The risk of misdiagnosing posture weakness as hyperactivity in ADHD: a case study

Vogt, Carsten

doi:10.1007/s12402-017-0221-1

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…They included two studies in which the CPT was combined with other measures such as information provided by a teacher or parents and suggested that rating scales and TOVA are measuring distinct but important aspects of ADHD, and the addition of TOVA makes a valuable contribution to assessment of ADHD. Also, according to Vogt (2017) , questionnaires are based on behavioral presentations and the correlation with neurocognitive tests is known to be low to moderate. In the future it would be interesting to compare the information provided by parents and teachers with performance in traditional and virtual CPTs.…”

Section: Discussionmentioning

confidence: 99%

Comparison between two continuous performance tests for identifying ADHD: Traditional vs. virtual reality

Rodríguez

Areces

García

et al. 2018

International Journal of Clinical and Health Psychology

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Background/Objective: Continuous Performance Tests (CPTs) have demonstrated validity when differentiating children with ADHD from healthy controls. However, these CPTs have limitations such as low ecological validity. New CPTs based on the use of Virtual Reality (VR) have appeared as supposedly improved methods for assessing ADHD. This study aims to compare the discriminant value of attentional variables produced by a VR CPT (Aula Nesplora) with that of variables from a traditional CPT (Test of Variables of Attention; TOVA) for identifying ADHD. Method: A total of 338 children aged between 6 and 16 years old (M = 10.84, SD = 3.01) participated in the study: 31.95% correspond to the inattentive presentation, 15.38% to the impulsive-hyperactive presentation, 22.78% to the combined presentation, and the remaining 29.88% correspond to children without ADHD. Results: Results indicated that Aula Nesplora predicts ADHD presentations better than TOVA. It also differentiates better between ADHD and non-ADHD students. Conclusions: These findings show the potential advantages of using virtual reality in ADHD assessment, as it facilitates the diagnosis of ADHD and the differentiation of its presentations in a realistic environment.

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Section: Discussionmentioning

confidence: 99%

Comparison between two continuous performance tests for identifying ADHD: Traditional vs. virtual reality

Rodríguez

Areces

García

et al. 2018

International Journal of Clinical and Health Psychology

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“…Although there is quantitatively a difference between the two groups, the high variance of activity in both groups suggests additional heterogeneity, pointing out to a more complex interplay with other factors that can influence activity other than those related to executive functions as described above, for example motor control (e.g. overflow movements) and motor timing difficulties, mechanical posture weakness, sensory modulation disorder and subcortical impairment [5,[25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Differences in measurements of hyperactivity between objective testing using infrared motion analysis (QbTest) and behavioural rating scales when comparing problems in alerting functions and response inhibition during the clinical assessment of ADHD

Vogt¹,

Williams²,

Susi³

et al. 2018

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Introduction: Little is known how problems in alerting functions or response inhibition affect objective infrared activity measurements during a continuous performance test (QbTest) despite an increasing use of these tests for the clinical assessment of ADHD. Difficulties in alerting functions and response inhibition are both associated with the presence of behavioural features in all three core domains of ADHD, i.e. inattention, impulsivity and hyperactivity. We hypothesized that objective infrared activity measurements during CPT and behavioural ratings for hyperactivity from a commonly used questionnaire for ADHD (Conners rating scale) would be raised for both alerting functions and response inhibition. Method: 951 sequential referrals completed a QbTest and parent and teacher Conners rating scales followed by a clinical assessment with a CAMHS clinician. Two groups, one with exclusive difficulties in alerting functions (inattention) and the other with exclusive difficulties in response inhibition (impulsive) resulting from the QbTest performance were extracted from the pool and activity measurements, rating scales and diagnostic outcome were compared. Results: Contrary to our hypothesis, only the group with difficulties in alerting functions (inattentive) showed significantly raised activity measurements during CPT. However, both groups had raised scores for hyperactivity in the behavioural rating scales. A higher number of cases with difficulties in alerting functions (79.6%) were assigned a diagnosis of ADHD compared to the group with exclusively difficulties in response inhibition (61.8%). Discussion: A cautious evaluation of activity measurements during the QbTest with full consideration of the interplay between naturalistic and laboratory environmental effects on motor activity is recommended

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“…The QbTest can help identify mechanical posture weakness as shown in a case study by Vogt. 23 The tracking of movement on the visual display from the report produces distinct configurations (►Fig. 3) as a result of slouching and stretching (condensed double clumping markings; increases in vertical body movement especially in the latter half of the test) that are easily identified.…”

Section: Activitymentioning

confidence: 99%

Clinical Conundrums When Integrating the QbTest into a Standard ADHD Assessment of Children and Young People

Vogt

2021

Neuropediatrics

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The uptake of the QbTest in clinical practice is increasing and has recently been supported by research evidence proposing its effectiveness in relation to clinical decision-making. However, the exact underlying process leading to this clinical benefit is currently not well established and requires further clarification. For the clinician, certain challenges arise when adding the QbTest as a novel method to standard clinical practice, such as having the skills required to interpret neuropsychological test information and assess for diagnostically relevant neurocognitive domains that are related to attention-deficit hyperactivity disorder (ADHD), or how neurocognitive domains express themselves within the behavioral classifications of ADHD and how the quantitative measurement of activity in a laboratory setting compares with real-life (ecological validity) situations as well as the impact of comorbidity on test results. This article aims to address these clinical conundrums in aid of developing a consistent approach and future guidelines in clinical practice.

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The risk of misdiagnosing posture weakness as hyperactivity in ADHD: a case study

Cited by 3 publications

References 21 publications

Comparison between two continuous performance tests for identifying ADHD: Traditional vs. virtual reality

Comparison between two continuous performance tests for identifying ADHD: Traditional vs. virtual reality

Differences in measurements of hyperactivity between objective testing using infrared motion analysis (QbTest) and behavioural rating scales when comparing problems in alerting functions and response inhibition during the clinical assessment of ADHD

Clinical Conundrums When Integrating the QbTest into a Standard ADHD Assessment of Children and Young People

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