title: The clinical utility of the continuous performance test and objective measures of activity for diagnosing and monitoring ADHD in children: a systematic review.
abstract: Attention-deficit hyperactivity disorder (ADHD) is typically diagnosed using clinical observation and subjective informant reports. Once children commence ADHD medication, robust monitoring is required to detect partial or non-responses. The extent to which neuropsychological continuous performance tests (CPTs) and objective measures of activity can clinically aid the assessment and titration process in ADHD is not fully understood. This review describes the current evidence base for the use of CPTs and objectively measured activity to support the diagnostic procedure and medication management for children with ADHD. Four databases (PsycINFO, Medline, Allied and Complementary Medicine (AMED), and PsycARTICLES) were systematically searched to understand the current evidence base for (1) the use of CPTs to aid clinical assessment of ADHD; (2) the use of CPTs to aid medication management; and (3) the clinical utility of objective measures of activity in ADHD. Sixty relevant articles were identified. The search revealed six commercially available CPTs that had been reported on for their clinical use. There were mixed findings with regard to the use of CPTs to assess and manage medication, with contrasting evidence on their ability to support clinical decision-making. There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation, which appears sensitive to medication effects and would also benefit from further research on their clinical utility. The findings suggest that combining CPTs and an objective measure of activity may be particularly useful as a clinical tool and worthy of further pursuit.
authors.affiliation: Division of Psychiatry and Applied Psychology, CLAHRC-EM, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK. Charlotte.hall@nottingham.ac.uk.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Hall
authors.affiliation: Division of Psychiatry and Applied Psychology, CLAHRC-EM, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
authors.forename: Althea Z
authors.initials: AZ
authors.lastname: Valentine
authors.affiliation: Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
authors.forename: Madeleine J
authors.initials: MJ
authors.lastname: Groom
authors.affiliation: Division of Psychiatry and Applied Psychology, CLAHRC-EM, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
authors.forename: Gemma M
authors.initials: GM
authors.lastname: Walker
authors.affiliation: Developmental Psychiatry, School of Medicine, University of Nottingham, Nottingham, UK.|Centre for ADHD and Neuro-developmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
authors.forename: Kapil
authors.initials: K
authors.lastname: Sayal
authors.affiliation: Centre for ADHD and Neuro-developmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.|School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: David
authors.initials: D
authors.lastname: Daley
authors.affiliation: Division of Psychiatry and Applied Psychology, CLAHRC-EM, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.|Centre for ADHD and Neuro-developmental Disorders Across the Lifespan (CANDAL), University of Nottingham, Nottingham, UK.|MindTech, Developmental Psychiatry, Queen's Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Hollis
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D006801:Humans; D009483:Neuropsychological Tests / Q000592:standards*; D011597:Psychomotor Performance / Q000502:physiology*
keywords: Activity; Attention-deficit hyperactivity disorder (ADHD); Continuous performance tests (CPTs); Objective measures; Systematic review