Understanding How ADHD and Attention Disorders Are Diagnosed: Continuous Performance Tests

What is a Continuous Performance Test?
One way ADHD professionals can test for ADHD in any number of individuals is by utilizing a continuous performance test (sometimes shortened to “CPT”). A neuropsychological measurement of sustained and selective attention, a continuous performance test is a highly useful tool to compare normal processing against individuals suspected to have ADHD, or other characteristics which may make tasks necessitating attention an issue. Though an understanding of an individual’s history is always also considered, a continuous performance test is a highly respected indicator of attention issues, especially in younger children who may not have a long enough history of attention issues or issues indicating ADHD, merely because they are too young.

A Continuous Performance Test Measuring Sustained and Selective Attention
The two types of attention a continuous performance test focuses upon as sustained and selective attention. Sustained attention merely measured how long an individual can stay focused on a task and is important to measure because a key indicator of ADHD or other attention issues is an inability to remain focused for extended periods of time. Therefore, sustained attention can be measured by making a continuous performance test purposefully repetitive or tedious. Instructed to concentrate as well as they possibly can, an inability to perform well on sustained attention tests may indicate impulsiveness, a tell-tale sign of ADHD and related issues. A continuous performance test also measures selective attention, or how well an individual focuses on one stimuli or task and ignoring unrelated stimuli or tasks. Therefore, portions of a continuous performance test focusing on measuring sustained attention may purposefully include superfluous stimuli the individual suspected of ADHD or attention issues is instructed to ignore. Poor performance on the selective attention portions of a continuous performance test will indicate high levels of distractability, another tell-tale sign of ADHD and other attention issues.

What is an Example of a Continuous Performance Test Measuring ADHD and Attention Issues?
A continuous performance test may be given in a number of ways, though all are purposefully designed to be rather boring. One kind of continuous performance test is known as the IVA+Plus Continuous Performance Test (the “plus” part of the titles comes from the fact that it is an amended continuous performance test redesigned to be given on a computer). This type of continuous performance test is straightforward and perhaps the greatest indicator and most widely respected measurement for ADHD and attention issues.

The client suspected of ADHD or similar issues merely sits before a computer screen and either sees the numbers one or two flashed upon the screen, or hears the numbers one or two on a pair of headphones. The client must merely click the mouse when seeing or hearing “one” and inhibit a response (not do anything) when they see or hear number “two”. While this may seem extremely simple, someone suffering from ADHD does not have the attention span to perform as well on this task as others who do not experience attention issues. Such an individual will perform poorly on this continuous performance test because they will either be inattentive due to boredom or accidentally click when seeing or hearing number two as well as one because the stimuli is presented rather quickly.

Furthermore, this continuous performance test includes about five-hundred trials, or instances of the numbers one or two being presented, thus someone with attention issues or ADHD will not be able to endure such longevity. Conversely, someone completing this continuous performance test may not perform perfectly, but their instances of error will be lesser than someone with ADHD. Therefore, you can see another reason for consulting personal history rather than merely using a continuous performance test to measure signs of ADHD and attention disorders, for if someone were to completed a continuous performance test but was not diagnosed at the end, that would be a rather fruitless and long interval of time during which they were subjected to such a repetitious task!

Conners, C.K. & MHS Staff. (Eds.) (2000) Conners’ Continuous Performance Test II: Computer Program for Windows Technical Guide and Software Manual. North Tonawanda, NY: Multi-Health Systems

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