Introducing a New Evidenced Based ADHD
Screening System
by Steven Spector,
Ph.D.
PADDS is a new and innovative Attention and
Executive Functions Screening System with
proven clinical reliability and validity for
the screening of Attention and Executive
disorders (Scott, 2005; Pedigo, 2003). The
PADDS system can be completed in total in
approximately 45 minutes by a clinician or
properly trained assistant.
The test is designed to screen for ADHD in
children between the ages of 6 to 12 years.
The testing process is built upon on three
brief and highly engaging computer
administered tasks referred to as the Target
Tests of Executive Functioning (TTEF).
It tests working memory, sequential memory
and procedural memory functions all integral
parts of executive functioning skills, which
are often deficient in AD/HD students. It can
also be used to assess whether medication has
a positive effect once an AD/HD diagnosis has
been made.
The Target Tests of Executive Functioning
moves beyond measuring routine persistence
(sustained attention) often found with
traditional continuous performance tests. It
taps additional aspects of executive
functioning such as: Activating, Focusing,
Planning, Organization, Working Memory,
Modulating Emotions, and Sustaining Effort.
The children are attracted to the game-like
feel of the tests; they remain engaged
without becoming frustrated as often happens
with other CPT's. PADDS more accurately
reflects a subject's higher -level cognitive
abilities rather than just how quickly they
give up on a boring, tedious task.
Another important aspect of PADDS are the
behavioral reports, which consist of (1) the
Computer Administered and Scored Snap-IV
Behavior Ratings and/or (2) the Computer
Administered Diagnostic Interview (CADI).
Combining the Target Tests of Executive
Functioning with the behavioral reports more
accurately delineates ADHD concerns and may
provide insight into possible co-morbid
conditions as well.
All information is reported in an efficient
user-friendly Nomographic evidence based,
graphic report analysis. This invaluable
report presents the positive and negative
predictive power across multiple lines of
evidence established for or against a
diagnosis of AD/HD.
The report also presents the incremental
movement (combined evidence) of the TTEF's
and the SNAP-IV inputs and overall predictive
index. Each report generated is based on age
specific information with relative cut
points, Z-scores, T-scores and percentile
comparisons of performance to the
non-clinical reference group.
Raw score confidence intervals are set at 95
percent which are also produced for each case
giving the examiner three distinct
performance references for each case. The
concise report has exportable capability and
is saved in a database for unlimited retest
comparisons over time.
This standardized evidence-based approach
efficiently provides a preliminary treatment
plan that can support a diagnosis when
combined with other procedures as deemed
necessary along with the clinician's
judgment.
With an approach that helps to overcome some
of the problems and limitations found when
using rating scales alone, or with less
effective test measures, the PADDS system
represents a clear advancement over existing
computerized performance tests for ADHD, and
by "raising the bar" on current assessment
practices, signaling the future of
evidence-based diagnostic screening.
The PADDS System incorporates the multi-level
evidence based approach in line with the
current emphasis of "Best Practices" of
prominent researchers, healthcare agencies
and professional academies.
Steven Spector, Ph.D. is a licensed
psychologist in independent practice. He is
also an adjunct assistant professor in the
Department of Pediatrics and Psychiatry at
Wayne State University School of Medicine,
Detroit, MI.
