Offering online/virtual ADHD assessments?

[quickpsych]

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I wasn’t referring to the WAIS; I’m not sure what you mean. I’m saying a pricey cpt/ tova that isn’t useful diagnostically isn’t the only way to conduct a continuous attention test.

You mentioned "coding" which I took as the subtest. I agree there are cheaper ways, but are those ways computer based and thus easily administered remotely?

 

[MCParent]

You mentioned "coding" which I took as the subtest. I agree there are cheaper ways, but are those ways computer based and thus easily administered remotely?

Oh derp. Like coding a program I meant.
If you program it it can be whatever you program!
Other people have already written go no go tests of course.

 

[quickpsych]

Oh derp. Like coding a program I meant.
If you program it it can be whatever you program!
Other people have already written go no go tests of course.

Appreciate the clarification.

I’m assuming your comment then is satire as this is Daniel Amen levels of absurdity or this:

Bender

A Bender meme. Caption your own images or memes with our Meme Generator.

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so thanks for the laugh 🤣.

A sense of humor is always welcome.

 

[R. Matey]

I think MCParent means write a computer program for Go/No Go. Similar to this one: Go/No-go task. Note that this version is experimental.

 

[MCParent]

Appreciate the clarification.

I’m assuming your comment then is satire as this is Daniel Amen levels of absurdity or this:
View attachment 392735

Bender

A Bender meme. Caption your own images or memes with our Meme Generator.

imgflip.com

so thanks for the laugh 🤣.

A sense of humor is always welcome.

….norm data for go no gos is published.

Which maybe you should know about if you’re doing psych/neuropsych testing.

Also sort of an odd critique in that the cpts in general aren’t going to be diagnostically useful. But, feel free to practice in whatever way you think you can get away with, I guess.

 

[quickpsych]

I think MCParent means write a computer program for Go/No Go. Similar to this one: Go/No-go task. Note that this version is experimental.

Thanks for the clarification. It’s kind of interesting that some on here will clamor against modern measures but happily use experimental software . Not you. Kind of interesting to spend time writing a program for personal use and use it in an unproven capacity in clinical work...when companies with career researchers, statisticians , and test developers have the time, money, and resources to do it correctly.

 

[quickpsych]

….norm data for go no gos is published.

Which maybe you should know about if you’re doing psych/neuropsych testing.

Also sort of an odd critique in that the cpts in general aren’t going to be diagnostically useful. But, feel free to practice in whatever way you think you can get away with, I guess.

I didn’t critique CPTs as not being diagnostically useful. CPTs are based on go/no go data; others have also replied in this thread with data about various CPTs. They’ve been using go/no go formats for years if not decades. This is known if you’ve seen an attention test or CPT test.

And no , no neuropsychologists or general psychologists I’ve talked to try to code their own CPTs or test measures along the way as you seem to imply you do using self use coding/programming software then using what’s created with real patients. Or you’re kind of cherry picking aspects of , and modifying, test measures ? Im not quite sure from your replies if you mean you’re just coding and programming these on your own then using the finished result in clinical settings? Thus the meme reply as it came across as quite outlandish, and again could be wrong so...

Please correct me if I’m mistaken, just how your reply came across; maybe you're referring to research and test development usage you’re doing on creating better measures? if so would be great to see some data and trial results. Just isn't clear from your replies.

 

[WisNeuro]

Thanks for the clarification. It’s kind of interesting that some on here will clamor against modern measures but happily use experimental software . Not you. Kind of interesting to spend time writing a program for personal use and use it in an unproven capacity in clinical work...when companies with career researchers, statisticians , and test developers have the time, money, and resources to do it correctly.

I believe that his point was, that if a university was going to mandate the use of an instrument/test that has very little utility in the purpose of the evaluation (i.e., diagnosis of ADHD), or much of anything, then why spend a lot of money on an expensive version?

 

[MCParent]

Thanks for the clarification. It’s kind of interesting that some on here will clamor against modern measures but happily use experimental software . Not you. Kind of interesting to spend time writing a program for personal use and use it in an unproven capacity in clinical work...when companies with career researchers, statisticians , and test developers have the time, money, and resources to do it correctly.

You do know that g/ngs are established tests, right? Or stop signal, etc. Standard admin practices and norms are published. It sounds like you think something being commercial is what makes it valid, which is an odd perspective.

I didn’t critique CPTs as not being diagnostically useful.

You should have.

 

[WisNeuro]

You do know that g/ngs are established tests, right? Or stop signal, etc. Standard admin practices and norms are published. It sounds like you think something being commercial is what makes it valid, which is an odd perspective.

You should have.

Easy enough to email a lab who already has an E-prime paradigm and several normative studies behind it. Which, we actually did way back when on a large ADHD grant in grad school.

 

[R. Matey]

You do know that g/ngs are established tests, right? Or stop signal, etc. Standard admin practices and norms are published. It sounds like you think something being commercial is what makes it valid, which is an odd perspective.

Yeah, I'm sure testing companies would love clinicians to believe to that they alone are the arbiters of valid clinical measures. If that were true, then the folks who produce the columbia or the diamond better reach out to Pearson.

Thanks for the clarification. It’s kind of interesting that some on here will clamor against modern measures but happily use experimental software . Not you. Kind of interesting to spend time writing a program for personal use and use it in an unproven capacity in clinical work...when companies with career researchers, statisticians , and test developers have the time, money, and resources to do it correctly.

I meant that the link was part of an experimental toolkit and shouldn't be used for clinical practice.

 

[smalltownpsych]

It seems that many of the psychologists I know IRL use or are ok with administering a CPT or TOVA. Outside of that, medical docs and others seem to think they are essential. I have never administered one myself and we weren’t trained with them back in the 2002-2006 when I was in school. Back then we were more focused on assessing executive functioning and finding out that differences in subtests on the WISC weren’t diagnostic. Much of my current clinical work is with the young adults who were treated at an early age for “ADHD” and it did not help with their early childhood trauma, neurodivergence, prodromal psychotic disorder, emerging Bipolar disorder, or anxious obsessive tendencies so my own thoughts about ADHD and the overdiagnosis of it is a bit skewed.

 

[quickpsych]

I believe that his point was, that if a university was going to mandate the use of an instrument/test that has very little utility in the purpose of the evaluation (i.e., diagnosis of ADHD), or much of anything, then why spend a lot of money on an expensive version?

Thanks for interpreting what he was trying to say, I've noticed a few people have to do that on here to his replies. As others have noted too, it seems some have differing opinions.

So if I'm understanding correctly, you're implying he's trying to say they're all "not good." However, isn't it a bit reckless to make comments on a professional forum implying "eh you could just go code your own," as if we don't have enough people just going around "winging it" and using actual snake oil nonsense. Let's not get that mixed up. Sure maybe @MCParent has more experience and understanding with the underpinnings of the measures and thus thinks since he can code his own, why can't others? That's the message he's presenting, which is why I laughed because that's quite absurd to suggest while also suggesting others should also consider doing the same. He's of course welcome to do that.

do know that g/ngs are established tests, right? Or stop signal, etc. Standard admin practices and norms are published. It sounds like you think something being commercial is what makes it valid, which is an odd perspective.

You should have.

They are, you don't need to repeat yourself. It's not being commercial that makes it valid, it's that it's been designed and based on established tests. It sounds like you assume everyone knows or should know how to take the underpinnings of established tests and make their own? Yeah I could build my own sports car in my backyard or a doctor could build their own MRI machine in their garage, you going to take that car on public roads or put real life patients in that machine? Big difference between playing around with software and seeing what you come up with vs taking it from your laptop to clinical use. You're right commercial product doesn't always equal best product, but there's a range of quality and utility, it's not black and white. I'd rather use an established product and keep an eye out for something improved down the line.

Easy enough to email a lab who already has an E-prime paradigm and several normative studies behind it. Which, we actually did way back when on a large ADHD grant in grad school.

There's a difference between academia/research vs real world use. We all know this. Why would a day to day practitioner email some lab at some research school to get this information to try to code their own program....to then turn around and use in the wild. Different then lab research and test development in controlled settings. Most clinicians aren't doing this.

On my end, I know most of the measures exist because I trained under and worked alongside neuropsychologists and psychologists using these CPTs. Board certified just like each of you. So they're all wrong and using "not diagnostically useful" materials? Yes I asked for thoughts and apparently I got thoughts and replies which is great. When @MCParent designs his own test measure that's more diagnostically useful and has much lower false positives than existing measures, I'll be in line to purchase it.

Yeah, I'm sure testing companies would love clinicians to believe to that they alone are the arbiters of valid clinical measures. If that were true, then the folks who produce the columbia or the diamond better reach out to Pearson.

I'm sure they would. It's a business. So who are the arbitrators of valid clinical measures? Last I checked, Pearson among other companies have neuropsychologists and other practitioners and researchers they have both on staff and consult with when designing and developing tests. The Columbia is a suicide rating scale and the Diamond is what an anxiety rating scale? Companies like money but I'm guessing monetizing, especially a suicide rating scale would not be a great look. Good attempt, bad analogy.

My takeaway from @WisNeuro and @MCParent 's views here is that they find most CPTs have a false positive rate that's uncomfortably high. Fair enough. However, many use these measures alongside other assessment tools without issue day in and day out. If there's a better one out there lets hear them.

 

[quickpsych]

It seems that many of the psychologists I know IRL use or are ok with administering a CPT or TOVA. Outside of that, medical docs and others seem to think they are essential. I have never administered one myself and we weren’t trained with them back in the 2002-2006 when I was in school. Back then we were more focused on assessing executive functioning and finding out that differences in subtests on the WISC weren’t diagnostic. Much of my current clinical work is with the young adults who were treated at an early age for “ADHD” and it did not help with their early childhood trauma, neurodivergence, prodromal psychotic disorder, emerging Bipolar disorder, or anxious obsessive tendencies so my own thoughts about ADHD and the overdiagnosis of it is a bit skewed.

Well said and makes a lot of sense. I too know many that regularly administer a CPT or other similar measures. And it's also been my experience that they're seen as of benefit in the medical community. I agree too that there was, it seems, a lot of over-diagnosis of ADHD back in the day kind of just slapping that label on kids without looking for other possible disorders or reasons for their symptoms.

 

[R. Matey]

I'm sure they would. It's a business. So who are the arbitrators of valid clinical measures? Last I checked, Pearson among other companies have neuropsychologists and other practitioners and researchers they have both on staff and consult with when designing and developing tests. The Columbia is a suicide rating scale and the Diamond is what an anxiety rating scale? Companies like money but I'm guessing monetizing, especially a suicide rating scale would not be a great look. Good attempt, bad analogy.

My takeaway from @WisNeuro and @MCParent 's views here is that they find most CPTs have a false positive rate that's uncomfortably high. Fair enough. However, many use these measures alongside other assessment tools without issue day in and day out. If there's a better one out there let hear them.

Best practice for ADHD is a thorough clinical interview and collateral information, which can be obtained by a rating scale. Test validity is shown by research. I've provided multiple resources that you refuse to acknowledge, choosing instead to double-down on your own opinions. As I said, do what you will, but if you keep asking me the same information, I will provide you with the same answer.

The DIAMOND is a clinical interview.

Edit to add: It doesn't really matter to me that some psychologists still administer the CPT out of ignorance themselves or another party (best case) or desire to bill for unnecessary test (worst case). It is our responsibility as clinicians to stay informed on the literature. In this case, the literature is pretty clear that the CPT has little, if any, added value.

 

[quickpsych]

Best practice for ADHD is a thorough clinical interview and collateral information, which can be obtained by a rating scale. Test validity is shown by research. I've provided multiple resources that you refuse to acknowledge, choosing instead to double-down on your own opinions. As I said, do what you will, but if you keep asking me the same information, I will provide you with the same answer.

Sorry if I was misunderstood. I acknowledged them and in fact agree with them. You are correct. But seems some of the folks on here disagree with you and I and think rating scales are not sufficient, among other measures being insufficient. You and I are in the same book, different page but that's good enough.

The DIAMOND is a clinical interview.

My bad, it's a clinical interview for , in part, anxiety: DIAMOND and DIAMOND-KID Interviews, Articles, Training Course and Rater Certification - Department of Philanthropy.

 

[MCParent]

Thanks for interpreting what he was trying to say, I've noticed a few people have to do that on here to his replies. As others have noted too, it seems some have differing opinions.

So if I'm understanding correctly, you're implying he's trying to say they're all "not good." However, isn't it a bit reckless to make comments on a professional forum implying "eh you could just go code your own," as if we don't have enough people just going around "winging it" and using actual snake oil nonsense. Let's not get that mixed up. Sure maybe @MCParent has more experience and understanding with the underpinnings of the measures and thus thinks since he can code his own, why can't others? That's the message he's presenting, which is why I laughed because that's quite absurd to suggest while also suggesting others should also consider doing the same. He's of course welcome to do that.


They are, you don't need to repeat yourself. It's not being commercial that makes it valid, it's that it's been designed and based on established tests. It sounds like you assume everyone knows or should know how to take the underpinnings of established tests and make their own? Yeah I could build my own sports car in my backyard or a doctor could build their own MRI machine in their garage, you going to take that car on public roads or put real life patients in that machine? Big difference between playing around with software and seeing what you come up with vs taking it from your laptop to clinical use. You're right commercial product doesn't always equal best product, but there's a range of quality and utility, it's not black and white. I'd rather use an established product and keep an eye out for something improved down the line.


There's a difference between academia/research vs real world use. We all know this. Why would a day to day practitioner email some lab at some research school to get this information to try to code their own program....to then turn around and use in the wild. Different then lab research and test development in controlled settings. Most clinicians aren't doing this.

On my end, I know most of the measures exist because I trained under and worked alongside neuropsychologists and psychologists using these CPTs. Board certified just like each of you. So they're all wrong and using "not diagnostically useful" materials? Yes I asked for thoughts and apparently I got thoughts and replies which is great. When @MCParent designs his own test measure that's more diagnostically useful and has much lower false positives than existing measures, I'll be in line to purchase it.

I'm sure they would. It's a business. So who are the arbitrators of valid clinical measures? Last I checked, Pearson among other companies have neuropsychologists and other practitioners and researchers they have both on staff and consult with when designing and developing tests. The Columbia is a suicide rating scale and the Diamond is what an anxiety rating scale? Companies like money but I'm guessing monetizing, especially a suicide rating scale would not be a great look. Good attempt, bad analogy.

My takeaway from @WisNeuro and @MCParent 's views here is that they find most CPTs have a false positive rate that's uncomfortably high. Fair enough. However, many use these measures alongside other assessment tools without issue day in and day out. If there's a better one out there lets hear them.

I’m sure that you think your attempt at insulting me is subtle and clever; let me assure you that it’s transparent in its defensiveness. 😉

 

[quickpsych]

I’m sure that you think your attempt at insulting me is subtle and clever; let me assure you that it’s transparent in its defensiveness. 😉

Check out the other thread on questions about what are good skills for psychologists to have. Being open and receptive to constructive feedback is a great one.

You make a lot of assumptions and yet have little reply to what is actually posted.

How is giving some feedback an insult?

Asking questions is defensive? Bringing up valid concerns and real world experiences is defensive?

I'd rather ask questions then pretend I know more than I know.

When's the last time you took the time to ask a question on here or ask for clarification to someone's question instead of just talking at people. Surely you don't know everything?

I can assure you my last reply wasn't an insult, it just seems you're having difficulty accepting that you might be incorrect about some things; but aren't willing or able to take a one down approach and be seen as someone who has to ask questions or gain more information before making conclusions. If others have to repeatedly reply to you to translate whatever it is you're trying to get across...that's something worth self-reflecting on and to improve.

A touch of humility would serve you well. You've done this in the past on this forum including insulting others when you don't agree with their viewpoint or don't understand it. Maybe you think you're clever or just think you know so much you can't certainly be incorrect about anything? Overconfidence is a slippery slope. Or maybe you're just trolling?

Anyways best of luck to you. Respectfully, this account is getting blocked. Others have provided constructive, vibrant, and useful replies without needing to insult others and balance criticism with common sense understanding that not everyone knows what they might know. In other words they've added value to this thread so others can also learn from their knowledge, from questions presented, and from intellectual curiosity to learn more.

 

[R. Matey]

Sorry if I was misunderstood. I acknowledged them and in fact agree with them. You are correct. But seems some of the folks on here disagree with you and I and think rating scales are not sufficient, among other measures being insufficient. You and I are in the same book, different page but that's good enough.

My read of the thread is that we're all basically saying the same thing and I don't know if adding tests based on vibes is an awesome evaluation approach.

 

[AcronymAllergy]

Sorry if I was misunderstood. I acknowledged them and in fact agree with them. You are correct. But seems some of the folks on here disagree with you and I and think rating scales are not sufficient, among other measures being insufficient. You and I are in the same book, different page but that's good enough.


My bad, it's a clinical interview for , in part, anxiety: DIAMOND and DIAMOND-KID Interviews, Articles, Training Course and Rater Certification - Department of Philanthropy.

I may have missed some stuff in prior posts, but I didn't get that feel. My take has been that most people would agree a solid clinical interview is all you really need to diagnose ADHD, and is the gold standard for such. If you're going to add something for additional (objective) data, a rating scale/psychological testing is probably your best bet, and I'd argue it falls into the "necessary" category with kiddos (and helps with symptom validity in adults). Cognitive testing doesn't do much (in its current state) to help with diagnosis and is really only needed if the person is seeking accommodations.

That said, I know of even (boarded) neuropsychologists who've developed and regularly use abbreviated cognitive test batteries for ADHD evaluations. I myself don't do that.

 

[quickpsych]

I may have missed some stuff in prior posts, but I didn't get that feel. My take has been that most people would agree a solid clinical interview is all you really need to diagnose ADHD, and is the gold standard for such. If you're going to add something for additional (objective) data, a rating scale/psychological testing is probably your best bet, and I'd argue it falls into the "necessary" category with kiddos (and helps with symptom validity in adults). Cognitive testing doesn't do much (in its current state) to help with diagnosis and is really only needed if the person is seeking accommodations.

That said, I know of even (boarded) neuropsychologists who've developed and regularly use abbreviated cognitive test batteries for ADHD evaluations. I myself don't do that.

Thanks I appreciate the reply. This is useful information and more in line with what I was trying to suss out in terms of feasibility. Abbreviated test batteries with a structured clinical interview and rating scales might be the way to phrase it. This is the kind of insight I'm looking for, real world applications and usage. 👍

 

[quickpsych]

My read of the thread is that we're all basically saying the same thing and I don't know if adding tests based on vibes is an awesome evaluation approach.

I don't think basing it on vibes is good either.

 

[quickpsych]

Thanks all for the insight and discussion. I think I’ve got some great info to work with here and some good information to research and now have a little better idea of things. Going to lock this thread and review later.