Here are answers to some of our researchers' most common questions:
I want to use the T.O.V.A. in my research. Is there a special rate?
The T.O.V.A. Company makes the T.O.V.A. available for use in approved research studies. You can download a research grant application from the T.O.V.A. Company website at http://www.tovatest.com/research-and-education/.
If you are affiliated with a university or clinical training program, you can use the T.O.V.A. for student research projects as part of a clinical training program site license. Please write or call for details.
Do I need IRB approval?
Institutional Review Board approval is a requirement for all research that takes place in the context of a university, hospital or large practice group. In short, if the institution with which you are affiliated has an IRB, then yes, you will almost certainly need to get their approval. We also ask for evidence of IRB approval as part of the application. Note that failure to obtain IRB approval may also make it harder to get your work published.
Since I already have the T.O.V.A. hardware, do I need another T.O.V.A. kit for my research project?
You may install the T.O.V.A. software on as many computers as you wish. Your T.O.V.A. test credits are stored on your T.O.V.A. hardware, so you can simply take the hardware with you when you go to your research site, and simply plug it in to the computer when you are ready to collect data.
If you are using the T.O.V.A. 8's External Audio/Video testing setup, then it will be more difficult and time consuming to move your T.O.V.A. hardware between computers. In this case, we recommend purchasing another T.O.V.A. 8 kit.
If you have multiple sites at which you are collecting data, please do take pains to keep your data files well backed-up and organized!
Should I update my T.O.V.A. to the latest version midway through my study?
Although we make frequent updates and improvements to the T.O.V.A. (and software updates are always free for both clinical and research users), we recommend that you maintain the same version across the duration of your study, and across multiple computers used to collect your data.
Our updates can, occasionally, subtly affect how the T.O.V.A. tests are analyzed. So in order to avoid confounding your results, it’s probably safer to use the same version throughout data collection. If you think you might want or need to upgrade your software mid-study, please contact us to discuss what effects any upgrade may have on your results, and how you would re-score existing data files with a new version.
Changes between version 7.0 and 7.3 that might affect your results are:
We made a small change to the post-stimulus window during which an early response is characterized as an anticipatory error, changing this window from 200 ms to 150 ms. This change may affect how some other scores are calculated. This change was made in response to the suggestion that some individuals with extensive video-game experience may, at times, be able to produce accurate response times that are less than 200 ms. We made this change to avoid flagging quarters as "invalid" in cases where the respondent is simply unusually fast.
Because omission errors are uncommon in late adolescence and adulthood, the occurrence of a single omission error resulted in a dramatic impact in the omission standard score. We felt that this ceiling effect created an undue impact based on a single event, so beginning with version 7.3, the effect of a single omission error was reduced to a maximum of one standard deviation (15 standard score points) reduction.
Changes between version 7.3 and 8.0 that might affect your results are:
Display calibration, new to the 8.0, removes any latency introduced by LCD panels. This may decrease your measured response times depending on the delay in your LCD monitor.
Multimedia test instructions, introduced in order to standard test instructions, may be different than what was used in your study.
There are just too many changes to the T.O.V.A. analysis and report to list here. If you're forced to upgrade to the T.O.V.A. 8 during your research study, we strongly recommend you import your T.O.V.A. 7 data and score all of your data on the T.O.V.A. 8.0.
We think you'll agree that it is prudent to avoid introducing any additional source of possible variance into your data. Note that you are able to import existing data files generated with earlier versions of the T.O.V.A. into the current version (to be re-scored), but is probably easier for you to avoid any change in your configuration midway through data collection. To further discuss this, please feel free to contact our Research and Education staff at 800-729-2886, or firstname.lastname@example.org.
Can my clinical T.O.V.A. protocols be used for research?
In a word: Yes!
One of our goals during 2008 and 2009 is to analyze archival data that can provide supplemental norms for specific clinical populations. Note that, in general, quality trumps quantity in data of this nature. For example, hundreds of raw T.O.V.A. data files without much contextual information are much less useful than fewer data files with well-documented clinical notes and results of other assessment tools. However, don’t hesitate to call us to discuss any archival research that you might have in mind. If your caseload includes patients with any of the following conditions, we’d love to talk to you:
- Traumatic Brain Injury (post-acute and follow-up data)
- Post Traumatic Stress Disorder
- Autism and Aspergers disorder
- Conduct disorders
- Neurological Illnesses (e.g., seizure disorders, Parkinsons, dementia, MS, etc.)
- Cancer survivors
- Affective disorders (especially anxiety disorders in children)
- Genetic disorders
- Substance abuse
Again, our goal in the immediate future is to compile clinical norms that will help other professionals better understand their patients, and to add special normative groups that reflect performance in third-world countries.
Articles of this nature are easy to write, and frequently cited. Your data is particularly useful it you still have the original T.O.V.A. raw data files. Please don’t delete them!
What kinds of research projects are available?
The T.O.V.A. Company has helped numerous graduate students complete their degrees, and has had a supportive role in the research of many established researchers and clinicians. We have projects that we’d like to see done, but we’d be happy to help you or your students with your ideas, too.
At present, we are most interested in supporting research that addresses the following:
- T.O.V.A. performance in blast trauma survivors
- T.O.V.A. performance in patients with anxiety disorders
- T.O.V.A. performance in patients with depression
- Use of the T.O.V.A. for ADHD medication management
- Treatment (other than pharmacotherapy) outcomes
- Diurnal effects on T.O.V.A. performance
- T.O.V.A. performance in specific diseases
- Test-retest of the auditory T.O.V.A.
- Auditory T.O.V.A. performance in known language-based LD cases
- Correlation of visual and auditory T.O.V.A. in normals and general clinical cases
- Effects of instruction to “fake bad” in adolescents and children on the T.O.V.A. visual and auditory tests
- Performance in groups that may be malingering
- Personality research and T.O.V.A. profiles (e.g., Conscientiousness, executive functioning, and T.O.V.A. performance)
- T.O.V.A. performance in unaffected persons (e.g. normal controls in your research)
- T.O.V.A. performance in third-world populations
- T.O.V.A. performance in low income or ethnically diverse samples
- Screening for attention disorders in school children and other samples
Again, feel free to contact us with your ideas. We are interested in hearing about the things that you want to investigate.
Are there any special services offered to researchers?
One of the most useful services we provide is conversion of T.O.V.A. 7 data files to spreadsheet so that you don’t have to manually enter any your data. This is a free service. Data scored in this manner also gives you access to some variables that don’t appear in the T.O.V.A. printed reports. Just call us, and we’ll help walk you through the necessary steps. Note that this service is now easier than ever: it is a feature built into the T.O.V.A. 8.0 called "Export to spreadsheet".
In addition, our research support staff is always available to answer research design, or data analysis questions. Give us a call or write to email@example.com.
What is the recommended way to use T.O.V.A.?
Administration instructions are provided in the T.O.V.A. Clinical Manual, available on our. We’ve also prepared a short document called A Guide to Using the T.O.V.A. in Research that you should review before undertaking the design or implementation of your study. (Contact us for a copy.) In general, you should be sure to administer the T.O.V.A. at a consistent time in the morning, with the same directions (see the guide or clinical manual), and with an examiner present in the room at all times during the administration of the T.O.V.A. The T.O.V.A. was normed as the first test given. Significant deviation from this procedure may impact your findings if you are comparing your results to the T.O.V.A. normative sample.
Since I am planning on using other assessment tools, does order matter with T.O.V.A.?
The T.O.V.A. is one of the most sensitive psychophysiological tests that you can use for clinical work or research. Over one hundred fifty published studies (and thousands of clinical and research users) attest to the utility of this measure.
Because of its sensitivity to nearly any factor that impacts alertness or attention, the T.O.V.A. must be used carefully. Sequence effects, diurnal effects, different instructions, and examiner presence/absence all have the potential to affect the results. Ideally, you would administer the T.O.V.A. as the first task of your battery, at the start of the session (and in the morning). We recognize that you may not be able to meet all of these requirements, so you should strive for consistency in the manner in which the task is administered. If not the first task in a battery, take pains to ensure that it is administered at the same point in the battery across subjects. Please review the Guide to Using the Test of Variables in Research, available at http://www.tovatest.com for more information.
As you plan your research battery, keep in mind that each administration of the T.O.V.A. takes about 25-30 minutes (a three minute practice test before the first full test plus 21.6 minutes or 11 minutes for 2.5 to 5 year olds). You should not administer the visual and auditory T.O.V.A. “back to back” - we recommend administering them about 90 minutes apart or on different days).
How do I cite the T.O.V.A. in my reference section?
When referring to the T.O.V.A. computer software, the following citation should be used:
Greenberg, L. M. (2007). The Test of Variables of Attention (Version 7.3) [Computer software]. Los Alamitos: The TOVA Company.
Greenberg, L. M. (2011). The Test of Variables of Attention (Version 8.0) [Computer software]. Los Alamitos: The TOVA Company.
When referring to content in the T.O.V.A. Clinical or Professional manuals, the works should be cited in this manner:
Leark, R. A., Greenberg, L. K., Kindschi, C. L., Dupuy, T. R., & Hughes, S. J. (2007). Test of Variables of Attention: Professional Manual. Los Alamitos: The TOVA Company.
Leark, R. A., Greenberg, L. K., Kindschi, C. L., Dupuy, T. R., & Hughes, S. J. (2007). Test of Variables of Attention: Clinical Manual. Los Alamitos: The TOVA Company.
Why do you recommend using other tools as well as T.O.V.A.?
The T.O.V.A. is widely recognized as one of the most useful measures of attention available. However, as with physiological measurements (e.g., assay of catecholamine metabolites, genetic testing, functional imaging), and other attention-sensitive tasks (P-300 tasks, n-back tasks, stop-signal tasks, gambling tasks, Posner’s Attention Network Test, the Test of Everyday Attention, and many measures of executive functioning), the behaviorally-defined DSM-IV criteria for ADHD are better predicted with the use of behavioral checklists that embed the DSM-IV diagnostic criteria themselves. This is a simple artifact of method variance, as the DSM criteria were themselves derived with the use of such instruments.
Objective measures play an increasingly important role in characterizing a patient’s unique expression of attention and behavior, eliminate rater bias, and are much more sensitivity to subtle treatment effects than questionnaires or diagnostic checklists. Tasks such as the T.O.V.A. are understood to more closely reflect underlying neurological processes that control attention, help to distinguish between potential subtypes, and play a critical role in differential diagnosis of attention problems and other phenotypically similar diagnoses.
Ultimately, your choice of additional measures for a study depends upon your research question. We find that a wide-scope clinical measure such as the Behavior Assessment System for Children-Second Edition is a useful addition because it is helpful in considering the presence of co-morbid or “masking” disorders. You may also consider using the Vanderbilt Rating Scales, or other commonly used behavior rating scales as an adjunct to the T.O.V.A. Use of a DSM-IV symptom checklist is a simple, quick way help you better understand the diagnostic status of your sample. We also recommend the Behavioral Rating Scale of Executive Functioning (BRIEF) as a tool to obtain additional information about the real-world functioning of subjects. There are also other instruments to consider. Please feel free to contact the T.O.V.A. research team at firstname.lastname@example.org with questions.
We hope this information is useful in planning and implementing your study. Feel free to call or write any time if we can assist you in your work.
And thanks for being a T.O.V.A. research user!
The T.O.V.A. Team