Tova
Encyclopedia
Test of Variables of Attention, or T.O.V.A., is an objective
, neuropsychological test
that measures a persons sustained and selective attention
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
. The test is a tool that the clinician can use along with history
, interview
s, behavior
ratings and symptom checklists to accurate
ly diagnose
and treat attention disorders.
Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
(typical antipsychotic), Dextroamphetamine
(psychostimulant), Hydroxyzine
(minor tranquilizer), and Placebo
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
and that the ratings themselves would be influenced by the testing environment and the raters bias
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
available in 1991.
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
people without attention problems, were measured to determine what is normal response times for the sex
and age
of the test taker as a basis for the interpretation provided.
Unlike any other CPT's
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
, neuropsychological test
that measures a persons sustained and selective attention
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
. The test is a tool that the clinician can use along with history
, interview
s, behavior
ratings and symptom checklists to accurate
ly diagnose
and treat attention disorders.
Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
(typical antipsychotic), Dextroamphetamine
(psychostimulant), Hydroxyzine
(minor tranquilizer), and Placebo
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
and that the ratings themselves would be influenced by the testing environment and the raters bias
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
available in 1991.
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
people without attention problems, were measured to determine what is normal response times for the sex
and age
of the test taker as a basis for the interpretation provided.
Unlike any other CPT's
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
, neuropsychological test
that measures a persons sustained and selective attention
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
. The test is a tool that the clinician can use along with history
, interview
s, behavior
ratings and symptom checklists to accurate
ly diagnose
and treat attention disorders.
Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
(typical antipsychotic), Dextroamphetamine
(psychostimulant), Hydroxyzine
(minor tranquilizer), and Placebo
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
and that the ratings themselves would be influenced by the testing environment and the raters bias
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
available in 1991.
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
people without attention problems, were measured to determine what is normal response times for the sex
and age
of the test taker as a basis for the interpretation provided.
Unlike any other CPT's
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
Objective test
An objective test is a psychological test that measures an individual's characteristics in a way that is independent of rater bias or the examiner's own beliefs, usually by the administration of a bank of questions that are marked and compared against exacting scoring mechanisms that are completely...
, neuropsychological test
Neuropsychological test
Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the...
that measures a persons sustained and selective attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
. The test is a tool that the clinician can use along with history
History
History is the discovery, collection, organization, and presentation of information about past events. History can also mean the period of time after writing was invented. Scholars who write about history are called historians...
, interview
Interview
An interview is a conversation between two people where questions are asked by the interviewer to obtain information from the interviewee.- Interview as a Method for Qualitative Research:"Definition" -...
s, behavior
Human behavior
Human behavior refers to the range of behaviors exhibited by humans and which are influenced by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion and/or genetics....
ratings and symptom checklists to accurate
ACCURATE
ACCURATE was established in 2005 by a group of computer scientists, psychologists and policy experts to address problems with electronic voting...
ly diagnose
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and treat attention disorders.
Origins
The T.O.V.A. was developed by Dr. Lawrence Greenberg, Professor Emeritus and former Head of Child and Adolescent Psychiatry at the University of Minnesota, a clinician and a leader in research in Attention Deficit Disorders for over 25 years. .Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
Chlorpromazine
Chlorpromazine is a typical antipsychotic...
(typical antipsychotic), Dextroamphetamine
Dextroamphetamine
Dextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
(psychostimulant), Hydroxyzine
Hydroxyzine
Hydroxyzine is a first-generation antihistamine of the diphenylmethane and piperazine classes. It was first synthesized by Union Chimique Belge in 1956 and was marketed by Pfizer in the United States later the same year, and is still in widespread use today....
(minor tranquilizer), and Placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
Subjectivity
Subjectivity refers to the subject and his or her perspective, feelings, beliefs, and desires. In philosophy, the term is usually contrasted with objectivity.-Qualia:...
and that the ratings themselves would be influenced by the testing environment and the raters bias
Bias
Bias is an inclination to present or hold a partial perspective at the expense of alternatives. Bias can come in many forms.-In judgement and decision making:...
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
Commerce
While business refers to the value-creating activities of an organization for profit, commerce means the whole system of an economy that constitutes an environment for business. The system includes legal, economic, political, social, cultural, and technological systems that are in operation in any...
available in 1991.
Testing
It’s a 21.6 minute test with two types: Visual and AuditoryAuditory system
The auditory system is the sensory system for the sense of hearing.- Outer ear :The folds of cartilage surrounding the ear canal are called the pinna...
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
Scoring & Variables
The T.O.V.A. measures 8 different variablesVariable (mathematics)
In mathematics, a variable is a value that may change within the scope of a given problem or set of operations. In contrast, a constant is a value that remains unchanged, though often unknown or undetermined. The concepts of constants and variables are fundamental to many areas of mathematics and...
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
Normality (behavior)
In behavior, normal refers to a lack of significant deviation from the average. The phrase "not normal" is often applied in a negative sense Abnormality varies greatly in how pleasant or unpleasant this is for other people.The Oxford English Dictionary defines "normal" as "conforming to a standard"...
people without attention problems, were measured to determine what is normal response times for the sex
Gender
Gender is a range of characteristics used to distinguish between males and females, particularly in the cases of men and women and the masculine and feminine attributes assigned to them. Depending on the context, the discriminating characteristics vary from sex to social role to gender identity...
and age
Ageing
Ageing or aging is the accumulation of changes in a person over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline...
of the test taker as a basis for the interpretation provided.
- Response Time Variability: A time measurement of how consistently the microswitch is pressed.
- Response Time: A time measurement of how fast or slow information is processed and responded to.
- d’ Signal Detection: A time measurement of how fast performance drops.
- Commission Errors: A measure of impulsivity: how many times the non-target is pressed.
- Omission Errors: A measure of inattention: how many times is the target not pressed.
- Post-Commission Response Time: A time measurement of how fast or slow a response is after a commission Error.
- Multiple Responses: A measure of how many times the button is pressed repeatedly. (Indicator of other problems)
- Anticipatory Responses: A time measurement how often a person is guessing rather than responding.
Unlike any other CPT's
Continuous Performance Task
A Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
See also
- Continuous Performance TaskContinuous Performance TaskA Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
- Attention-deficit hyperactivity disorderAttention-deficit hyperactivity disorderAttention deficit hyperactivity disorder is a developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.ADHD is the most commonly studied and...
- Adult attention-deficit disorder
Further reading
Test of Variables of Attention, or T.O.V.A., is an objectiveObjective test
An objective test is a psychological test that measures an individual's characteristics in a way that is independent of rater bias or the examiner's own beliefs, usually by the administration of a bank of questions that are marked and compared against exacting scoring mechanisms that are completely...
, neuropsychological test
Neuropsychological test
Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the...
that measures a persons sustained and selective attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
. The test is a tool that the clinician can use along with history
History
History is the discovery, collection, organization, and presentation of information about past events. History can also mean the period of time after writing was invented. Scholars who write about history are called historians...
, interview
Interview
An interview is a conversation between two people where questions are asked by the interviewer to obtain information from the interviewee.- Interview as a Method for Qualitative Research:"Definition" -...
s, behavior
Human behavior
Human behavior refers to the range of behaviors exhibited by humans and which are influenced by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion and/or genetics....
ratings and symptom checklists to accurate
ACCURATE
ACCURATE was established in 2005 by a group of computer scientists, psychologists and policy experts to address problems with electronic voting...
ly diagnose
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and treat attention disorders.
Origins
The T.O.V.A. was developed by Dr. Lawrence Greenberg, Professor Emeritus and former Head of Child and Adolescent Psychiatry at the University of Minnesota, a clinician and a leader in research in Attention Deficit Disorders for over 25 years. .Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
Chlorpromazine
Chlorpromazine is a typical antipsychotic...
(typical antipsychotic), Dextroamphetamine
Dextroamphetamine
Dextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
(psychostimulant), Hydroxyzine
Hydroxyzine
Hydroxyzine is a first-generation antihistamine of the diphenylmethane and piperazine classes. It was first synthesized by Union Chimique Belge in 1956 and was marketed by Pfizer in the United States later the same year, and is still in widespread use today....
(minor tranquilizer), and Placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
Subjectivity
Subjectivity refers to the subject and his or her perspective, feelings, beliefs, and desires. In philosophy, the term is usually contrasted with objectivity.-Qualia:...
and that the ratings themselves would be influenced by the testing environment and the raters bias
Bias
Bias is an inclination to present or hold a partial perspective at the expense of alternatives. Bias can come in many forms.-In judgement and decision making:...
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
Commerce
While business refers to the value-creating activities of an organization for profit, commerce means the whole system of an economy that constitutes an environment for business. The system includes legal, economic, political, social, cultural, and technological systems that are in operation in any...
available in 1991.
Testing
It’s a 21.6 minute test with two types: Visual and AuditoryAuditory system
The auditory system is the sensory system for the sense of hearing.- Outer ear :The folds of cartilage surrounding the ear canal are called the pinna...
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
Scoring & Variables
The T.O.V.A. measures 8 different variablesVariable (mathematics)
In mathematics, a variable is a value that may change within the scope of a given problem or set of operations. In contrast, a constant is a value that remains unchanged, though often unknown or undetermined. The concepts of constants and variables are fundamental to many areas of mathematics and...
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
Normality (behavior)
In behavior, normal refers to a lack of significant deviation from the average. The phrase "not normal" is often applied in a negative sense Abnormality varies greatly in how pleasant or unpleasant this is for other people.The Oxford English Dictionary defines "normal" as "conforming to a standard"...
people without attention problems, were measured to determine what is normal response times for the sex
Gender
Gender is a range of characteristics used to distinguish between males and females, particularly in the cases of men and women and the masculine and feminine attributes assigned to them. Depending on the context, the discriminating characteristics vary from sex to social role to gender identity...
and age
Ageing
Ageing or aging is the accumulation of changes in a person over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline...
of the test taker as a basis for the interpretation provided.
- Response Time Variability: A time measurement of how consistently the microswitch is pressed.
- Response Time: A time measurement of how fast or slow information is processed and responded to.
- d’ Signal Detection: A time measurement of how fast performance drops.
- Commission Errors: A measure of impulsivity: how many times the non-target is pressed.
- Omission Errors: A measure of inattention: how many times is the target not pressed.
- Post-Commission Response Time: A time measurement of how fast or slow a response is after a commission Error.
- Multiple Responses: A measure of how many times the button is pressed repeatedly. (Indicator of other problems)
- Anticipatory Responses: A time measurement how often a person is guessing rather than responding.
Unlike any other CPT's
Continuous Performance Task
A Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
See also
- Continuous Performance TaskContinuous Performance TaskA Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
- Attention-deficit hyperactivity disorderAttention-deficit hyperactivity disorderAttention deficit hyperactivity disorder is a developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.ADHD is the most commonly studied and...
- Adult attention-deficit disorder
Further reading
Test of Variables of Attention, or T.O.V.A., is an objectiveObjective test
An objective test is a psychological test that measures an individual's characteristics in a way that is independent of rater bias or the examiner's own beliefs, usually by the administration of a bank of questions that are marked and compared against exacting scoring mechanisms that are completely...
, neuropsychological test
Neuropsychological test
Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the...
that measures a persons sustained and selective attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. Some psychiatrists do not feel that the T.O.V.A. is adequate for diagnosis of ADHD, and prefer a full battery of neuropsychological testing combined with detailed history from both the patient and adjunctive information from parents, teachers, pediatrician, etc.
Over 150 studies have been done utilizing the T.O.V.A. to detect attention in people with attention disorders and traumatic brain injuries. In addition, The TOVA Research and Education Foundation has provided researchers, schools, and training programs with the T.O.V.A. to be used in objective assessment of attention at reduced cost.
Although the T.O.V.A. can accurately identify 87% of normal people, 84% of non-hyperactive ADHD, and 90% of the hyperactive that take the test, the test or its makers never make a claim the test can diagnose medical conditions such as Attention Deficit Disorders or Traumatic Brain Injuries
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
. The test is a tool that the clinician can use along with history
History
History is the discovery, collection, organization, and presentation of information about past events. History can also mean the period of time after writing was invented. Scholars who write about history are called historians...
, interview
Interview
An interview is a conversation between two people where questions are asked by the interviewer to obtain information from the interviewee.- Interview as a Method for Qualitative Research:"Definition" -...
s, behavior
Human behavior
Human behavior refers to the range of behaviors exhibited by humans and which are influenced by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion and/or genetics....
ratings and symptom checklists to accurate
ACCURATE
ACCURATE was established in 2005 by a group of computer scientists, psychologists and policy experts to address problems with electronic voting...
ly diagnose
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and treat attention disorders.
Origins
The T.O.V.A. was developed by Dr. Lawrence Greenberg, Professor Emeritus and former Head of Child and Adolescent Psychiatry at the University of Minnesota, a clinician and a leader in research in Attention Deficit Disorders for over 25 years. .Development began back in the mid-1960s with the first mechanical machine that could test response time. Utilizing tachistoscopic technology, Herman (named after one of the children it was run on) ran the program VIRTEST (Test of Variability, Inattention, and Response Time), which was designed to randomly present two different geometrical visual stimuli, and the child was asked to press a response button only when they saw the one that was the designated target.
Dr. Greenberg tested the children for 4 different medications utilizing Herman: Chlorpromazine
Chlorpromazine
Chlorpromazine is a typical antipsychotic...
(typical antipsychotic), Dextroamphetamine
Dextroamphetamine
Dextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
(psychostimulant), Hydroxyzine
Hydroxyzine
Hydroxyzine is a first-generation antihistamine of the diphenylmethane and piperazine classes. It was first synthesized by Union Chimique Belge in 1956 and was marketed by Pfizer in the United States later the same year, and is still in widespread use today....
(minor tranquilizer), and Placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
. After each medication was administered he took behavior ratings from “Herman”, the mothers of the child, and the teachers of the child. Although the mothers preferred the tranquilizer, both Herman and the teachers preferred the Dextroamphetamine. Ironically, the mothers preferred their children to be sleepy and under control which in turn, did not help with attention levels. However, the teachers and “Herman”, showed that the child was still full of energy but able to focus better and learn.
Upon the findings of this study Dr. Greenberg decided that using behavioral ratings alone was too subjective
Subjectivity
Subjectivity refers to the subject and his or her perspective, feelings, beliefs, and desires. In philosophy, the term is usually contrasted with objectivity.-Qualia:...
and that the ratings themselves would be influenced by the testing environment and the raters bias
Bias
Bias is an inclination to present or hold a partial perspective at the expense of alternatives. Bias can come in many forms.-In judgement and decision making:...
. Dr. Greenberg continued to develop an objective means to determine how to help with diagnosis and treatment of those with attention problems. With the advance of computers, the T.O.V.A. was made commercially
Commerce
While business refers to the value-creating activities of an organization for profit, commerce means the whole system of an economy that constitutes an environment for business. The system includes legal, economic, political, social, cultural, and technological systems that are in operation in any...
available in 1991.
Testing
It’s a 21.6 minute test with two types: Visual and AuditoryAuditory system
The auditory system is the sensory system for the sense of hearing.- Outer ear :The folds of cartilage surrounding the ear canal are called the pinna...
. During the first section of the test, the objective is to measure attention during a boring task. This section is 10.8 minutes long and the target is presented 1 time for every 3.5 times the non-target is presented. The second section of the test is a measure of attention while attending to a stimulating task. This section is also 10.8 minutes long and the target is presented 3.5 times for every 1 time a non-target is presented.
The visual T.O.V.A. uses two simple geometric figures and involves clicking the microswitch when the person taking the test sees the target figure and not clicking when it’s the non-target figure. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.
The auditory test is the same process. The test taker clicks when they hear the target and does not click when they hear the non-target. The target tone is G above Middle C (392.0 Hz) and the non-target tone is Middle C (261.6 Hz).
The test is monochromatic, non-sequential, language and culturally independent. It is presented in both clinical and screening versions. Clinical version is used by health professionals. The screening version has no diagnostic terms and is used by school-based professionals.
Scoring & Variables
The T.O.V.A. measures 8 different variablesVariable (mathematics)
In mathematics, a variable is a value that may change within the scope of a given problem or set of operations. In contrast, a constant is a value that remains unchanged, though often unknown or undetermined. The concepts of constants and variables are fundamental to many areas of mathematics and...
to measure whether or not response times and attention is at the normal range for the sex and age of the test taker. Over 2000 normal
Normality (behavior)
In behavior, normal refers to a lack of significant deviation from the average. The phrase "not normal" is often applied in a negative sense Abnormality varies greatly in how pleasant or unpleasant this is for other people.The Oxford English Dictionary defines "normal" as "conforming to a standard"...
people without attention problems, were measured to determine what is normal response times for the sex
Gender
Gender is a range of characteristics used to distinguish between males and females, particularly in the cases of men and women and the masculine and feminine attributes assigned to them. Depending on the context, the discriminating characteristics vary from sex to social role to gender identity...
and age
Ageing
Ageing or aging is the accumulation of changes in a person over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline...
of the test taker as a basis for the interpretation provided.
- Response Time Variability: A time measurement of how consistently the microswitch is pressed.
- Response Time: A time measurement of how fast or slow information is processed and responded to.
- d’ Signal Detection: A time measurement of how fast performance drops.
- Commission Errors: A measure of impulsivity: how many times the non-target is pressed.
- Omission Errors: A measure of inattention: how many times is the target not pressed.
- Post-Commission Response Time: A time measurement of how fast or slow a response is after a commission Error.
- Multiple Responses: A measure of how many times the button is pressed repeatedly. (Indicator of other problems)
- Anticipatory Responses: A time measurement how often a person is guessing rather than responding.
Unlike any other CPT's
Continuous Performance Task
A Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
commercially available, The T.O.V.A. uses a microswitch to record responses. Because 5 out of 8 of the determining factors are time based, any delay can severely affect the scoring of the user. The microswitch is used because it can obtain very accurate time measurements (±1 msec). Computer keyboards and mice are not as reliable and can vary significantly (±28 msec).
See also
- Continuous Performance TaskContinuous Performance TaskA Continuous Performance Task/Test, or CPT, is a neuropsychological test which measures a person's sustained and selective attention and impulsivity. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli, and is associated with impulsivity....
- Attention-deficit hyperactivity disorderAttention-deficit hyperactivity disorderAttention deficit hyperactivity disorder is a developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.ADHD is the most commonly studied and...
- Adult attention-deficit disorder
Further reading
- ADHD and T.O.V.A.
- Chae, P. K. (1999). Correlation study between WISC-III scores and TOVA performance. Psychology in the Schools, 36(3), 179-185.
- Fitzgerald, R. L. (2001). Statistical reliability of the T.O.V.A.RTM test of variables of attention. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61 (7-B), 3895.
- Greenberg, L. M., & Waldman, I. D. (1993). Developmental normative data on the test of variables of attention (T.O.V.A.). Journal of Child Psychology and Psychiatry, 34(6), 1019–1030.
- Leark, R. A., Wallace, D. R., & Fitzgerald, R. (2004). Test-retest reliability and standard error of measurement for the test of variables of attention (T.O.V.A.) with healthy school-age children. Assessment, 11(4), 285-289.
- Li, X., & Wang, Y. (2000). A preliminary application of the test of variables of attention (TOVA) in china. [Chinese]. Chinese Mental Health Journal, 14(3), 149-152.
- Mann, J. B. (1997). Assessment of ADHD: Does the addition of continuous performance tests, memory tests, and direct behavioral observations enhance informants' ratings of the child? Dissertation Abstracts International: Section B: The Sciences and Engineering, 58 (5-B), 2688.
