Test of Variables of Attention (TOVA)
The Tests of Variables of Attention (TOVA) are individually administered computerized tests of attention and impulse control that are used with both normal and clinical populations. The TOVA assists in the screening, diagnosis, and treatment monitoring of attention disorders like ADHD and is an objective, neurophysiological measure of attention as opposed to other measures of attention and behavior such as the Conners’ 3 rating scales. There are two versions of the TOVA for administration; a visual and an auditory format. Both versions involve sustaining attention in the absence of immediate reinforcement and utilizing a clicker to press a button when a target stimulus is either seen on screen or heard through speakers, and conversely, not pressing the button when presented with a non-target stimulus. For both versions the stimulus is present for 100ms at 2000ms intervals. On the visual format two geometric figures are centered on the computer screen. The TOVA tests have been normed for administration with individuals ages 4 to 80+ years. The tasks measure four distinct attention variables: response time variability, response time, impulsivity (commission errors), and inattention (omission errors). Each area is assessed across four quarters or two halves with each quarter taking 5.4 minutes for a total test time of 21.6 minutes. The actual test is administered following a three minute practice test and in younger children ages 4 to 5 test time is shortened to only half of the full 21.6 minutes. The first half contains less target responses than non-target responses with a ratio of 36 to 126 for each quarter. In the second half the opposite is the case with more target responses than non-target responses with a ratio of 126 to 36 for each quarter. Raw scores, standard scores, and percentiles are calculated based on the responses, non-responses, and reaction times of the examinee. The standard scores have a mean of 100 and standard deviation of 15 and are provided for each variable by quarters, halves, as well as totals. Additional indices include anticipatory responses (guessing), multiple responses, post-commission response time (response time variability), d-prime (discriminability), and beta (response style) domains. An ADHD score is also provided which compares the performance of the examinee to an ADHD group to analyze how similar their performance is to a known ADHD profile.
-Lawrence M. Greenberg, MD
In addition to the TOVA, which is a direct measure of attention, there are many rating scales used to assess attention skills. For example:
Behavior Assessment System for Children, Third Edition (BASC-III): Inattention and Inattention/Hyperactivity scale
Conners-3: Rating scale of attention problems associated with ADHD
Vanderbilt: Rating scale used by doctors to obtain various rater’s opinion of a child’s attention (teachers, family members)