Clinical Sample Demographics

Clinical testing of the PADDS Target Tests of Executive Functioning consisted of 725 children (240 females and 485 males) age 6 to 12 years (M = 8.63, SD = 1.72) split approximately evenly between those diagnosed with ADHD (n = 395) and age matched Non-ADHD/ Typical peers (n = 330). Data were collected in seven states through a total of 10 data collection sites. Institutional Review Board (IRB) approval for the overall project was established through Armstrong Atlantic State University in Savannah, Georgia. Specific sites included specialty ADHD assessment centers in Illinois, Georgia, Idaho, New Jersey, Tennessee, California, and Florida. Each specialty site also obtained independent IRB review from their respective institution or agencies. Consent forms were sent home to parents explaining the study, and all children with parents consenting who were tested received a $10.00 gift in return for their participation. All children signed assent forms detailing the gift and the right to discontinue at any time while still receiving the gift incentive. Children not meeting the screening criteria outlined below were excluded from the study. Participants recruited included both males and females from various ethnic and socioeconomic groupings. The break down of participants' ethnicity and ages by state are listed in Tables 8.1 and 8.2 respectively:


Table 8.1. Number and percent of Participants by Ethnic breakdown
State Number Percent CC AA HIS
Georgia 377 52% 215 136 26
Idaho 200 27% 180 05 15
Tennessee 50 07% 45 05 0
California 50 07% 35 10 05
Florida 15 02% 6 3 6
New Jersey 18 03% 15 0 3
Illinois 15 02% 10 05 0
Total sample and number/percent by ethnicity 725 100% 506(70%) 164(23%) 55(07%)
National estimate as of 2006 (76%) (15%) (20%)

*HTTP://WWW/CENSUS.GOV/POPEST/NATIONAL/ASRH/
CC=CAUCASION
AA=AFRICAN AMERICAN
HIS=HISPANIC

All information from both components is maintained in a database for collection and comparison over time. The Nomographically displayed Evidence-based Analysis combines the incremental validation of information from parent and teacher ratings of DSM-IV ADHD diagnostic criteria, with results from the three Target Tests of Executive Functions tasks, and if desired, select information provided by the individual clinician. This Evidence-based format compares these results in incremental fashion beginning with a base rate of 4 percent to help establish the positive and negative predictive power for or against a diagnosis.

PADDS Links

Sample Reports(pdf)

Forms and Protocols (pdf)

PADDS Research

Table 8.2. Number of Participants by State, Sex and Age
State N Males Females Age 6 Age 7 Age 8 Age 9 Age 10 Age 11 Age 12
Georgia 377 264 113 47 56 74 73 72 38 17
Idaho 200 130 70 22 31 45 40 34 20 08
Tennessee 50 32 18 10 12 09 06 04 05 04
California 50 30 20 10 07 10 05 07 06 05
New Jersey 18 12 06 04 02 03 03 02 02 02
Illinois 15 08 07 02 02 03 02 02 02 02
Florida 15 09 06 02 02 03 02 02 02 02
Totals 725 485 240 97 112 147 131 123 75 40

Note n=725

Subject Selection Criteria

The diagnostic assessment and testing process used to identify the ADHD subjects included at minimum: Clinical interview covering background, developmental, medical and family histories, reports from home and school, any available school testing and grades, intelligence testing, cognitive testing for short term auditory and visual memory, performance on either the CPT-II or TOVA continuous performance tests and a review of criteria met for diagnosis based on the Diagnostic and Statistical Manual, 4th ed. (DSM-IV) criteria for ADD/ADHD.

Prior to clinical testing with the PADDS Target Tests of Executive Functioning, a review of the previously diagnosed ADHD children's records was conducted to ensure the child had been prescribed stimulant medication with reports of improvement from home and school. All ADHD children completed the PADDS Target Tests of Executive Functioning prior to receiving their daily dose of psycho-stimulant medication. Additionally, efforts were taken to evaluate children during the summer break or over the weekend when they would normally be on medication holiday. Additionally, within the ADHD sample, all psychological testing data were reviewed to ensure there were no significant emotional disorders or clinically significant signs of depression or anxiety evident in any of the participants. Only ADHD children receiving psycho-stimulants were included in the clinical study. All ADHD children were tested with the PADDS TTEF subtests during the morning hours to limit diurnal effects on test performance.

The typical or non-ADD/ADHD children were drawn from various elementary schools within the same states as listed in Table 8.2. Consent forms were sent home via student folders. The typical children who returned consent forms were screened with the Connors Rating Scale-Teacher Version (Connors, 1997) prior to inclusion in the study. Each child signed an assent form detailing that they could choose to discontinue participation at any time and still receive the gift incentive. All typical children were tested with the PADDS TTEF subtests during the morning hours to limit diurnal effects on test performance. All participants with Connors Rating Scale T scores greater than 65 were deemed potentially atypical and thus were removed from the typical data set for the purpose of further analysis in a separate study.

All data collected were forwarded from each data collection site to the Department of Psychology at Armstrong Atlantic State University for analysis. Analyses were completed using Statistical Package for the Social Sciences (SPSS) statistical software package, version 11, 2001.

Summary

The effort to validate the PADDS Target Tests of Executive Functioning described here represents the most comprehensive work on developing a computer measure of ADHD to date, both in terms of sample size in this restricted range (6-12 yrs) as well as in terms of the make up of the sample. Significant time and effort were equally utilized developing the underlying statistical methodology and automated Evidence-based Analysis approach, ensuring that the PADDS system and its users will be as up-to-date as possible in the area of measuring ADHD.