Upgrading the science and technology of assessment and diagnosis: Laboratory and clinic-based assessment of children with ADHD

Reviews the usefulness of clinic-based and laboratory-based instruments and paradigms for diagnosing attention deficit hyperactivity disorder (ADHD) a nd monitoring treatment effects. Extant literature examining the performanc e of normal children and those with ADHD on an extensive range of neurocogn itive tests, tasks and experimental paradigms indicates that particular typ es of instruments may be more reliable than others with respect to detectin g between-group differences. We review task parameters that may distinguish the more reliable from less reliable instruments. The value of clinic-base d and laboratory-based instruments for monitoring treatment response in chi ldren with ADHD is questionable when evaluated in the context of ecological ly relevant variables such as classroom behavior and academic functioning. We present a general conceptual model to highlight conceptual issues releva nt to designing clinic-based and laboratory-based instruments for the purpo ses of diagnosing and monitoring treatment effects in children with ADHD. A pplication of the model to currently conceptualized core variables indicate s that attention and impulsivity-hyperactivity may represent correlative ra ther than core features of the disorder: We discuss implications of these f indings for designing the next generation of clinic-based and laboratory-ba sed instruments.