biofeedback: A new treatment option for ADD/ADHD. Journal of Neurotherapy, 1(2), 39-43. Explored the effectiveness of EEG biofeedback as an alternative to pharmacological treatments for attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD). 36 Ss with ADD/ADHD (aged 6-17 yrs) who completed at least 30 sessions of EEG biofeedback treatment were evaluated using observation of behavioral changes through parental questionnaires, measures of quantitative EEG (QEEG) changes, and a comparison of Test of Variables Assessment (TOVA) scores taken before training and after 20 sessions. 30 Ss showed some significant overall improvement in their condition upon completion of the EEG biofeedback treatment. Results indicate a good correlation between TOVA score improvement and changes in QEEG parameters. Of the 24 patients on medication for their ADD/ADHD condition, 5 Ss were able to be removed completely from their medication after the treatment. 11 Ss showed a decreased dependence on their medication in that their dosage was able to be reduced. The remaining 8 Ss initially on medication showed no change. However, 4 of these 8 Ss showed overall improvement, implying that this same dosage of drug was more effective. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Avior, G., Fishman, G., Leor, A., Sivan, Y., Kaysar, N., & Derowe, A. (2004). The effect of tonsillectomy and adenoidectomy on inattention and impulsivity as measured by the test of variables of attention (TOVA) in children with obstructive sleep apnea syndrome. Otolaryngology - Head & Neck Surgery, 131(4), 367-371. OBJECTIVE: To evaluate children with obstructive sleep apnea syndrome (OSAS) for features of attention deficit disorder (ADD) using an objective test of inattention and impulsivity: Test of Variables of Attention (TOVA) and then to determine whether tonsillectomy and adenoidectomy (T+A) results in an improvement in TOVA scores. STUDY DESIGN AND SETTING: This study was a prospective interventional comparative trial in a tertiary care children's hospital. Nineteen children ages 5 to 14 years with OSAS, and otherwise healthy, with a clinical indication for T+A. Preoperative and 2 months postoperative OSA-18, CBCL questionnaires, and TOVA scores were evaluated. RESULTS: The preoperative TOVA scores were in the abnormal range in 12/19 (63%) of the children. The mean preoperative TOVA score was -2.9 (+/- 3.1). The mean postoperative TOVA score was -0.4 (+/-2.8). The improvement in the TOVA scores was significant ( P < 0.0001, t -test). CONCLUSION: This preliminary data suggests that treatment of OSAS with T+A results in significant improvement in objective parameters of inattention and impulsivity. Significance These findings may be important in understanding the impact of OSAS and therapeutic interventions on behavioral problems in children.

Baker, L. B., Conroy, D. E., & Kenney, W. L. (2007). Dehydration impairs vigilance-related attention in male basketball players. Medicine & Science in Sports & Exercise, 39(6), 976-983. PURPOSE: To determine the effects of dehydration (DEH) on attentional vigilance in male basketball players. METHODS: The Test of Variables of Attention (TOVA; Universal Attention Disorders) was administered to 11 male basketball players (17-28 yr) at baseline (test 1), after walking (50% V O2max) in the heat (40 degrees C and 20% relative humidity) (test 2), and then after a simulated basketball game (test 3). Tests 2 and 3 were performed while subjects were either DEH (1-4%) or euhydrated (EUH). The TOVA consisted of target-infrequent and target-frequent conditions, simulating static and dynamic (such as a basketball game) environments, respectively. TOVA measures included errors of omission (OE) and commission (CE), response time (RT), and sensitivity. RESULTS: During the target-infrequent half of test 3, EUH resulted in significantly better sensitivity (+0.4+/-1.2 vs -0.9+/-1.3), faster RT (-8+/-20 vs +16+/-28), and fewer OE (-0.4+/-0.7 vs +1.3+/-2.4) compared with DEH. During the target-frequent half, EUH resulted in significantly fewer OE (-4+/-15 vs +5+/-7) and CE (-1.9+/-3.2 vs 0.6+/-1.4) in test 2 and greater sensitivity (+0.7+/-2.6 vs -0.7+/-1.1) and faster RT (-21+/-28 vs +5+/-31) than DEH in test 3. CONCLUSION: Vigilance-related attention of male basketball players was impaired by DEH, especially during the target-frequent condition of the TOVA. These results suggest that fluid replacement is essential to prevent the decline in vigilance that occurs with DEH in highly dynamic environments. Therefore, basketball players should be advised to maintain EUH for optimal concentration and attentional skills during competition.

Bandstra, E. S., Morrow, C. E., Anthony, J. C., Accornero, V. H., & Fried, P. A. (2001). Longitudinal investigation of task persistence and sustained attention in children with prenatal cocaine exposure. Neurotoxicology & Teratology, 23(6), 545-559. The present study estimates the longitudinal effects of prenatal cocaine exposure on indicators of sustained attention processing at 3, 5 and 7 years of age in an urban sample of full-term African-American children (235 cocaine-exposed, 207 noncocaine-exposed). The sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview, urine and meconium toxicology assays. Sustained attention was measured at age 3 years using a standardized measure of task persistence during a challenging task [G.A. Morgan, N.A. Busch-Rossnagel, C.A. Maslin-Cole and R.J. Harmon, Individualized Assessment of Mastery Motivation: Manual for 15-36 Month Old Children, 1992.], and at ages 5 and 7 years using omission error scores from computerized continuous performance tasks (CPT) [L. Greenberg, R. Leark, T. Dupuy, C. Corman, C. Kindschi, M. Cenedela, Test of Variables of Attention (T.O.V.A. and T.O.V.A.-A.), 22, Universal Attention Disorders, Los Alamitos, CA, 1996; C.K. Conners, Conners' Continuous Performance Test (CPT), second ed., Multi-Health Systems, Canada, 1995.]. Findings from longitudinal GLM/GEE analyses of the three measured time points support a stable influence of prenatal cocaine exposure on indicators of sustained attention, after controlling for prenatal exposure to alcohol, marijuana, tobacco and over 20 additional medical and social-demographic covariates drawn from potentially confounding influences assessed at birth and later assessment visits (D=0.21; 95% CI=0.04, 0.38; P=.017). This effect was not mediated by fetal growth or gestational age and remained highly stable with increasing levels of covariate control. Separately, using the age 7 data, a structural equations model (SEM) was constructed combining all available self-report and bioassay data to measure magnitude of cocaine exposure in relationship to attention task performance. Results indicated a gradient of influence, with each standard deviation increase in the level of prenatal cocaine exposure relating to a 16% standard deviation increase in omission error scores at age 7. Overall findings support a stable cocaine-specific effect on indicators of sustained attention processing during the early childhood years. Results are discussed within the context of neurobiological and behavioral research linking prenatal cocaine exposure to long-lasting disruption of the brain systems subserving arousal and attention.

Bernstein, G. A., Carroll, M. E., Crosby, R. D., Perwien, A. R., Go, F. S., & Benowitz, N. L. (1994). Caffeine effects on learning, performance, and anxiety in normal school-age children. Journal of the American Academy of Child & Adolescent Psychiatry, 33(3), 407-415. OBJECTIVE: The purpose of this investigation was to study the acute effects of caffeine on learning, performance, and anxiety in normal prepubertal children. METHOD: Twenty-one children were evaluated in a double-blind, placebo-controlled crossover design. Subjects were studied during four sessions, 1 week apart, under the following conditions: baseline, placebo, 2.5 mg/kg caffeine, and 5.0 mg/kg caffeine. Subjects were randomized to order of placebo and the two dosages of caffeine. Dependent measures included tests of attention, manual dexterity, short-term memory, and processing speed. Anxiety rating scales were also administered. Saliva samples were analyzed for caffeine levels. RESULTS: Caffeine improved performance on two of four measures of the Test of Variables of Attention and on a test of manual dexterity in the dominant hand. There was a trend toward increased current level of self-reported anxiety after caffeine on a visual analogue measure of anxiety. Children reported feeling significantly less "sluggish" after caffeine ingestion than after placebo ingestion. CONCLUSIONS: In a small sample size, there was indication that caffeine enhanced performance on a test of attention and on a motor task. Children also reported feeling less "sluggish" but somewhat more anxious. Because caffeine is so widely available and frequently consumed by children, these results are important and need replication.

Bernstein, G. A., Carroll, M. E., Dean, N. W., Crosby, R. D., Perwien, A. R., & Benowitz, N. L. (1998). Caffeine withdrawal in normal school-age children. Journal of the American Academy of Child & Adolescent Psychiatry, 37(8), 858-865. Examined whether children manifest withdrawal effects after cessation of caffeine intake. 30 normal 8-12 yr olds completed the single-blind, within-subjects, repeated-measures study with weekly sessions. Ss were tested 4 times: (1) baseline (on regular caffeine diet consisting of an average of 20 mg/day); (2) on caffeine (approximately 120 to 145 mg/day); (3) during withdrawal (24 hrs after discontinuation of caffeine taken for 13 consecutive days); and (4) at return to baseline. Ss were evaluated with self-report measures of symptoms and objective measures of attention, motor performance, processing speed, and memory. Tests included the Caffeine Rating Scale, the Finger Tapping Test, and the Test of Variables of Attention. During caffeine withdrawal, there was a significant deterioration on response time, which persisted for 1 wk, on a visual continuous performance test of attention. This finding is consistent with caffeine withdrawal. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Blaskovic, D., & Albrecht, P. (1963). [TICK-BORNE ENCEPHALITIS AS A MODEL OF ARBORVIRUS ENCEPHALITIS.]. [Klie S Tov'a Encefalit'ida Ako Model Arbov'irusov'ych Encefalit'id.] Lekarsky Obzor, 12, 527-537.

Boivin, M. J. (2002). Effects of early cerebral malaria on cognitive ability in senegalese children. Journal of Developmental & Behavioral Pediatrics, 23(5), 353-364. Twenty-nine Senegalese children with a history of cerebral malaria (CM) performed more poorly on the Kaufman Assessment Battery for Children (K-ABC) Simultaneous Processing domain and on the Test of Variables of Attention (TOVA) attention capacity indicators in comparison with a matched control group. Thus, CM can disrupt neuropsychological integration during critical developmental periods, impacting on global neurological integrity, attentional vigilance, perceptual acuity, and subsequent development of visual-spatial processing and memory foundational to global cognitive ability. A subsequent structural equation model confirmed that rural children are at greater risk for CM, subsequent attention deficits, and other developmental risk factors in addition to the CM impact on K-ABC performance. We document CM as one of a host of developmental risk factors within the complex web of poverty in sub-Saharan Africa, which limit children's ability to achieve their full intellectual potential and, thus, extend the human cost of the disease beyond general measures of mortality and morbidity.

Boivin, M. J., Bangirana, P., Byarugaba, J., Opoka, R. O., Idro, R., Jurek, A. M., et al. (2007). Cognitive impairment after cerebral malaria in children: A prospective study. Pediatrics, 119(2), e360-6. OBJECTIVE: This study was conducted to assess prospectively the frequency of cognitive deficits in children with cerebral malaria. METHODS: Cognitive testing in the areas of working memory, attention, and learning was performed for Ugandan children 5 to 12 years of age with cerebral malaria (n = 44), children with uncomplicated malaria (n = 54), and healthy community children (n = 89) at admission and 3 and 6 months later. RESULTS: Six months after discharge, 21.4% of children with cerebral malaria had cognitive deficits, compared with 5.8% of community children. Deficits were seen in the areas of working memory (11.9% vs 2.3%) and attention (16.7% vs 2.3%). Children with cerebral malaria had a 3.7-fold increased risk of a cognitive deficit, compared with community children, after adjustment for age, gender, nutritional status, school level, and home environment. Among children with cerebral malaria, those with a cognitive deficit had more seizures before admission (mean: 4.1 vs 2.2) and a longer duration of coma (43.6 vs 30.5 hours), compared with those without a deficit. Children with uncomplicated malaria did not have an increased frequency of cognitive deficits. CONCLUSIONS: Cerebral malaria may be a major cause of cognitive impairment in children in sub-Saharan Africa. Cognitive deficits in children with cerebral malaria are more likely for those who have multiple seizures before effective treatment for cerebral malaria.

Boivin, M. J., Giordani, B., Crist, C. L., Chounramany, C., Xaisada, S., Choulamountry, L., et al. (1996). Validating a cognitive ability testing protocol with lao children for community development applications. Neuropsychology, 10(4), 588-599. The emergence of the sociocultural perspective in cross-cultural psychology has discouraged the adaptation of standardized tests in nonindustrialized settings. Yet, cognitive assessments are needed for monitoring the effects of nutritional, health, and educational interventions. Forty-seven Lao children 5 to 12 years of age completed the Kaufman Assessment Battery for Children (K-ABC), the Tactual Performance Test (TPT), and the computerized Tests of Variables of Attention (TOVA). TPT performance measures were related to physical (nutritional) development, whereas the K-ABC global cognitive ability indicators were sensitive to parental education and quality of home environment. TOVA performance was related to K-ABC global performance and TPT memory, suggesting that these measures are at least partially undergirded by attentional ability. Sociocultural concerns aside, these finding suggest that validated neuropsychological and cognitive assessments can be adapted that effectively tap basic and universal brain-behavior traits.

Boyd, W. D., & Campbell, S. E. (1998). EEG biofeedback in the schools: The use of EEG biofeedback to treat ADHD in a school setting. Journal of Neurotherapy, 2(4), 65-71. Six middle school students (aged 13-15 yrs) diagnosed with attention deficit hyperactivity disorder (ADHD) were selected for sensorimotor rhythm training with EEG biofeedback. Ss were evaluated following a 72-hr drug-free period with the Wechsler Intelligence Scale for Children (WISC) Digit Span subtest and the Test of Variables of Attention (TOVA). Five of the Ss received 20 sessions of EEG biofeedback and one of the Ss received 9 sessions of EEG biofeedback. Ss were evaluated again following a 72-hr drug-free period. Five of the 6 Ss improved on their combined WISC Digit Span, TOVA Inattention, and TOVA Impulsivity scores. These results support previous findings that EEG biofeedback can be effective in the treatment of ADHD (S. Othmer et al, 1991). More importantly, this study demonstrated that EEG biofeedback could be used in an actual school setting. Recommendations for implementing an EEG biofeedback program in the schools are provided. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Braverman, E. R., Chen, T. J., Schoolfield, J., Martinez-Pons, M., Arcuri, V., Varshavskiy, M., et al. (2006). Delayed P300 latency correlates with abnormal test of variables of attention (TOVA) in adults and predicts early cognitive decline in a clinical setting. Advances in Therapy, 23(4), 582-600. Delayed P300 latency identifies dementia better than the Mini-Mental Status Exam and, in some cases, the Wechsler Memory Scale (WMS-III). The purpose of this study was to determine whether the outcome of an objective Test of Variables of Attention (TOVA) correlates with the findings of an electrophysiologic test-P300 latency-in patients 40 y of age or older. Adult attention deficit disorder may be an important premorbid marker of memory dysfunction or dementia. In males, the means for P300 latency and age-adjusted P300 latency were significantly greater for patients classified as SD-BL (significantly deviant or borderline: TOVA2 SD-BL quarters had significantly delayed P300 latency and age-adjusted P300 latency compared with males who had 0 SD-BL quarters (P2 SD-BL quarters had significantly delayed P300 latency and age-adjusted P300 latency compared with males who had 0 SD-BL quarters (P2 SD-BL quarters had significantly delayed P300 latency and age-adjusted P300 latency compared with males who had 0 SD-BL quarters (P2 SD-BL quarters had significantly delayed P300 latency and age-adjusted P300 latency compared with males who had 0 SD-BL quarters (P2 SD-BL quarters had significantly delayed P300 latency and age-adjusted P300 latency compared with females who had 0 SD-BL quarters (P<.005) and 1 SD-BL quarter (P<.010). Results suggest that TOVA abnormalities may be an indicator of delayed P300 and attention disorder. Recent research correlates TOVA abnormalities with impaired WMS scores of early dementia. Coupling of TOVA assessment findings with results of P300, Mini-Mental Status Exam, and WMS-III may allow for enhanced accuracy in the diagnosis and evaluation of the complex pathway of failing attention, memory, and cognition that leads to dementia.

Brewis, A. (2002). Social and biological measures of hyperactivity and inattention: Are they describing similar underlying constructs of child behavior?. Social biology, 49(1-2), 99-115. The relationship between 27 different measures of hyperactive, impulsive, and inattentive behavior, including those considered to be more objective and those considered more influenced by social factors, is examined using a normal sample of 219 Mexican children, ages 6 to 12. Measures were based on activity monitoring by accelerometry, ethological observation of attentional and movements states in the classroom, cognitive testing using the TOVA continuous performance test (CPT), and parents' and teachers' reports on ratings scales and symptom checklists. Factor analysis was used to examine to what degree these different measures are reporting similar underlying constructs (factors) of hyperactivity and inattention. Parent and teacher ratings appear to be describing underlying constructs that are distinct from those described by the other measures, but measures based on CPT, observation, and activity monitoring did not factor together either, nor more highly correlate to each other. Analysis combining all the measures showed that parent and teacher ratings factored together based on who was reporting the behavior, rather than the behavior being reported. The findings underscore that each type of measurement of hyperactivity, impulsivity, and inattention measures a different aspect of a complex behavioral phenomenon, rather than some better measuring than others the same underlying factor.

Byas-Smith, M. G., Chapman, S. L., Reed, B., & Cotsonis, G. (2005). The effect of opioids on driving and psychomotor performance in patients with chronic pain. Clinical Journal of Pain, 21(4), 345-352. OBJECTIVES: This study compared the psychomotor performance and driving ability of patients with chronic pain managed with stable regimens of opioid analgesics with that of normal healthy volunteers. The hypothesis was that patients with chronic pain on stable opioid analgesic regimens operate their automobiles safely with proficiency equal to normal volunteer controls. METHODS: Patients were evaluated for errors while driving their own automobile through a predetermined route in the community, including variable residential and highway conditions, and for speed and accuracy on repeated trials through a 5-station obstacle course that evaluated forward and reverse driving, turning, and parallel parking. Patients also completed the Test of Variables of Attention and the Digit Symbol Substitution Test. RESULTS: No significant differences were observed among groups in driving performance in the community and on the obstacle course or on the Test of Variables of Attention. Results on dependent measures within the opioid group generally were not correlated with morphine equivalent daily opioid doses, which averaged 118 mg (median 40 mg). CONCLUSIONS: Many patients with chronic pain, even if treated with potent analgesics such as morphine and hydromorphone, show comparable driving ability as normals.

Cantor, S. R. (1999). The effect of sleep loss on nighttime sleep, daytime sleepiness, and cognitive functioning in children with attention deficit hyperactivity disorder. Dissertation Abstracts International: Section B: The Sciences and Engineering, 60 (1-B), 0360. The purpose of this investigation was to define groups of ADHD and Non-ADHD prepubertal children, and assess the impact of sleep loss on sleep, daytime sleepiness, and performance on a continuous performance task, the Test of Variables of Attention (T.O.V.A.-super(TM)). 20 children (11 ADHD and 9 non-ADHD) were evaluated in the CCNY Sleep Disorders Center. Participants who met inclusion criteria returned to begin a two night, two day study in which their sleep and levels of daytime alertness were electronically recorded. To partially sleep deprive participants, they went to bed two hours later on Night 2. Levels of daytime alertness/sleepiness were assessed with the Multiple Sleep Latency Test. Post sleep loss dependent variables included: (1) Night 2 of sleep, (2) Day 2 MSLTs, and (3) T.O.V.A-super(TM) performance. One significant interaction effect was found for sleep. ADHD children had a significantly higher percentage of transitional, lighter Stage 1 sleep after sleep loss, in contrast to the non-ADHD group, who had lower Stage 1% on Night 2, a more expectable response. Parent reports on the questionnaire of children's sleep correlated somewhat with empirical recordings. Items seem to be useful in identifying children with sleep difficulties. ADHD children did not become sleepier than non-ADHD children from mild sleep loss: there was no difference found between the groups on the MSLT. However, all participants, had statistically significantly lower Sleep Latency means on MSLT 2, suggesting that just two hours of sleep loss can have some impact on the high levels of alertness seen in most participants the first day. ADHD group T.O.V.A.-super( TM) means, before and after sleep loss, were not different. ADHD group's T.O.V.A.-super(TM) performance did not show more severe decrements than controls after the sleep loss condition. Preliminary findings showed non-ADHD children made more errors on the T.O.V.A.-super(TM) after mild sleep deprivation. Further research is indicated to follow up investigating the group differences and relationships suggested by this study between sleep loss and nocturnal sleep, decrements in diurnal alertness, and T.O.V.A.-super( Tm) performance in ADHD and non-ADHD children. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Carmody, D. P., Radvanski, D. C., Wadhwani, S., Sabo, M. J., & Vergara, L. (2001). EEG biofeedback training and attention-deficit/hyperactivity disorder in an elementary school setting. Journal of Neurotherapy, 4(3), 5-27. EEG biofeedback was conducted on site in an elementary school. An experimental group of 8 children (aged 8-10 yrs) completed 35-47 sessions of EEG biofeedback training over a 6-mo period. Four Ss in the experimental group were diagnosed with attention deficit hyperactivity disorder (ADHD) and 4 were not diagnosed with ADHD. Eight children in the waitlist control group were matched to the experimental group on age, grade, teacher, and diagnosis. None of the 16 Ss were medicated for ADHD. Attention abilities as measured by the Test of Variables of Attention showed the experimental group of children with ADHD reduced errors of commission and anticipation, indicating a reduction in impulsivity. Teacher reports using the McCarney Scale indicated improvements in attention but no changes in impulsivity and hyperactivity. It is concluded that several confounds require exploration before attribution of changes are assigned to neurofeedback. Whether the effects are due to the neurofeedback protocols, attendance at individual sessions away from the classroom, the attention of the technician, or the excitement of a special program cannot be determined with this study. It will be necessary to have a placebo group in order to separate systematically the variables in the training program. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Carter, C. S., Krener, P., Chaderjian, M., Northcutt, C., & Wolfe, V. (1995). Asymmetrical visual-spatial attentional performance in ADHD: Evidence for a right hemispheric deficit. Biological psychiatry, 37(11), 789-797. This study was designed to confirm the presence of a lateralizing deficit in visual-spatial attention in children with ADHD, to further characterize the nature of this deficit and to specify the likely hemispheric locus of dysfunction. Two versions of the covert orienting of attention procedure which evaluated separately endogenous and exogenous cuing effects were administered to 20 unmedicated children aged 9-12 with ADHD and 20 matched controls. Both groups also underwent thorough psychiatric assessment and testing using the TOVA and the Wisconsin Card Sorting Task (WCST). Children with ADHD showed an asymmetrical performance deficit characterized by a loss of costs on controlled (endogenous) attentional orienting to invalidly cured left visual field targets. The degree of cost asymmetry correlated negatively with the number of categories sorted on the WCST. It was concluded that unmedicated children with ADHD show an asymmetrical performance deficit on the covert orienting procedure characterized by a disruption of right hemispheric attentional mechanisms. This deficit may be related to diminished right hemispheric frontal-striatal catecholamine activity.

Chae, P. K., Jung, H. O., & Noh, K. S. (2001). Attention deficit hyperactivty disorder in korean juvenile delinquents. Adolescence, 36(144), 707-725. This study was conducted to identify attention deficit hyperactivity disorder (ADHD) in Korean juvenile delinquents. Intelligence tests (KEDI-WISC, K-WAIS), the Test of Variables of Attention (TOVA), the Teacher Report Form (TRF), the Youth Self-Report (YSR), and the Rosenberg Self-Esteem Scale were administered to 98 incarcerated Korean adolescents (the delinquent group) and 84 adolescent nondelinquents (the control group). The groups were compared, and significant differences were found for ADHD; 42.4% of the adolescents in the delinquent group were identified as having ADHD, in comparison to 11.9% of the adolescents in the control group. Delinquent adolescents and adolescents with ADHD were found to have lower IQ scores, poorer TOVA performance, more severe problem behaviors, and lower self-esteem than nondelinquent adolescents and adolescents without ADHD. Delinquent adolescents with ADHD consistently fared the worst on assessments of intelligence, TOVA performance, problem behaviors, and self-esteem.

Chae, P. K. (1999). Correlation study between WISC-III scores and TOVA performance. Psychology in the Schools, 36(3), 179-185. The Continuous Performance Test (CPT), such as the Test of Variable Attention (TOVA), is widely used in the assessment of attention deficit hyperactivity disorder (ADHD) with other behavioral ratings and observations. Since some clinicians argue that CPTs measure psychomotor speed function rather than sustained attention, a correlation study between Performance IQ (PIQ) of the Wechsler Intelligence Scale for Children-III (WISC-III) and TOVA was conducted to find out if a significant relationship of any kind existed. Forty 6-16 yr old children with ADHD were studied, and the results indicate that there was no correlation between TOVA and PIQ of the WISC-III. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Chae, P. K., Kim, J., & Noh, K. (2003). Diagnosis of ADHD among gifted children in relation to KEDI-WISC and T.O.V.A. performance. Gifted Child Quarterly, 47(3), 192-201. The following study was conducted to evaluate the correlation between intelligence and a Continuous Performance Test (CPT) that assesses Attention-Deficit Hyperactivity Disorder (ADHD) in children. Characteristics of attention in gifted children with ADHD were also investigated. A sample of 177 elementary school students was studied, and their attention was measured with the Test of Variables of Attention (TOVA). About 9.4% of the gifted children were identified with ADHD using the TOVA, Child Behavior Check List (CBCL), and Teacher's Report Form (TRF). Significant positive correlations were found between intelligence (KEDI-WISC) and omission error, commission error, and response time (RT) variability on the TOVA. That is, children with a high level of intelligence made fewer omission and commission errors and responded more consistently on the TOVA. than children with lower intelligence. No significant correlation was found between intelligence and response time. Overall, gifted children performed better on the TOVA. than nongifted children. Specifically, with the exception of response time and response time variability, gifted children with ADHD performed better on tasks of omission error, commission error, and response sensitivity than nongifted children with ADHD... (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)

Chevreau, L. P. (2005). Neurofeedback and childhood adhd. Dissertation Abstracts International: Section B: The Sciences and Engineering, 66 (5-B), 2870. This was a multiple-case study of neurofeedback (NF) treatments of attention deficit hyperactivity disorder (ADHD) in children. The research investigated the effects on (a) physiological and behavioral functioning, (b) learning and memory, and (c) social and emotional functioning. Quantitative and qualitative methods were used to assess treatment effects for four boys aged 8 to 11. In each, information was obtained from a caretaker and a teacher. All boys had been diagnosed by their physicians and through neurodiagnostic testing. In every case, the boys had comorbid disorders, including sleep disorders, and, in one case, oppositional defiant disorder (ODD). Three boys were taking medication. NF treatments involved 20 sessions, administered by the investigator. Sensors were placed on the boys' scalps to monitor brain electrical activity. The boys responded to visual stimuli they viewed on a computer monitor, which incorporated this EEG (electroencephalographic) activity as feedback. NF helps participants train their brain activity toward better self-regulation. Pretreatment and posttreatment involved the Test of Variables of Attention (TOVA); the Behavior Assessment System for Children (BASC); parent and teacher monitor ratings; physician information; interviews with child, parent, and teacher; and neurotherapist observations. Results were mixed, with the least progress on TOVA scores. BASC ratings reflected greater improvement at school and home, and interviews and observations included even more positive assessments in all areas of investigation. Gains included greater behavior control, attention, organizational skills, homework completion, and overall academic performance; more positive self-esteem; better sleep; and cooperation with parents and teachers. Potential confounding factors included comorbidity, medication changes in certain boys, and behavioral changes due to expectations of the investigator and other adults. Notably, 40 treatments might have shown further gains. This partial success underscores the importance of further study of NF for ADHD. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Cooper, J., Tyler, L., Wallace, I., & Burgess, K. R. (2004). No evidence of sleep apnea in children with attention deficit hyperactivity disorder. Clinical pediatrics, 43(7), 609-614. Children with attention deficit hyperactivity disorder (ADHD) may have a component of sleep apnea causing arousal and contributing to ADHD behavior during the day. Twenty non-ADHD children between 4 and 16 years of age were compared with 18 children with ADHD with use of nocturnal polysomnography (PSG) and psychometric tests. The psychometric testing confirmed that the control group were normal and that the ADHD children fulfilled the diagnostic criteria for ADHD. The PSG showed normal arousal indexes for the ADHD group (9.8 +/- 3.9/hr) and controls (10.2 +/- 3.1/hr), and normal apnea/hypnea indexes for the ADHD group (1.0 +/- 2.4/hr) and controls (0.6 +/- 0.9/hr). The sleep architecture was not significantly different between groups. There were no sleep abnormalities in the ADHD children that could be responsible for, or contributing to, the disorder.

Cotman, A., & Sandman, C. (1997). Cognitive deficits and their remediation in the homeless. Journal of Cognitive Rehabilitation, 15(1), 16-23.

Craw, M. J. (1998). Race and ethnic differences on the test of variables of attention. Dissertation Abstracts International: Section B: The Sciences and Engineering, 58 (9-B), 5111. To assess the relationship between the Test of Variables of Attention (TOVA) and race/ethnicity, 40 Caucasian, 40 Asian, and 20 Hispanic children between the ages of 8 and 10, were administered the TOVA and the attention factor from the Child Behavior Checklist (CBCL). Gross annual income and years of parent education were used as covariates to partial out variance due to socioeconomic status. All of the children who were participants in the study attended the same elementary school and lived in the same neighborhood. Consent forms were given to all of the children in the 2nd, 3rd, and 4th grades and those parents who agreed to participate were then included in the study and assigned to the appropriate race/ethnic group. Results indicated that there was a significant difference between the three groups on total percentage of omission errors (inattention). Post hoc analysis indicated that the Hispanic group made significantly more errors of omission than the Caucasian group and significantly more errors of omission than the Asian group. This difference remained even after the covariates representing socioeconomic status were removed. There was a significant difference between groups on variability (a measure of consistency), but the difference did not remain after inclusion of the covariates. However, the covariates removed a negligible amount of variance, and a loss of power was seen as responsible for not achieving significant differences between groups on variability. There were no significant differences between groups on commission errors, response time, or the attention factor on the CBCL. In the current study there was evidence that the TOVA may not measure attention in the same way for different race/ethnic groups. The Hispanic group was shown to be less attentive, as defined by increased omission errors on the TOVA, compared to the Asian group and the Caucasian group. There was also evidence that the three groups differed in terms of consistency in responding. Thus, the current study provides the first empirical evidence that the TOVA cannot be assumed to be a culture free test. The results were further explained using tenets from the philosophy of science known as constructionism. It is asserted that attention is a hypothetical construct that cannot be dispassionately observed. Thus, any operational definition of attention, like the TOVA, is created within subsystems of culture, values, economy, and politics that guide the scientific process. In this way, no single measure of attention, however objective it may appear, can accurately measure attention for individuals across various culture and ethnic groups. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

David, H. P. (1981). Review of women in eastern europe and the soviet union. PsycCRITIQUES.Vol 26 (12), Dec, 1981, Originally published in Contemporary Psychology: APA Review of Books, 1981, Vol 26(12), 967-968. Reviews the book, Women in Eastern Europe and the Soviet Union by Tova Yedlin (Ed.) (1980). This is a unique collection of 14 papers originally presented at the Conference on Women in Eastern Europe and the Soviet Union, convened at the University of Alberta in October 1978. Particularly useful is the critical examination by Alena Heitlinger of "Marxism, Feminism, and Sex Equality." Although "female labor-force participation is a prerequisite of emancipation, a state socialist transformation is insufficient to bring about the liberation of women." Without a social and political climate favoring socialization of housework and child care, "women can hardly hope to play equal roles in society." Although the variety of topics and approaches renders generalization hazardous, the editor suggests that "the question of full equality for women under socialism remains a thing of the future." (PsycINFO Database Record (c) 2007 APA, all rights reserved)

De Jong, M. D. (2001). A comparison of EEG activity in adults with attention deficit hyperactivity disorder and normal controls while performing tasks that require attention. Dissertation Abstracts International: Section B: The Sciences and Engineering, 62 (2-B), 1072. Children with Attention Deficit Hyperactivity Disorder (ADHD) have been reported to have electroencephalographic (EEG) abnormalities in the form of increased levels of theta band activity and lower than normal levels of beta band activity. The purpose of the present study was to determine if these abnormalities can also be observed in adults with ADHD. There were 32 control subjects, 25 subjects with ADHD of the primarily hyperactive type (ADHDhy), and 17 subjects with ADHD of the primarily inattentive type (ADHDpi). For the purposes of analysis, the ADHDhy and ADHDpi groups were combined to form a CLINICAL group. The subjects were right handed males and females between the ages of 20 and 50 years of age. During the study, EEG activity was recorded from 19 electrode sites while subjects sat with their eyes open and eyes closed, and while they performed a variety of tasks including: the Tests of Variability of Attention (TOVA), a reading task, a mental rotation task, a selective attention task, and a listening task. The results of the discriminant function analyses produced functions that correctly classified an average of 60 out of 74 of the control and ADHD subjects during the TOVA, listening, and selective attention tasks (p < .0005). An ANOVA of inter-hemispheric activity revealed that only the ADHDpi group were significantly different from the control group with more right than left hemispheric activity in the delta band during the mental rotation task (p < .006). A paired t-test analysis of inter-hemispheric activity showed that both the ADHDhy and ADHDpi groups had different percentage levels of right and left hemispheric activity (p < .005) during the performance of the eyes closed, T.O.V.A., mental rotation, and reading tasks; there were no significant differences in the control group in any of these comparisons. A MANOVA of regional (frontal, central, posterior, left temporal, and right temporal) activity revealed statistically significant differences in the theta/beta ratio during the eyes closed condition for the ADHDhy group with a higher ratio in the frontal region and right temporal area (p < .006). The results suggest that the differences between normal and ADHD children continues into adulthood but that the magnitude of the differences is reduced. A dysfunction in EEG activity caused by a maturational lag is supported by the results of this study. Based on the results of the analyses, recommendations are made as to which frequency bands and electrode sites should be targeted for use in neurotherapy. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

DeBaun, M. R., Schatz, J., Siegel, M. J., Koby, M., Craft, S., Resar, L., et al. (1998). Cognitive screening examinations for silent cerebral infarcts in sickle cell disease. Neurology, 50(6), 1678-1682. OBJECTIVE: In children with sickle cell disease (SCD), silent cerebral infarcts are the most frequent cause of neurologic injury. We determined the sensitivity and specificity of selective neurocognitive measures when separating children with silent cerebral infarcts and SCD from sibling controls. Additionally, we tested the validity of the same cognitive measures to identify patients with overt strokes. METHODS: We examined performance on a neuropsychologic battery containing measures of attention/executive, spatial, language, memory, and motor functioning for seven children with SCD and silent cerebral infarct, 21 children with SCD and overt stroke, and 17 normal siblings. Diagnosis of cerebral infarct was based on results of MRI. RESULTS: Measures from the attention and executive domains were the most useful for identifying children with silent cerebral infarct. The Test of Variables of Attention was the most robust measure and yielded a sensitivity rate of 86% and a specificity rate of 81%. This measure also showed a sensitivity rate of 95% in identifying overt stroke. CONCLUSIONS: Brief cognitive screening measures, if properly constructed, may be an effective means of identifying children with silent cerebral infarct. Future prospective studies should be pursued to assess the utility of cognitive screening for silent cerebral infarcts in SCD.

Denzin, N. K. (Ed.). (2004). Studies in symbolic interaction, vol 27(2004). Studies in symbolic interaction, Vol 27. xi, 346 pp. US: Elsevier Science/JAI Press.(create) This latest volume continues the series focus on symbolic interaction and communication. Structurally, the text is divided into four sections. Part One honors the contributions of Laurel Richardson to the field. Part Two, which presents two papers from the Peter M. Hall Lecture Series, covers the the topics of symbolic interaction and its relationship to sociology and the changing society; and the stigmatization of certain occupations (the real-estate developer in particular). Part Three explores the most recent developments in interactionist theory and practice. Finally, Part Four presents a collection of creative writings entitled "Border Crossings/Border Performances". (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Deredzhian, A., & Damianov, D. (1974). [Patients with cancer of the cecum previously subjected to surgery for appendicitis]. [Nashi nabliudeniia vurkhu bolni s rak na sliapoto chervo, operirani predi tova za apenditsit] Khirurgiia, 27(4), 278-282.

Dobrusin, S. J. (2000). Determining the diagnostic capabilities of computer performance tests for adults with attention deficit disorder. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61 (1-B), 583. Testing for ADHD in the adults is difficult. Questionnaire data (self-repor ts) are used by mental health professionals to diagnose this condition. Other fa mily members may also complete questionnaires and a thorough developmental histo ry is obtained verifying childhood symptoms for the ADHD adult, but this informa tion is subjective. Objective laboratory measures, such as continuous performanc e tests (CPTs), are available to aid in the diagnosis. The present study examin ed the use of two CPTs, the Gordon Diagnostic System (GDS) (Gordon, 1987) and th e Test of Variables of Attention (TOVA) (Greenberg, 1991), in diagnosing adults with ADHD. The results of the two CPTs were compared between adults with a preli minary diagnosis of ADHD and a control group who had no ADHD symptoms. To determ ine if differences existed in patterns of results between the two groups and in outcomes between the CPTs for either group. The findings showed that the ADHD ( n = 60) and nonADHD (n = 30) groups differed on the TOVA, but no differences wer e found between the two groups on the Gordon. When the two tests were compared r egarding their ability to diagnose ADHD, no differences were found between the T OVA and GDS. The discriminant function analysis showed that TOVA scores includin g response time standard scores, TOVA scores for ADHD, response time variability were stronger predictors of ADHD than individual scores on the GIDS. The WAIS-R vocabulary score was a stronger predictor of ADHD than the block design. Ancill ary findings were also reported on the sensitivity and specificity of the two CP Ts based on their outcomes. It appeared that the GDS had better sensitivity than the TOVA, while the specificity levels appeared to be similar. The lack of a g old standard for diagnosing ADHD provides a cautionary note in the use of CPTs. Mental health professionals who work with ADHD adults should consider using the CPT as part of their diagnostic protocol, but should not rely on their results t o provide a basis for diagnosis. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Downey, K. K., Stelson, F. W., Pomerleau, O. F., & Giordani, B. (1997). Adult attention deficit hyperactivity disorder: Psychological test profiles in a clinical population. Journal of Nervous and Mental Disease, 185(1), 32-38. Used established tests with age-corrected norms to report the battery of psychological and neuropsychological tests conducted on 78 outpatients admitted to an attention deficit hyperactivity disorder (ADHD) clinic. ADHD Ss scored significantly higher than norms on the tridimensional personality questionnaire novelty seeking and harm avoidance scales and Minnesota Multiphasic Personality Inventory-2 scales F, 2, 4, 7, and 8. Further, these Ss were impaired on the California verbal learning test, the attentional capacity test, and the omissions and variability subtests of the test of variables of attention. Adult ADHD Ss had high comorbidity with current depressive disorder, antisocial personality disorder, and alcohol and drug abuse/dependence. High correlations were found between Ss' and independent observers' reports of ADHD symptom severity. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Drozd, J. S. (1997). A comparative study of continuous performance test (cpt) profiles, of a stratified random sample of ethnically diverse urban public school eight and nine-year-olds, with the standardization sample of anglo suburban public school students. Dissertation Abstracts International: Section B: The Sciences and Engineering, 57 (12-B), 7770. Continuous performance tests are instruments which require the test subjects to be, at all times or continuously, attentive to the task presented. In this way lapses or gaps in attention, which can detrimentally affect learning, can be quantified against some standard or norming group. Continuous performance tests (CPT) have been utilized for forty (40) years. Only within the past fifteen (15) years have the format, administration, scoring and norms been standardized as the result of the advancement in computer technology. None of the three commercially produced CPT's include ethnic or socio-economic status information in their normative data. No significant information with regard to possible ethnic or cultural differences in CPT performance is currently available. As the application of CPT's moves from the research lab to clinics, hospitals, and schools, its potential impact on children, especially minorities, also increases. This research involves the statistical comparison of the original suburban Anglo norming of a commercially available CPT, the Tests of Variables of Attention (T.O.V.A.), with a stratified random sampling of an ethnically diverse urban population. Forty (40) boys and forty-three (43) girls between the ages of 8 years 0 months, to 9 years 11 months, were selected from Florida's Dade County Public Schools for inclusion in this study. Results suggest no significant differences in the performance profile of the current research population relative to the original standardization sample. A discussion of minor incongruencies and possible causative factors is included. These findings support the use of the T.O.V.A. as a school based screening instrument, and as part of a multimodal learning problem assessment battery in ethnically diverse urban settings. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Fernandez, T., Herrera, W., Harmony, T., Diaz-Comas, L., Santiago, E., Sanchez, L., et al. (2003). EEG and behavioral changes following neurofeedback treatment in learning disabled children. Clinical Electroencephalography, 34(3), 145-152. Neurofeedback (NFB) is an operant conditioning procedure, by which the subject learns to control his/her EEG activity. On one hand, Learning Disabled (LD) children have higher values of theta EEG absolute and relative power than normal children, and on the other hand, it has been shown that minimum alpha absolute power is necessary for adequate performance. Ten LD children were selected with higher than normal ratios of theta to alpha absolute power (theta/alpha). The Test Of Variables of Attention (TOVA) was applied. Children were divided into two groups in order to maintain similar IQ values, TOVA values, socioeconomical status, and gender for each group. In the experimental group, NFB was applied in the region with highest ratio, triggering a sound each time the ratio fell below a threshold value. Noncontingent reinforcement was given to the other group. Twenty half-hour sessions were applied, at a rate of 2 per week. At the end of the 20 sessions, TOVA, WISC and EEG were obtained. There was significant improvement in WISC performance in the experimental group that was not observed in the control group. EEG absolute power decreased in delta, theta, alpha and beta bands in the experimental group. Control children only showed a decrease in relative power in the delta band. All changes observed in the experimental group and not observed in the control group indicate better cognitive performance and the presence of greater EEG maturation in the experimental group, which suggests that changes were due not only to development but also to NFB treatment.

Fitzgerald, R. L. (2001). Statistical reliability of the T.O.V.A.RTM test of variables of attention. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61 (7-B), 3895. ?The problem. The purpose of this study was to measure the temporal reliability of the Test of Variables of Attention (T.O.V.A.). The T.O.V.A. is a continuous performance test (CPT) used to assess attention in neuropsychological and neuropsychiatric evaluations. A problem that physicians, clinicians, and researchers face is the lack of reliable instruments that objectively screen for disorders of attention, for medication titration, and for monitoring treatment of symptoms of Attention Deficit-Hyperactivity Disorder (ADHD) over time. Method. Reliability of the T.O.V.A. was examined using a test-retest reliability correlation approach to report the degree to which the scores for omission, commission, response time, and response time variability obtained by the T.O.V.A. (Visual Version) over a 7-day (+2) period were correlated. The test subjects were 33 school-aged children from the Orange County, California, area. To answer the research questions, 4 null hypotheses were generated: that the scores for omission, commission, response time, and response time variability will not be significantly correlated over a 7-day (+2) period. Results. Analysis of the data revealed a positive correlation of omission, commission, response time, and response time variability scores of .86, .74, .81, and .87, respectively. There were no significant differences between males and females regarding obtained T.O.V.A. scores. A correlated t test was used to determine if a significant difference exists between Test 1 and Test 2 on the omission, commission, response time, and response time variability scores. T test results on the omission, response time, and response time variability scores did not find a significant difference. A significant difference did exist on the commission scores. Data analysis suggests that the T.O.V.A. is a reliable, clinic-based assessment instrument that can be used as a tool for evaluating children referred for ADHD assessment. In addition, the T.O.V.A. can be used for possible diagnosis considerations, medication, and treatment effects. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Flint, R. W.,Jr, & Turek, C. (2003). Glucose effects on a continuous performance test of attention in adults. Behavioural brain research, 142(1-2), 217-228. Increases in plasma blood glucose levels modulate memory, mood, and, to some extent, attention in adults. Participants in the present study were administered glucose (10, 100, and 500 mg/kg, or 50 g) or placebo (23.7 mg saccharin) shortly prior to completing the test of variables of attention (TOVA), a continuous performance test (CPT) commonly used to assess attention for diagnostic purposes. There were significant increases in blood glucose levels for the 500 mg/kg and 50 g groups, but only the 100 mg/kg group showed significant changes in behavior in comparison to the saccharin group. Specifically, the 100 mg/kg group performed worse on measures of commission errors, post-commission responses, and post-commission response time variability. There were no differences among the groups on other major variables of attention, including omission errors, response time, and response time variability. The results of this study demonstrate that large doses of glucose which increase blood glucose levels do not influence attention, but that a moderate dose (100 mg/kg) selectively impairs measures of impulsivity or disinhibition. Practitioners and researchers should maintain an awareness of dietary effects on attention and continue to examine micronutrients as potential confounds on diagnostic tests of cognition and behavior.

Foks, M. (2005). Neurofeedback training as an educational intervention in a school setting: How the regulation of arousal states can lead to improved attention and behaviour in children with special needs. Educational and Child Psychology, 22(3), 67-77. The current choice of treatment for the remediation of attentional and behavioural difficulties among primary school children with special educational needs (SEN) is, increasingly, pharmacological. If-neurofeedback can regulate brain arousal states and thereby improve attention, behaviour and readiness to learn, there may be a case for incorporating it into the special needs provision of mainstream primary schools, thus avoiding the use of potentially damaging stimulant medication as a means of controlling behaviour and promoting inclusion. An experimental design was used, employing the TOVA test as a pre-/post-test measure of attention and the TOVA rating scale as parental pre/post measure of behaviour, plus qualitative feedback as a post-treatment measure of attention/behaviour. Results indicate that neurofeedback may make an important impact on emotions and affect of the SEN individual, leading to improved behaviour and improved attentional capability; quality time spent on a no-failure task of any kind on a one-to-one basis may be beneficial to children with SEN, affecting their personal belief system and behaviour; incorporating neurofeedback as part of the school-based special needs provision is feasible and practicable. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)

Forbes, G. B. (1998). Clinical utility of the test of variables of attention (TOVA) in the diagnosis of attention-deficit/hyperactivity disorder. Journal of clinical psychology, 54(4), 461-476. Ability of the Test of Variables of Attention (TOVA) to distinguish between referred children with attention deficit hyperactivity disorder (ADHD) and other (OTHER) clinical diagnoses were studied in 146 children (aged 6-12.11 yrs). Ss, their parents, and/or their teachers completed measures concerning behavioral assessments, educational history, development and behavioral history, and the Ss' cognitive learning style. Results show that 117 Ss were placed into the ADHD group and 29 Ss were placed in the OTHER group. Results show that there were large differences between the ADHD group on teacher ratings of activity and inattention. Analysis of the TOVA variables indicated the ADHD group exceeded the OTHER group on omission errors, response time, variability, and the number of multiple responses. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Friedman, D. H. (1998). Social skills and problem behaviors of adolescents with learning disabilities with and without attention/impulsivity problems: A comparison of teacher and student perceptions. Dissertation Abstracts International Section A: Humanities and Social Sciences, 59 (5-A), 1525. The purpose of this study was to compare teacher and student perceptions of social skills and problem behaviors in subgroups of adolescents with LD. The Test of Variables of Attention--T.O.V.A. was administered to all students in the sample in order to form four subgroups: (a) students with learning disabilities and elevated levels of inattention/impulsivity (LD/ADD), (b) students with learning disabilities and average levels of attention/impulsivity (LD/nADD), (c) normally-achieving students with elevated levels of inattention/impulsivity (NA/ADD), and (d) normally-achieving students with average levels of attention/impulsivity (NA/nADD). The Social Skills Rating System--SSRS-T was used to measure teacher-perceptions of Social Skills, Problem Behaviors, and Academic Competence of all students in the sample (N=87). Separate 2 x 2 MANOVAS, with ADD (ADD, nADD) and ED (LD, NA) representing group types were performed for Social Skills and Problem Behaviors. Results of Social Skills showed that students with ADD received significantly lower ratings than the nADD students on cooperation and self-control. Students with LD were rated significantly lower than their NA peers on all three dependent variables: cooperation, assertion, and self-control Results of Problem Behaviors revealed that the ADD groups exhibited more externalizing problem behaviors than the nADD groups; the students with LD exhibited more externalizing and internalizing problem behaviors than their NA peers. On Academic Competence, results of a 2 x 2 ANOVA indicated that students with ADD and students with LD were seen as less academically competent than the N/ADD and NA groups respectively. The Social Skills Rating System--SSRS-S was administered to all students to measure self-perceptions of their social skills. Self-ratings only differentiated students with ADD from those with nADD on one factor: cooperation. Discrepancies in perceptions between members of each group type (ADD, ED) and their teachers were found utilizing two separate 2 x 2 ANOVAS. The largest discrepancy existed between students with LD and their teachers. The finding that students with LD do not match the social skills behaviors that their regular education teachers expect of them is discussed for current mainstreaming practices. Also discussed is the confounding nature of achievement on social skills functioning. Future research utilizing other assessment methods, multiple settings, and different age-levels is suggested. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Fuchs, T., Birbaumer, N., Lutzenberger, W., Gruzelier, J. H., & Kaiser, J. (2003). Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: A comparison with methylphenidate. Applied Psychophysiology and Biofeedback, 28(1), 1-12. Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder (ADHD). We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm (12-15 Hz) and beta1 activity (15-18 Hz) with stimulant medication. Participants were N = 34 children aged 8-12 years, 22 of which were assigned to the neurofeedback group and 12 to the methylphenidate group according to their parents' preference. Both neurofeedback and methylphenidate were associated with improvements on all subscales of the Test of Variables of Attention, and on the speed and accuracy measures of the d2 Attention Endurance Test. Furthermore, behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale. These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment."

Gillen, W. G. (2003). The tova: Discriminant validity for adhd and depression. Dissertation Abstracts International: Section B: The Sciences and Engineering, 64 (3-B), 1491. The purpose of this study was to investigate the differential diagnostic aspects of ADHD, depression, and normality in samples of the adult population using a continuous performance test (CPT). This study examined the Test of Variables of Attention (TOVA) for accuracy of classification among three samples of adults. Participants ranged from 19-59 years of age and were taking no psychotropic medication. Structured interviews classified 30 participants as meeting the criteria for ADHD and 30 as meeting the criteria for depression. The TOVA developers supplied the baseline data for 30 adult participants with no psychiatric diagnosis. The group with ADHD and the group with depression were given TOVAs and the variable scores were compared among the three groups. A discriminate function analysis determined that the TOVA accurately classified both 63% of the participants diagnosed with ADHD and 63% of the participants with no diagnosis. The TOVA correctly classified 33-40% of the participants with depression. The TOVA variables of (a) variability of response and (b) response time were the only predictor variables significantly contributing to the classification. Thus in adults, the TOVA does not totally discriminate between ADHD and no diagnosis. Further, the randomness of classification for depression (33-40%) suggests that the TOVA not only fails to empirically identify this disorder, but fails to significantly mistake depression for ADHD. Adaptive strategies for adults with ADHD are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Goldstein, S. (2005). Review of clinical applications of continuous performance tests: Measuring attention and impulsive responding in children and adults. Archives of Clinical Neuropsychology, 20(4), 559-560. Reviews the book "Clinical Applications of Continuous Performance Tests: Measuring Attention and Impulsive Responding in Children and Adults," (see record 2001-06202-000) by Cynthia A. Riccio, Cecil R. Reynolds and Patricia A. Lowe. The authors review over 300 studies utilizing CPT paradigms. This volume begins with a cogent review of the neurobiology of attention and executive control. Chapter Two offers an overview of the development of CPT paradigms and the theoretical construct that tasks requiring continuous performance over time can be used as sensitive, neuropsychological measures. Chapter Three provides an extensive overview of common CPTs in clinical use, including the Conners, Gordon Diagnostic System, the Integrative Visual and Auditory Continuous Performance Test and the Test of Variables of Attention. Chapter Four begins a series of chapters examining the relationship of CPTs to a variety of phenomena; including cognitive and behavioral measures, brain function, diagnostic efficacy and treatment response. Finally, Chapter Ten concludes with a thoughtful summary of the book and the authors' suggestions for clinicians and future research. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Greenberg, L. M. (1998). Test of variables of attention. Journal of clinical psychology, 54, 461-476.

Greenberg, L. M. (2002). Test of variables of attention. Journal of learning disabilities, 35, 114-120.

Greenberg, L. M., & Dupuy, T. R. Test of variables of attention.

Greenberg, L. M., & Dupuy, T. R. (2000). Test of variables of attention. Journal of paediatrics and child health, 36, 134-138.

Greenberg, L. M., & Dupuy, T. R. (2001). Test of variables of attention. Neuropsychology, 15, 136-144.

Greenberg, L. M., & Waldman, I. D. (1993). Developmental normative data on the test of variables of attention (T.O.V.A.). Journal of Child Psychology and Psychiatry, 34(6), 1019-1030. Presents developmental normative data for 377 boys and 398 girls (aged 6-16 yrs) for the TOVA, a 23-min fixed interval (FI) visual continuous performance test with minimal language demands and no left-right discrimination. The target is presented on 22.5% and 77.5% of the trials during the 1st and 2nd halves, respectively. TOVA indices include omission and commission errors, response time means and standard deviations, and anticipatory responses. Attention and impulse control developed in a nonlinear manner, changing rapidly in early childhood and leveling off during later childhood and adolescence. Males made more omission, commission, and anticipatory errors and had faster mean reaction time (RT) than females. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Grin'Yatsenko, V. A., Kropotov, Y. D., Ponomarev, V. A., Chutko, L. S., & Yakovenko, E. A. (2001). Effect of biofeedback training of sensorimotor and beta -sub-1EEG rhythms on attention parameters. Human physiology, 27(3), 259-266. The effects of the electroencephalogram (EEG)-biofeedback (EEG-BFB) procedure, aimed at increasing the sensorimotor (12-15 Hz) and beta -sub-1(15-18 Hz) rhythms on the psychological and electrophysiological parameters of attention, were studied using the methods of scalp recording of evoked potentials in the bistimulus paradigm Go/No-Go and a psychological attention test (Test of Variables of Attention; TOVA). 25 children (mean age 11.4 yrs) with %ADHD symtoms were included in the study. EEG-BFB sessions significantly improved the attention, behavior, and school study results in 19 (76%) children. In these cases, a significant increase in the amplitude of the inhibitory component in the frontocentral leads and improvement of the TOVA parameters were found. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Grisanzio, W. R. (2001). Evaluation of the effectiveness of an attention enhancement program for children diagnosed with ADHD administered in the school setting. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61 (9-B), 5043. Attention-Deficit Hyperactivity disorder (ADHD), a persistent pattern of inattention and or hyperactivity-impulsivity, is a growing concern in many school districts because it is estimated to affect as much as 3 percent to 5 percent of the school age population (APA, 1994). The problem is that regardless of the currently accepted methods of treatment such as parent training, family therapy, classroom management, social skills training, and medication therapy, the symptoms of ADHD persist into adolescence at an alarming rate. Children with disorders of behavior exhibit excessive theta brainwave activity compared to normal children (Lubar, 1991). The present study administered a changing criterion treatment protocol, which integrated components of neurofeedback, meditation, and control theory, in order to decrease theta brainwave activity. The purpose of the present study was to explore whether a school system could identify specific profiles of attention with a computerized continuous performance test (CPT), administer an attention enhancement program, and remedy those deficits identified by the CPT. The subjects were 5 male children between the ages of 8 and 10 years who were diagnosed ADHD by their family physicians. Subjects were selected according to their performance on the Test of Variables of Attention (T.O.V.A.), a computerized continuous performance test. Subjects received between 18 and 26 attention enhancement sessions over a four month period during their regular school day. Although the T.O.V.A. showed moderate ability to identify specific profiles of attention, as supported by moderate Pearson correlations between T.O.V.A. impulsivity and ADHDT impulsivity (r = -.58, P < .05) and T.O.V.A. inattention and ADHDT inattention (r = -.63, P < .05), T.O.V.A. performance did not consistently improve after attention training. Although the attention enhancement program was completed within the school, there were many unforseen difficulties and impediments to its successful administration. Secondary dependent measures included the Stroop Color and Word Test, Attention-Deficit Hyperactivity Disorder Test (ADHDT), EEG measures, Parenting Stress Index, and Behavior Rating Profile. The results of these measures were equivocal. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Grooms, S. P. (1996). Within test variance for omission and commission scores for the test of variables of attention (TOVA). Dissertation Abstracts International: Section B: The Sciences and Engineering, 56 (9-B), 5194. The problem. The major purpose of this study was to examine the differences between children who had been diagnosed as having Attention-Deficit Hyperactivity Disorder (ADHD), and those who had not been diagnosed, with regard to their level of performance variability on the Test of Variables of Attention (TOVA) relating to scores of omission and commission. The objectives of this study were: (1) to determine whether a difference existed between the two groups, and (2) to determine whether the variability scores implemented for the TOVA were sufficiently sensitive to detect any significant differences between normals and non-normals. Method. The subjects' scores were extracted from the original norming data for the TOVA published by Greenberg and Waldman (1993) in The Journal of Child Psychology and Psychiatry (data were used with permission). The experimental group included 106 subjects with an average age of 9.96 years and a Standard Deviation (SD) of 2.24 (boys and girls who had been diagnosed as having ADHD and UADD). The non-disordered comparison group consisted of 769 children with an average age of 10.3 years and a SD of 2.75, both groups ranging in age from 6 years to 15 years. Results. Significant differences were found to exist between the two groups for commission and omission within test variance scores. The TOVA within test variance for omission and commission supported the test's sensitivity to ADHD children, demonstrating an ability to accurately predict normals from non-normals. In this study there were significant statistical differences obtained for both hypotheses. Significance was found when employing both the MANOVA and the Univariate F-test to the TOVA within test variance scores. This significance indicates that the two groups being studied were different in their TOVA within test variances for omission and commission errors. The results of this study indicate that both groups are heterogeneous with regard to within test variance as a predicto (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Gross-Tsur, V., Goldzweig, G., Landau, Y. E., Berger, I., Shmueli, D., & Shalev, R. S. (2006). The impact of sex and subtypes on cognitive and psychosocial aspects of ADHD. Developmental Medicine & Child Neurology, 48(11), 901-905. We compared the effect of sex and attention-deficit-hyperactivity disorder (ADHD) subtyping in groups of females and males. One hundred and one females with ADHD (mean age 10y 4mo [SD 2y 8mo]; range 5y-18y) were classified according to subtype by Diagnostic and Statistical Manual of Mental Disorders (4th edn) criteria (inattentive [ADHD-I]; combined [ADHD-C]) and balanced by subtype to 101 males (mean age 10y 5mo [SD 2y 9mo]; range 5y 4mo-17y 6mo). All children underwent IQ and reading assessment, and 109 underwent the continuous performance task (Test Of Variables of Attention [TOVA]). Parents completed the Conners' Abbreviated Rating Scale (ABRS), the Child Behavior Checklist (CBCL), learning disability questionnaires, and reported use and efficacy of methylphenidate. Teachers completed the Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) rating scale. Sex differences were found only on the CBCL; females were more impaired on the attention (p<0.001) and somatization (p=0.028) subscales but not for IQ, other questionnaires, TOVA scores, methylphenidate treatment, or demographics. Females with ADHD-C, but not males, had significantly higher T-scores than females with ADHD-I on social, attention, delinquent, and aggressive behaviours. Regardless of sex, children with ADHD-C had higher scores on all CBCL subscales (p=0.047), ABRS (p<0.001), and SKAMP (p=0.03) than children with ADHD-I. The results support the supposition that ADHD in females is the same disorder as in males. ADHD subtyping was the important determinant of ADHD core symptoms; females with ADHD were found to have significant risk of psychopathology.

Hansen, L. M., Trudeau, D. L., & Grace, D. L. (1996). Neurotherapy and drug therapy in combination for adult ADHD, personality disorder, and seizure disorder: A case report. Journal of Neurotherapy, 2(1), 6-14. Presents a case report of a 36-yr-old female patient with attention deficit hyperactivity disorder (ADHD), temporal seizure disorder, and borderline personality disorder treated with 30-weekly sessions of sensorimotor rhythm neurofeedback and carbamazepine. Posttreatment measures showed improvements in Test of Variables of Attention (L. M. Greenberg and I. W. Woldman, 1993), self-reports, and quantitative EEG. Both neurofeedback and carbamazepine showed the most effect in early treatment. Progress continued after discontinuance of the drug. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Hardy, P., Collet, J., Goldberg, J., Ducruet, T., Vanasse, M., Lambert, J., et al. (2002). Neuropsychological effects of hyperbaric oxygen therapy in cerebral palsy. Developmental Medicine & Child Neurology, 44(7), 436-446. We conducted a double-blind placebo study to investigate the claim that hyperbaric oxygen treatment (HBO2) improves the cognitive status of children with cerebral palsy (CP). Of 111 children diagnosed with CP (aged 4 to 12 years), only 75 were suitable for neuropsychological testing, assessing attention, working memory, processing speed, and psychosocial functioning. The children received 40 sessions of HBO2 or sham treatment over a 2-month period. Children in the active treatment group were exposed for 1 hour to 100% oxygen at 1.75 atmospheres absolute (ATA), whereas those in the sham group received only air at 1.3 ATA. Children in both groups showed better self-control and significant improvements in auditory attention and visual working memory compared with the baseline. However, no statistical difference was found between the two treatments. Furthermore, the sham group improved significantly on eight dimensions of the Conners' Parent Rating Scale, whereas the active treatment group improved only on one dimension. Most of these positive changes persisted for 3 months. No improvements were observed in either group for verbal span, visual attention, or processing speed.

Harris, E. L., Schuerholz, L. J., Singer, H. S., & Reader, M. J. (1995). Executive function in children with tourette syndrome and/or attention deficit hyperactivity disorder. Journal of the International Neuropsychological Society, 1(6), 511-516. Examined the extent to which executive function (EF) is impaired in Tourette Syndrome (TS), and whether these deficits can be attributed to comorbid attention deficit hyperactivity disorder (ADHD) in children (aged 6-14 yr olds), 10 with TS-only, 48 with ADHD-only, and 32 with TS and ADHD. Ss completed the Diagnostic Interview for Children and Adolescents, Test of Variables of Attention, Wisconsin Card Sorting Test, and the Complex Figure Test. Ss in all groups could not efficiently produce output on a timed continuous performance task. TS-only Ss appeared to have fewer EF impairments and significantly higher perceptual organization scores than TS and ADHD or ADHD-only Ss. Findings suggest that deficiencies in choice reaction time and consistency of timed responses are common to all 3 groups, but TS-only Ss have relatively less EF impairment than TS and ADHD or ADHD-only Ss. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Hemme, J. M. (2004). Comparison of neuropsychological and behavioral correlates in children with TBI and ADHD. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65 (5-B), 2629. Recent findings suggest that traumatic brain injury (TBI) entails risk for acquired Attention-Deficit/Hyperactivity Disorder (ADHD) symptomatology, yet there are indications that the nature of attentional impairments in children with TBI and ADHD may differ. In addition, previous research has found that inhibitory deficits were related to activity levels in children with TBI and ADHD. Thus, this study compared the attentional profiles and ADHD symptomatology in groups of children with history of TBI or ADHD. It was hypothesized that children with TBI and ADHD would differ in their performances within several domains of attention including: sustained attention, focused/selective attention, working memory, and processing speed. It was also expected that groups would differ in hyperkinesis but not in attention deficit symptoms, with the group of children with ADHD being significantly more hyperactive. Fifty-six participants were identified retrospectively from medical records of a university-affiliated children's hospital. Children who sustained a moderate to severe TBI (n = 24) were compared to children diagnosed with ADHD (n = 32). Both groups of children were evaluated with the following measures: Test of Everyday Attention for Children (TEACh; Manly, Robertson, Anderson, & Nimmo-Smith, 1999), Test of Variables of Attention (TOVA; Greenberg & Dupuy, 1993), Wechsler Intelligence Scale for Children-III (WISC-III; Wechsler, 1994), and the Conners' Parent Rating Scale-Revised (CPRS-R:L; Conners, 1997; completed by caregivers). As expected, children with ADHD were rated as more hyperactive than children with TBI, but contrary to my hypothesis both groups demonstrated elevated levels of inattention. Consistent with previous research, 18% of the TBI sample scored in the range suggestive of ADHD-Predominantly Inattentive Type according to strict cut-off scores from the CPRS-R:L. The hypotheses of this study suggesting that children with TBI would perform more poorly than children with ADHD on focused/selective attention, working memory, and processing speed tasks were not supported. Children with ADHD also did not differ from children with TBI on sustained attention tasks. Finally, the neurobehavioral correlates of attention did not differ between the two groups. Findings from this study underscore the importance of developing specific interventions for children with TBI and ADHD. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Henry, G. K. (2005). Probable malingering and performance on the test of variables of attention. Clinical Neuropsychologist, 19(1), 121-129. Fifty subjects with mild head injury involved in personal injury litigation and 2 subjects referred for evaluation of their disability status underwent comprehensive neuropsychological examination including the Test of Variables of Attention (TOVA). Group status was determined by performance on symptom validity testing. Twenty-six subjects who failed symptom validity testing formed the probable malingering (PM) group, while 26 subjects who passed symptom validity testing comprised the not malingering (NM) group. Subjects in the PM group performed significantly worse on all TOVA variables relative to subjects in the NM group. Discriminant function analyses revealed that TOVA omission errors >/=3 errors was the best predictor of group status. Malingering research employing a group of probable clinical malingerers has direct generalizability to real-world settings.

Herod, L. A. (1999). Auditory and visual continuous performance tests in ADHD: A comparison of sensory modalities, age, and response to methylphenidate. Dissertation Abstracts International: Section B: The Sciences and Engineering, 60 (2-B), 0831. Attention Deficit Hyperactivity Disorder (ADHD) is a behavioral disorder characterized by developmentally inappropriate levels of inattention, impulsivity, and/or hyperactivity. Interviews, behavior rating scales, behavioral observation, and laboratory tasks have been employed to evaluate the presence of ADHD symptoms. The continuous performance test (CPT) is a laboratory test commonly used in clinical and research settings with individuals suspected of having ADHD. The CPT is a type of vigilance task that requires monitoring for a particular stimulus embedded in a series of stimuli. Typically, CPTs are presented visually. Little research exists that compares performance between the auditory and visual modalities. This study was designed to determine if there are differences in CPT performance based on modality of presentation. Fifty-three ADHD subjects between the ages of 6 and 15 participated in the study. Each child completed two standardized and normed CPTs, with an auditory and visual version. Total correct and commission errors were compared across modalities and tests (the Gordon Diagnostic System and the Test of Variables of Attention) using Z-scores which were adjusted for the child's age. ADHD children obtained significantly more correct on the two auditory CPTs, relative to the visual CPTs. Commission errors were significantly lower only on the auditory Test of Variables of Attention, relative to the other measures. The effect of age and medication on performance was also investigated. Normal children display a developmental trend in performance, with older subjects detecting more targets and committing fewer errors. Similar to normal children, performance in this sample of ADHD children improved with age. With the exception of the Test of Variables of Attention commissions, there were significant improvements with age. Results suggest that the CPTs employed in this study may have limited utility when assessing adolescents for ADHD, due to the finding that this group detected a high number of correct targets with few errors. Methylphenidate is a commonly prescribed stimulant used to treat the symptoms of ADHD. Medication has been demonstrated to improve both auditory and visual CPT performance. To determine whether methylphenidate improves performance similarly across modality, thirty-two subjects were recruited to participate twice, once while taking a placebo and once while taking methylphenidate. Methylphenidate was found to enhance performance equally across modality. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Hinds, P. L. (2000). Correlation of continuous performance test variables with teacher ratings of behavior among referred and nonreferred students. Dissertation Abstracts International Section A: Humanities and Social Sciences, 60 (11-A), 3978. The purpose of this study was to explore the nature of the relationship between a continuous performance test (CPT) and teachers' ratings of behavior. Assessment data were archival in nature. one hundred-one children from one rural, middle-class, predominately Caucasian school district in a Midwestern state were selected who had taken the Test of Variables of Attention (TOVA) and whose teachers had completed the Attention Deficit Disorders Evaluation Scale-School Version (ADDES) and the Child Behavior Checklist-Teacher Report Form (TRF). of this group 46 had been referred for Attention-Deficit/Hyperactivity Disorder (ADHD) and/or learning difficulties and 55 had participated in a local norming project for the TOVA. Descriptive statistics were found for CPT variables and teachers' ratings of behavior for all participants, boys and girls separately, and referred and nonreferred separately. The research question was investigated using a matrix of partial correlations controlled for age. TOVA variables included Omissions, Commissions, Response Time, Response Time Variability, Anticipatory Responses, and Multiple Responses. Teacher's rating scale variables included the ADDES Total and subscales Inattention, Impulsive, and Hyperactive as well as the TRF Attention Problems, and Aggressive Behavior. Research provided support that TOVA Omissions and Commissions are valid indicators of ADHD as measured by teachers' ratings of behavior. Response Time Variability and Multiple Responses may be valid indicators of generalized behavior dysfunction as measured by teachers, ratings of behavior. Anticipatory Responses and Response Time may aid in distinguishing ADHD with and without hyperactivity but further research is recommended. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Hong, H. J., Shin, D. W., Lee, E. H., Oh, Y. H., & Noh, K. S. (2003). Hypothalamic-pituitary-adrenal reactivity in boys with attention deficit hyperactivity disorder. Yonsei medical journal, 44(4), 608-614. The hypothesis 'whether subjects with attention-deficit/ hyperactivity disorder (ADHD), who showed under-reactivity of the hypothalamic-pituitary-adrenal (HPA) axis to stress, would make more commission errors in attention tasks', was examined. Forty-three boys, with ADHD, who visited the psychiatric outpatient clinic, at Kangbuk Samsung Hospital, were the subjects of this study. Both pre- and post-test morning saliva samples were collected from the patients at the Korean Educational Development Institute-Wechsler Intelligence Scale for Children (KEDI-WISC), and Tests of Variables of Attention (T.O.V.A.) performed. The Standard scores of the T.O.V.A were compared between the patients with decreases, or increases, in the salivary cortisol levels after the test. Decreases, or increases in the salivary cortisol levels after the test were shown in 28 and 15 patients, respectively. The patients with decreased cortisol levels after the test tended to make more commission errors in compared with those with increased cortisol levels. The patients with the decreased cortisol levels after test had more omission errors in the first quarter of the test, and more commission errors in the second half of the test compared to those with the increased cotisol levels. Subjects who show decreased salivary cortisol levels after stress make more commission errors in attention tests. This suggests that the blunted HPA axis response to stress is related to the impulsivity in patients with ADHD.

Horesh, N. (2001). Self-report vs. computerized measures of impulsivity as a correlate of suicidal behavior. Crisis: Journal of Crisis Intervention & Suicide, 22(1), 27-31. OBJECTIVES: To compare the use of a self-report form of impulsivity versus a computerized test of impulsivity in the assessment of suicidal adolescent psychiatric inpatients. METHODS: Sixty consecutive admissions to an adolescent in patient unit were examined. The severity of suicidal behavior was measured with the Childhood Suicide Potential Scale (CSPS), and impulse control was measured with the self report Plutchik Impulse Control Scale (ICS) and with the Test of Variables of Attention (TOVA), a continuous performance test (CPT). The TOVA is used to diagnose adolescents with attention deficit disorder. RESULTS: There was a significant but low correlation between the two measures of impulsivity. Only the TOVA commission and omission errors differentiated between adolescent suicide attempters and nonattempters. CONCLUSIONS: Computerized measures of impulsivity may be a useful way to measure impulsivity in adolescent suicide attempters. Impulsivity appears to play a small role only in nondepressed suicidal adolescents, especially boys.

Huang, Y. S., Chao, C. C., Wu, Y. Y., Chen, Y. Y., & Chen, C. K. (2007). Acute effects of methylphenidate on performance during the test of variables of attention in children with attention deficit/hyperactivity disorder. Psychiatry & Clinical Neurosciences, 61(3), 219-225. This study attempted to determine the acute effects of methylphenidate (MPH) on cognitive performance using the Test of Variables of Attention (TOVA) in children with attention deficit/hyperactivity disorder (ADHD). The study subjects comprised 57 children diagnosed with ADHD aged 6-13 years. Diagnoses of ADHD and other comorbid psychiatric disorders were based on Diagnostic and Statistical Manual of Mental Disorders-fourth edition criteria following a standard interview with the Schedule for Affective Disorder and Schizophrenia for School-Age Children, epidemiologic version. The subjects' performance on the TOVA was compared before and 1 h after administration of MPH. After administration of MPH, commission scores, response time and ADHD scores improved significantly, however, there were no significant changes in omission scores, response time variability or response sensitivity. The authors concluded that administration of one dose of MPH (0.5-1.0 mg/kg) produced more effects on impulsivity than on attention deficiency in children with ADHD, and that the second half section of the TOVA could be more sensitive than the first half in determining the acute effects of MPH therapy in children with ADHD. However, the effects of different MPH doses on the TOVA results need further investigation.

Huang, Y. S., Chen, N. H., Li, H. Y., Wu, Y. Y., Chao, C. C., & Guilleminault, C. (2004). Sleep disorders in taiwanese children with attention deficit/hyperactivity disorder. Journal of sleep research, 13(3), 269-277. To assess obstructive sleep apnea syndrome (OSAS) and periodic limb movement disorder (PLMD) in children with attention deficit/hyperactivity disorder (ADHD) compared with a control group. The ADHD was diagnosed based on Diagnostic and Statistical Manual, version IV (DSM-IV) criteria on successively seen elementary school children aged 6-12 years referred to a psychiatric clinic for suspected ADHD. A standardized interview (Kiddie-SADS-E), parents and teacher questionnaires, neuropsychological testing, and nocturnal polysomnography were completed for each child. Eighty-eight children (77 boys) with ADHD and 27 controls were involved in the study. Fifty children with ADHD (56.8%) had an apnea-hypopnea index (AHI) >1 event h(-1) and 17 (19.3%) had an AHI >5 event h(-1). Nine children (10.2%) had a periodic limb movement index (PLMI) >5 events h(-1). There is one child with AHI >1 and none with a PLMI > 5 in the control group. In the test of variables of attention (TOVA), the response time was significantly worse in ADHD with sleep disorders than those without them. The child behavior checklist (CBCL) showed a significant difference between groups in the hyperactivity subscale. The diagnostic criteria for ADHD based on DSM-IV do not differentiate between children with or without sleep disorders. Evaluation of sleep disorders should be considered before starting drug treatment for ADHD.

Huang, Y. S., Guilleminault, C., Li, H. Y., Yang, C. M., Wu, Y. Y., & Chen, N. H. (2007). Attention-deficit/hyperactivity disorder with obstructive sleep apnea: A treatment outcome study. Sleep medicine, 8(1), 18-30. BACKGROUND: Children diagnosed with attention-deficit/hyperactivity disorder (ADHD), based on Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) criteria, may also have obstructive sleep apnea (OSA), but it is unclear whether treating OSA has similar results as methylphenidate (MPH), a commonly used treatment for ADHD. METHODS: This study enrolled 66 school-age children, referred for and diagnosed with ADHD, and 20 healthy controls. Polysomnography (PSG) performed after ADHD diagnosis showed the presence of mild OSA. After otolaryngological evaluation, parents and referring physicians of the children could select treatment of ADHD with MPH, treatment of OSA with adenotonsillectomy or no treatment. Systematic follow-up was performed six months after initiation of treatment, or diagnosis if no treatment. All children had pre- and post-clinical interviews; pediatric, neurologic, psychiatric and neurocognitive evaluation; PSG; ADHD rating scale, child behavior checklist (CBCL) filled out by parents and teacher; test of variables of attention (TOVA); and the quality of life in children with obstructive sleep disorder questionnaire (OSA-18). RESULTS: ADHD children had an apnea-hypopnea index (AHI)>11 considered abnormal is detrimental to children with ADHD. Recognition and surgical treatment of underlying mild sleep-disordered breathing (SDB) in children with ADHD may prevent unnecessary long-term MPH usage and the potential side effects associated with drug intake.

HuangStorms, L., BodenhamerDavis, E., Davis, R., & Dunn, J. (2007). QEEG-guided neurofeedback for children with histories of abuse and neglect: Neurodevelopmental rationale and pilot study. Journal of Neurotherapy, 10(4), 3-16. Background: Poor self-regulation of arousal is central to the behavioral difficulties experienced by children with traumatic caretaker attachment histories. EEG biofeedback teaches children to self-regulate brain rhythmicity, which may in turn affect global improvements in the areas of attention, aggression, impulse control, and trust formation. Research literature reports successful use of neurofeedback for children with ADHD, autism, asthma, stroke, and migraine. This study extends current research by investigating the effectiveness of neurofeedback in reducing behavioral problems commonly observed in abused/neglected children. Methods: Treatment records of twenty adopted children with histories of removal from their biological home by Child Protective Services were obtained from a private neurofeedback practice. All of the children were assessed prior to treatment using the Child Behavior Checklist (CBCL) and the Test of Variables of Attention (TOVA) and again after 30 sessions of individualized, qEEG-guided neurofeedback. Results: T-test analysis of pre- and post-scores on the CBCL showed significant changes in the areas of externalizing problems, internalizing problems, social problems, aggressive behavior, thought problems, delinquent behavior, anxiety/depression, and attention problems (p < .05). TOVA omission error, commission error, and variability scores also improved significantly following neurofeedback training (p < .05). Some pre-treatment qEEG patterns common to this group of children were identified. Conclusions: The CBCL and TOVA score improvements observed in this study indicate that neurofeedback is effective in reducing behavioral, emotional, social, and cognitive problems in children with histories of neglect and/or abuse. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)

Hyman, S. L., Shores, A., & North, K. N. (2005). The nature and frequency of cognitive deficits in children with neurofibromatosis type 1. Neurology, 65(7), 1037-1044. OBJECTIVE: To assess the frequency and severity of specific cognitive deficits in children with neurofibromatosis type 1 (NF1) in a large unbiased cohort. METHODS: Extensive cognitive assessments were performed in 81 children with NF1 ages 8 to 16 years and their performance was compared with that of 49 unaffected sibling controls. RESULTS: Eighty-one percent of the children with NF1 had moderate to severe impairment in one or more areas of cognitive functioning. Although 51% of children with NF1 performed poorly on tasks of reading, spelling, and mathematics, specific learning disabilities (as defined by IQ-achievement discrepancies) were present in only 20% of the children. Sustained attention difficulties were present in 63% of children with NF1, with 38% of children with NF1 fulfilling the diagnostic criteria for attention deficit-hyperactivity disorder. The NF1 neuropsychological profile is characterized by deficits in perceptual skills (visuospatial and visuoperceptual), executive functioning (planning and abstract concept formation), and attention (sustained and switching). Interestingly, both verbal and visual memory was unaffected in NF1 children, and their memory skills were in general stronger than their level of general intellectual function. Although both expressive and receptive language skills were significantly impaired in NF1 children, they appeared to be relatively better preserved than visuospatial abilities once IQ is taken into account. CONCLUSION: There is an extremely high frequency of cognitive problems in children with neurofibromatosis type 1, making cognitive dysfunction the most common complication to affect quality of life in these children.

Jensen, P. S., & Kenny, D. T. (2004). The effects of yoga on the attention and behavior of boys with attention-deficit/ hyperactivity disorder (ADHD). Journal of Attention Disorders, 7(4), 205-216. Boys diagnosed with ADHD by specialist pediatricians and stabilized on medication were randomly assigned to a 20-session yoga group (n = 11) or a control group (cooperative activities; n = 8). Boys were assessed pre- and post-intervention on the Conners' Parent and Teacher Rating Scales-Revised: Long (CPRS-R:L & CTRS-R:L; Conners, 1997), the Test of Variables of Attention (TOVA; Greenberg, Cormna, & Kindschi, 1997), and the Motion Logger Actigraph. Data were analyzed using one-way repeated measures analysis of variance (ANOVA). Significant improvements from pre-test to post-test were found for the yoga, but not for the control group on five subscales of the Conners' Parents Rating Scales (CPRS): Oppositional, Global Index Emotional Lability, Global Index Total, Global Index Restless/Impulsive and ADHD Index. Significant improvements from pre-test to post-test were found for the control group, but not the yoga group on three CPRS subscales: Hyperactivity, Anxious/Shy, and Social Problems. Both groups improved significantly on CPRS Perfectionism, DSM-IV Hyperactive/ Impulsive, and DSM-IV Total. For the yoga group, positive change from pre- to post-test on the Conners' Teacher Rating Scales (CTRS) was associated with the number of sessions attended on the DSM-IV Hyperactive-Impulsive subscale and with a trend on DSM-IV Inattentive subscale. Those in the yoga group who engaged in more home practice showed a significant improvement on TOVA Response Time Variability with a trend on the ADHD score, and greater improvements on the CTRS Global Emotional Lability subscale. Results from the Motion Logger Actigraph were inconclusive. Although these data do not provide strong support for the use of yoga for ADHD, partly because the study was under-powered, they do suggest that yoga may have merit as a complementary treatment for boys with ADHD already stabilized on medication, particularly for its evening effect when medication effects are absent. Yoga remains an investigational treatment, but this study supports further research into its possible uses for this population. These findings need to be replicated on larger groups with a more intensive supervised practice program.

Jondeau, G. (2005). [The best of cardiac failure in 2004]. [L'essentiel de 2004 en insuffisance cardiaque.] Archives des Maladies du Coeur et des Vaisseaux, 98 Spec No 1(Spec 1), 23-32. Regarding cardiac failure, the year 2004 was notable for the dissemination of indications for the use of medical devices in heart failure: indications for cardioversion with the long awaited publication of the COMPANION study, advancement of the concept of intra-ventricular asynchronism, and studies of defibrillators in non-ischaemic cardiac failure (COMPANION, DEFINITE, SCD-HeFT, TOVA). Furthermore, pragmatic clinical studies allowed refinement of the uses of BNP (diagnostic and prognostic), underlining the importance of renal function and its progression during hospitalisation, and the risks of using strong, modern therapy in populations without "ad hoc" surveillance which do not correspond with study populations (aldactone in Canada). Just as in coronary patients, it appears to be important to commence full medical treatment prior to hospital discharge, because treatment is rarely changed thereafter. The management of seriously ill patients is evolving with several therapeutic advances: the methods of selecting patients for heart transplants have changed, with the advancement of opportunities for circulatory assistance. Attention has also been turned to the significant group, still poorly understood, of patients with diastolic heart failure, for whom diagnostic methods have been defined, as well as their clinical characteristics. Lastly the medication studies: new drugs in acute cardiac failure (preliminary results for vasopressin antagonists), wider indications for betablockers in elderly subjects (SENIORS), and advances in cellular cardiomyoplasty (using haemopoietic stem cells especially this year). It has been a fruitful year, difficult to summarise in a few lines, or even several pages.... [References: 39]

Joyce, M., & Siever, D. (2000). Audio-visual entrainment program as a treatment for behavior disorders in a school setting. Journal of Neurotherapy, 4(2), 9-25. ADHD children produce higher amounts of theta (5-7 Hz) and less beta (13-21 Hz) brain wave activity than normals. Many researchers are testing the therapeutic effectiveness of Audio-Visual Entrainment (AVE) as a treatment for a variety of low arousal brain disorders. AVE is the repetitive and intermittent presentation of light and sound. AVE affects EEG output in that brain wave output can be suppressed or enhanced at specific frequencies. 34 elementary students from two different schools were given AVE over the course of 7 wks. Ss were given the Test of Variables of Attention (TOVA) before and after participation. A second group of 8 Ss were in a special reading (SPALDING) class. All of the students in this class received the Standardized Test for the Assessment of Reading (STAR) and were compared with a control group. Overall inattention, impulsivity and variability as rated by the TOVA improved significantly. The 8 Ss from the SPALDING reading program who received AVE improved their reading scores more than their control classmates. The results included normalization as recorded on the TOVA, substantial improvements in reading as recorded on the STAR, and improvements in general behavior as noted by teachers and parents. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Kaiser, D. A., & Othmer, S. (2000). Effect of neurofeedback on variables of attention in a large multi-center trial. Journal of Neurotherapy, 4(1), 5-15. Neurofeedback studies have been criticized for including small numbers of subjects. The effect of sensorimotor-beta neurofeedback training on the Test of Variables of Attention was evaluated in 1,089 Ss (aged 5-67 yrs) from 32 clinics. Ss underwent 20 or more sessions of SMR-beta neurofeedback training for attentional and behavioral complaints at thirty-two clinical settings affiliated with EEG Spectrum, Inc. Ss were evaluated prior to training and at training completion. 157 Ss who elected extensive training (40 sessions or more) were tested after both 20 and 40 training sessions. Results indicated that neurofeedback training produced significant improvement in attentiveness, impulse control, and response variability. Significant clinical improvement in one or more measures was seen in 85% of those Ss with moderate pre-training deficits. It is concluded that neurofeedback training is effective in remediating attentional dysfunction. Nevertheless, large-scale studies with greater control (e.g., wait-list designs) are needed. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Kennel, S. E. (2005). The effect of binaural auditory beats on inattention in children and adolescents with attention-deficit hyperactivity disorder. (Ph.D., University of Virginia). , 148. Purpose. The purpose of this investigation was to determine the effectiveness of binaural auditory beat stimulation in reducing the symptom of inattention in children and adolescents with Attention-Deficit Hyperactivity Disorder (ADHD). Methods. This study was a randomized, double-blind, placebo-controlled clinical investigation to determine the effectiveness of binaural auditory beats on the symptom of inattention in children with ADHD. Participants were randomly assigned to listen to a CD that contained binaural auditory beats or a sham CD, three times a week for three weeks while completing homework assignments. Sample. The sample was comprised of 20 children and adolescents, eight to twenty-one years of age. Participants were recruited from Charlottesville, Virginia and the surrounding counties via newspaper advertisements, brochures and flyers that were posted in the Primary Care Clinic at the University of Virginia's Health Center and local pediatrician's offices. Measures. The Children's Color Trails Test, The Color Trails Test and the Test of Variables of Attention (TOVA) were used to measure changes in inattention pre and post intervention. The Homework Problem Checklist was used to measure changes in homework behaviors during the three week study. Results. Repeated measures ANOVA were used to analyze pre and post intervention scores on the Color Trails Tests. Analysis of Covariance (ANCOVA) was used to analyze pre and post intervention scores on the TOVA. The effect of time was significant on the Color Trails Test. However, there were no significant group differences on this measure. In addition, there were no significant group differences on the TOVA when pre and post-intervention scores were compared. Repeated measures ANOVA were used to evaluate changes on the Homework Problem Checklist over three week intervention. Homework problems significantly decreased in both groups; however, group differences were not significant. Conclusion. The results from the present study suggest that BABS did not significantly reduce the symptom of inattention in children and adolescents affected with Attention Deficit Hyperactivity Disorder. This may be attributable to the small sample size. Therefore, this modality should be studied using a sufficient sample to determine its effectiveness to reduce the symptom of inattention in those diagnosed with ADHD.

Kiger, N. C. (1998). An evaluation of parent and teacher rating scales as predictors of the T.O.V.A. measures of inattention, impulsivity, response time and variability. Dissertation Abstracts International Section A: Humanities and Social Sciences, 58 (9-A), 3417. This study evaluated the relationship of six parent and eight teacher rating scales to the T.O.V.A. measures of Inattention, Impulsivity, Response Time and Variability. Subjects consisted of 88 children 6 through 14 years of age, referred by teachers and parents to a school psychologist in a small midwestern community for evaluation of ADHD symptomatology. These students attended school at four public elementary schools and three private religious elementary schools. Sixty-eight subjects were males and twenty subjects were females. Each child was administered the T.O.V.A. by a school psychologist. Parents filled out the BASC:PRS, CPRS-48, and the ADHD Rating Scale. Teachers completed the BASC:TRS, CTRS-28, the ADHD Rating Scale and the APRS. Results from correlational analyses of parent rating scales, teacher rating scales and the four T.O.V.A. variables are presented and discussed. Multiple regression analyses were used to evaluate sets of parent and teacher rating scales as predictors of the four T.O.V.A. variables. On the basis of the study it was concluded that the combination of the sets of parent and teacher rating scales accounted for approximately one-sixth of the variance of the T.O.V.A. Impulsivity measure. The combination of the sets of parent and teacher rating scales did not explain an important part of the variance of the T.O.V.A. Inattention, Response Time or Variability measures. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

King, A., Herron, S., McKinstry, R., Bacak, S., Armstrong, M., White, D., et al. (2006). A multidisciplinary health care team's efforts to improve educational attainment in children with sickle-cell anemia and cerebral infarcts. Journal of School Health, 76(1), 33-37. The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically before and after the intervention. A baseline evaluation was completed assessing the presence of an Individualized Education Plan (IEP), grade retention in school, and days absent from school in the year preceding the intervention. A postintervention assessment occurred 2 years later for these same measurements. At baseline, 74% (17 of 23) of the students were receiving IEPs. Two years later, 87% (20 of 23) students received IEPs (p = .34). Despite the intervention, the rate of children retained in their school grade increased from 0.6 per 100 years in school at baseline to 1.7 per 100 years, 95% CI (-3.86, 1.49). The school absenteeism rate did not significantly change after the intervention; the average days absent per student rose from 15.5 to 22.5, (p = .05). The multidisciplinary team effort alone was insufficient to decrease grade retention and absenteeism rate. Further support, from either the parents or school administration, is needed to increase education attainment of students with cerebral infarcts.

Knoblich, D. L. (2001). A controlled study to test the efficacy of eeg-driven stimulation (eds) on attention and memory of adults with attention deficit disorders. Dissertation Abstracts International: Section B: The Sciences and Engineering, 62 (2-B), 1133. This study was designed to assess the clinical efficacy of EEG-Driven Stimulation (EDS) on attention and memory of adults with Attention Deficit Hyperactivity Disorder. Two groups were used in the study, a photic stimulation EDS group (N = 12; mean age = 37.7) and a stimulant medication (MED) group (N = 13; mean age = 45.8). Both groups were similar with respect to age, IQ, an approximate measure of hypnotic ability, gender, and primary and secondary diagnoses. Participants in the MED group were adults already taking stimulant medication. They were off their medication 24 hours prior to and during pretesting. For the remainder of the study and during posttesting, they remained on their medication. Due to the individualized nature of the EDS training protocol, participants in the EDS group were in treatment from 4 to 5 months with a mean number of treatment sessions being 28. The generalized goal of training was to reduce amplitude in delta and alpha bands from 21 scalp locations down to 2-3 microvolts. It was hypothesized that EDS training would be associated with a significant decrease in theta/high beta power ratios along with significant improvements in attention and memory. It was also hypothesized that the EDS group and MED group would demonstrate comparable improvements in attention and memory. The Test of Variables of Attention (TOVA), the Rey Auditory-Verbal Learning Test (RAVLT), and theta/high beta power ratios from 21 scalp locations were used to assess both groups' pre- to posttreatment changes in attention, memory, and EEG activity. Statistically significant results in attention were observed in both treatment groups. For the memory variables, only the IVIED group yielded statistically significant results. Regarding difference in degree of improvement in attention and memory variables, no statistical significance was found between treatment groups. Though not significant, an overall reduction in theta/high beta power ratios along 21 scalp locations for the EDS group was observed. No difference in power ratios, from nonmediated to medicated conditions was demonstrated in the MED group. Despite the apparent ability of both EEG-driven stimulation and stimulant medication to improve adult attention, the hypothesized mechanism for change, that is, reductions in theta/high beta power ratios, was not found to be a correlate of change, nor was hypnotic ability or suggestibility found to be a factor. These clinical findings suggest that physiological and psychological mechanisms may have had only a limited impact on change. Further research is needed to assess the influence of proposed mechanisms of change as well as nonspecific effects. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Lavi, U., Lahav, E., Genizi, A., Degani, C., Gazit, S.,Hillel, J. (1991). Quantitative genetic analysis of traits in avocado cultivars. Plant Breeding, 106(2), 149-160. Quantitative genetic analysis of several avocado traits was evaluated from progenies of crosses between and within avocado cv. Parenthood was determined by isozymes and the seedling progenies were assessed for 8 traits (tree size, flowering intensity, fruit density, fruit wt., inflorescence length, seed size, fruit softening time and harvest duration). A biometrical genetic approach for analysis of this breeding project is presented. Genetic profiles of the traits and cv. were detailed by several characteristics. 5 avocado cv. Fuerte, Hass, Ettinger, Tova and Rosh-Hanikra were characterized separately for each trait. Practical conclusions for the breeder with respect to economically important quantitative traits are discussed.

Leark, R. A., Wallace, D. R., & Fitzgerald, R. (2004). Test-retest reliability and standard error of measurement for the test of variables of attention (T.O.V.A.) with healthy school-age children. Assessment, 11(4), 285-289. Test-retest reliability of the Test of Variables of Attention (T.O.V.A.) was investigated in two studies using two different time intervals: 90 min and 1 week (2 days). To investigate the 90-min reliability, 31 school-age children (M = 10 years, SD = 2.66) were administered the T.O.V.A. then read ministered the test 90 min afterward. Significant reliability coefficients were obtained across omission (.70), commission (.78), response time (.84), and response time variability (.87). For the second study, a different sample of 33 school-age children (M = 10.01 years, SD = 2.59) were administered the test then read ministered the test 1 week later. Significant reliability coefficients were obtained for omission (.86), commission (.74), response time (.79), and response time variability (.87). Standard error of measurement statistics were calculated using the obtained coefficients. Commission scores were significantly higher on second trials for each retest interval.

Leark, R. A., Dixon, D., Hoffman, T., & Huynh, D. (2002). Fake bad test response bias effects on the test of variables of attention. Archives of Clinical Neuropsychology, 17(4), 335-342. This study investigated the effects of faking bad (FB) on the Test Of Variables of Attention (TOVA) using 36 Ss (mean age 22.38 yrs) randomly placed into 2 groups. Ss in Group 1 took the TOVA under normal conditions (NQ first; they were then requested to subtly fake bad. Group 2 Ss took the TOVA under the same fake bad instructions first, then took the test under normal conditions the second time. An analysis of the effects of test order yielded non-significant differences for basic TOVA variables across all 4 quarters, both halves and the total score. An analysis for group mean differences between the NC and the FB instructions yielded significant differences across the basic TOVA variables across the 4 quarters, 2 halves and total score. The FB group had excessive amounts of omission and commission errors, a greater response time mean (i.e., slower to respond) and had greater variance around their mean response time. The study affirms that the professional using the TOVA needs to carefully eliminate a fake bad test-taking bias when Ss produce excessive test results. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Lee, K. T., Mattson, S. N., & Riley, E. P. (2004). Classifying children with heavy prenatal alcohol exposure using measures of attention. Journal of the International Neuropsychological Society, 10(2), 271-277. Deficits in attention are a hallmark of the effects of heavy prenatal alcohol exposure but although such deficits have been described in the literature, no attempt to use measures of attention to classify children with such exposure has been described. Thus, the current study attempted to classify children with heavy prenatal alcohol exposure (ALC) and non-exposed controls (CON), using four measures of attentional functioning: the Freedom from Distractibility index from the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), the Attention Problems scale from the Child Behavior Checklist (CBCL), and omission and commission error scores from the Test of Variables of Attention (TOVA). Data from two groups of children were analyzed: children with heavy prenatal alcohol exposure and non-exposed controls. Children in the alcohol-exposed group included both children with or without fetal alcohol syndrome. Groups were matched on age, sex, ethnicity, and social class. Data were analyzed using backward logistic regression. The final model included the Freedom from Distractibility index from the WISC-III and the Attention Problems scale from the CBCL. The TOVA variables were not retained in the final model. Classification accuracy was 91.7% overall. Specifically, 93.3% of the alcohol-exposed children and 90% of the control children were accurately classified. These data indicate that children with heavy prenatal alcohol exposure can be distinguished from non-exposed controls with a high degree of accuracy using 2 commonly used measures of attention.

Li, H., Huang, Y., Chen, N., Fang, T., & Lee, L. (2006). Impact of adenotonsillectomy on behavior in children with sleep-disordered breathing. Laryngoscope, 116(7), 1142-1147.

Li, X., & Wang, Y. (2000). A preliminary application of the test of variables of attention (TOVA) in china. [chinese]. Chinese Mental Health Journal, 14(3), 149-152. Studied the application of the TOVA in children with attention deficit hyperactivity disorder (ADHD) in China. 56 children with ADHD (aged 8-13 yrs) (matching the criteria of the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) and Ss' IQ <= 75) and 16 normal children (aged 8-13 yrs) in Beijing were tested with the visual software of the TOVA. Ss' reaction time (RT), mistakes, and missing errors were compared between ADHD Ss and the normals. ADHD Ss received medication and were tested and retested before and after; the test results were compared with the results of the Conner's Parent Rating Scale. It is reported that significant difference in each variable of the TOVA was found between the ADHD Ss and the normals; and that the sensitivity and speciality of diagnosis of the TOVA were 85.7% and 87.5% respectively compared to the clinical standards. The ADHD Ss also improved significantly after medication. The results of the TOVA reflect the pathological characteristics of ADHD and demonstrate sensitivity to treatment efficacy. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Llorente, A. M., Voigt, R. G., Jensen, C. L., Berretta, M. C., Kennard Fraley, J., & Heird, W. C. (2006). Performance on a visual sustained attention and discrimination task is associated with urinary excretion of norepineprhine metabolite in children with attention-deficit/hyperactivity disorder (AD/HD). Clinical Neuropsychologist, 20(1), 133-144. The degree of association between performance on a sustained attention task requiring visual discrimination and urinary excretion of catecholamine metabolites was examined in a cohort of 6- to 12-year-old children (n = 31) strictly selected and diagnosed with attention-deficit/hyperactivity disorder (AD/HD) according to DSM-IV and other strict criteria. Sustained visual attention and discrimination were measured using the Test of Variables of Attention (T.O.V.A.). Urinary excretion of dopamine (DA) and norepinephrine (NE) metabolites was measured by reversed high-pressure liquid chromatography (HPLC). Pearson product-moment correlations were used to investigate the relationship between T.O.V.A. errors of omission (OMM), errors of commission (COM), response time (RT), and response time variability (RTV) and catecholamine metabolites of DA and NE. All T.O.V.A. indexes under investigation were significantly correlated with urinary excretion of NE metabolites, but correlations were low-to-moderate in magnitude (.37-.50). In contrast, there were no statistically significant correlations between T.O.V.A. indices and DA metabolites. These findings and their concordance with past research in human adults and animals, as well as theoretical issues associated with the present results, are discussed.

Llorente, A. M., Amado, A. J., Voigt, R. G., Berretta, M. C., Fraley, J. K., Jensen, C. L., et al. (2001). Internal consistency, temporal stability, and reproducibility of individual index scores of the test of variables of attention in children with attention-deficit/hyperactivity disorder. Archives of Clinical Neuropsychology, 16(6), 535-546. Psychometric properties of the Test of Variables of Attention (TOVA) were examined in a cohort of 63 children strictly diagnosed with attention deficit hyperactivity disorder (ADHD). Internal consistency was assessed via correlational analyses to determine the degree of agreement among various test portions. The temporal stability of errors of omission, errors of commission, response time, and response time variability was evaluated using test-retest reliability. Reproducibility of individual scores for the same indices was assessed using the Bland-Altman procedure. Select TOVA index scores exhibited high internal consistency in this cohort. Although the temporal stability of group scores (test-retest reliability) was satisfactory, individual test scores were less reproducible. Temporal stability and individual test-retest score agreement were greater for response time and spouse time variability than for errors of omission and errors of commission. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Lou, H. C., Rosa, P., Pryds, O., Karrebaek, H., Lunding, J., Cumming, P., et al. (2004). ADHD: Increased dopamine receptor availability linked to attention deficit and low neonatal cerebral blood flow. Developmental Medicine & Child Neurology, 46(3), 179-18