Individual and Combined Effects of Attention Deficits and Learning Disabilities on Computerized ADHD Assessment

Abstract

The widespread use of computerized assessments in the diagnosis of attention deficit disorders (ADD/ADD-H) necessitates identification of factors that influence performance on these instruments. The individual and combined influence of two factors, attention deficits (determined by DSM-III) and learning disabilities (LD), on computerized ADHD assessment was evaluated in a clinic population of 253 children referred because of problems with attention or concentration, high activity levels, or poor academic achievement. Intelligence scores, levels of academic achievement, DSM-III diagnoses, parent and teacher rating scale data, and the presence of LDs were recorded. In ADD subjects, 66% also had one or more identified LD. In children without ADD, 64% were diagnosed as LD. Analyses of both summary scores (age-adjusted percentiles) and separate trial (raw) scores of a computerized assessment device indicated main effects for ADD/ADD-H on the continuous performance task (CPT) number correct and number of commissions. No main effect for LD was found. Delay task (DRL) results were not as clear; ADD effects were significant when raw scores, but not percentile scores, were used. It appears the computerized CPT task is influenced by ADD/ADD-H and is not affected independently by LD; however, age and IQmust be considered in such assessment. The delay task might not be as clinically useful.