About the Target Tests of Executive Functioning (TTEF)
The Target Tests of Executive Functioning tasks are enjoyable and engaging. Most of the children polled during the normative process reported them as "fun but hard". Clinician's frequently observe a wide range of escape behaviors elicited by children in response to completing commonly used CPTs. These off-task behaviors, while of observational importance, can be produced in a wide range of children for various reasons unrelated to ADHD. Thus, these negative reactions can be a critical source of error. Additionally, since computer measures are often used as screening tools and presented early on in the evaluation process, unduly frustrating children can lead to compromised rapport, invalid test results and reduced effort for subsequent tasks.
It is Dr. Russell Barkley's model of behavioral inhibition which emphasizes the abilities to inhibit prepotent responses to stop a response and to mitigate interference combined with Miller and Cohen's view of cognitive control as hinging on selective bias and neural recruitment that has served as the basis for the selection of stimuli and task demands employed by the Target Tests of Executive Functions subtests. The unifying theme used from both models is the ability to select/detect important information while inhibiting non-relevant or competing material in the service of the employment of the executive processes. Each of the three Target Subtests were designed to force these controls while placing demands on various executive functions. It was hypothesized that such demands would tax both the inhibitory or cognitive controls for ADHD subjects thus producing inefficient use of the executive functions as tapped by the Target Tests of Executive Functioning subtests.
Demands Basic To All Three Target Subtests
- Subject is pre-loaded to search and detect relevant information
- Subject must inhibit irrelevant stimuli
- Subject must use a metacognitive strategy forcing the use of internal dialogue
- Subject must wait a short lag time before employing task demands
- Subject must inhibit while formulating a plan of action
- Subject must formulate, reconstitute and execute plans in the face of changing or novel stimuli
- Subject must be sensitive and responsive to feedback
- Subject must be able to do the above to discover that there are recurrent patterns presented in the task demands
- Subject must employ motivational and emotional control in the service of ongoing activity
- Subject must evaluate outcome against plans, intentions and feedback to direct future efforts accurately
Task Specific Demands
Target Recognition - Target Recognition presents five large colored squares with smaller squares inside them. Below the squares are five small boxes labeled 1 thru 5.
The colored squares simultaneously blink on and off the screen at 1 ½ second intervals for a total of 153 presentations. The child is taught a strategy to read from left to right and to count the number of large squares with small squares inside them of the same color and then to click on the corresponding number in the small box below labeled 1 thru 5.
Specific requirements for task completion include among others:
Attention to detail, avoiding distraction, maintenance of effort or persistence, holding information in mind through the use of metacognition, feedback, and emotional regulation while developing a response to changes in novel stimuli.
Target Sequencing - Across 39 trials five large colored circles are presented. A small square moves through them starting in the middle or at either of the end circles. The child is taught to attend only to circles when the square matches it in color and to say the name of the color to him or her self while at the same time disregarding the circles that have squares with different color. Once the squares have moved through all five circles the child clicks on each of the circles that had matching colors in the order that they stated to him/herself. First match first, second match second and last match last.
Specific requirements for task completion include among others:
Attention to detail, avoiding distraction, maintenance of effort or persistence, holding information in mind through the use of metacognition, feedback, and emotional regulation during the initiation and follow through of a response to complex sequences while remaining sensitive to changes in novel stimuli.
Target Tracking - Through 20 trials this subtest presents four colored shapes at the top and bottom of the screen. The computer creates one move at a time two and three step moves that the child must repeat/recreate in the same order seen. First move first, second move second and last move last.
Specific requirements for task completion include among others:
Attention to detail, maintaining divided attention, holding information in mind, maintenance of effort or persistence and emotional regulation while completing complex two and three step instructions.
