Diagnostic efficiency of neuropsychological test scores for discriminatingboys with and without attention deficit-hyperactivity disorder

A growing literature has documented group differences between boys with and without attention deficit-hyperactivity disorder (ADHD) on neuropsychologi cal rests; however, whether or not such tests can discriminate individuals with ADHD from non-ADHD controls remains unclear. This study used condition al probability and receiver operating characteristic analyses to examine th e efficiency of lest-based diagnostic discriminations in a large sample of referred boys with and without ADHD. Single neuropsychological tests had li mited discriminating ability at various cutoff scores. When multiple tests were used together, prediction of ADHD status improved but overall diagnost ic efficiency remained limited, Diagnostic efficiency did not differ when m edicated and nonmedicated index children were considered separately. Result s suggest that children with ADHD show variable deficits on neuropsychologi cal tests of attention and executive functions. Impairments on multiple neu ropsychological tests are predictive of ADHD, but normal scores do not rule out the diagnosis. The prognostic implications of variable neuropsychologi cal deficits in children with ADHD require further investigation.