Clinical applicability of the computerized visual attention test in children and adolescents with attention-deficit and hyperactivity disorder

Abstract

Background: Previous studies have demonstrated associations between specific attentional deficits and the Computerized Visual Attention Test (CVAT) parameters in its 15-minute version, including also its contribution to the diagnosis of Attention-Deficit and Hyperactivity Disorder (ADHD). Given the high prevalence of ADHD in the general population and the inherent challenges of its clinical diagnosis, investigating novel tools capable of assisting clinicians in its identification is necessary. Here we bring a data analysis of an on going larger study already submitted to the Brazilian Reserch Ethics Review System (Plataforma Brasil) and approved by the Research Ethics Committee. Objective: This present study aims to verify whether the 90-second version of CVAT can serve as an auxiliary tool for the diagnosis of ADHD. Methods: The CVAT evaluates four main parameters: omission errors (OE), commission errors (CE), reaction time of correct responses (RT), and reaction time variability of correct responses (RTV). As established in other papers, CVAT 15-minute long version is a validated instrument for supporting ADHD diagnosis, specially based on the RTV parameter. We used a normative sample consisting of 2,104 participants aged 5–17 years. This sample was stratified by sex (male and female) and age groups (5–7, 8–10, 11–13 and 14–17 years). Performance was analyzed according to percentile ranks derived from this normative dataset. Scores at or below the 25th percentile were considered below the expected range, whereas scores above the 50th percentile were considered above the normative mean. We compared this database to participants with clinical ADHD diagnosis that receive care at a public healthcare establishment. Results: Among 22 evaluated participants aged 8 to 13 years and with clinical ADHD diagnosis, 10 scored at or below the 25th percentile at the RTV parameter. This value is substantially higher than the expected frequency of approximately 5 cases. Conversely, only 4 participants scored above the 50th percentile, which is markedly lower than the expected value of approximately 11 cases. The distribution of results was therefore significantly different from chance expectations. Conclusion: The findings suggest that the 90-second version of the CVAT shows potential clinical utility as an auxiliary tool in the diagnostic assessment of Attention-Deficit/Hyperactivity Disorder.