A follow-up pilot study of objective measures in children with attention deficit hyperactivity disorder

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.

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.

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).

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.