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About the T.O.V.A. ™
Introducing the T.O.V.A. ™ (Test Of Variables of Attention)
The T.O.V.A. ™ uses geometric stimuli (to minimize the effects of
cultural differences and learning problems), and contains two test
conditions: target infrequent and target frequent. In the first half of
the test (the target infrequent half), the target:nontarget ratio is
1:3.5, i.e.: a target is presented (randomly) only once every 3.5
nontarget presentations. In this half which is similar to most of the
other Continuous Performance Tests (CPTs), the task is boring and
fatiguing, and the subject must pay close attention to respond to the
infrequent target correctly. When a subject does not respond to the
target, it is called an error of omission and is a measure of inattention.
In the second half of the test (target frequent half), the
target:nontarget ratio is 3.5:1, i.e: 3.5 targets are presented for every
1 nontarget. In this half of the test, the subject expects to respond most
of the time but occasionally must inhibit the tendency to respond.
When a subject responds to the nontarget, it is called an error of
commission and is a measure of impulsivity. Thus the ability to pay
attention to a boring, repetitive task is best measured in the first half
of the T.O.V.A. ™ while the ability to inhibit oneself is best measured in
the second half.
Like most CPTs, the T.O.V.A. ™ uses a fixed, mid-range interstimulus
interval (2secs) and visual stimuli. However, unlike most CPTs, the
T.O.V.A. ™ stimuli are nonsequential, simple geometric configurations and
monochromatic. Since these features along with the use of a 2.5 minute
practice, minimize practice effects, the T.O.V.A. ™ can be used for serial
measurements.
Mode of response is a particularly important variable that
significantly affects test reliability. Unfortunately, since most CPTs use
the keyboard to record responses, they have large inherent errors of
measurement of time (up to +/-28 msec). However, the T.O.V.A. ™ uses a
specially designed microswitch with an insignificant error of measurement
(+/- 1 msec) and which minimizes muscular fatigue.
Duration The duration of testing is a significant factor, since
subjects who are older and more intelligent can compensate for mild or
moderate attention problems for 5, 10, even 15 minutes. As a result, the
T.O.V.A. ™ is 21.8 minutes long for 6 year olds and older. An appropriately
shorter version (10.9 minutes) is administered for 4-5 year olds.
Variables measured T.O.V.A. ™ measures include variability of response
time (consistency), response time, commission (impulsivity), errors of
omission (inattention), post-commission response times, multiple and
anticipatory responses, and an ADHD score, which is a comparison to an
age/gender specific ADHD group.
The T.O.V.A. ™ immediately analyzes the results quarter by quarter and
provides written interpretation and graphics.
Advantages of Using The T.O.V.A. ™
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Increases Diagnostic Accuracy
The T.O.V.A. ™ promotes data based clinical decision making with its
objective information about attention and impulsivity - information that
clinicians do not obtain from behavior ratings and history Alone, the
T.O.V.A. ™ correctly identifies over 86% of ADHD cases and the “hit” rate
improves with the addition of other clinical information. However, as is
true with all tests, the T.O.V.A. ™ does not make a diagnosis - only a
clinician does.
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Improves Response to Treatment
The T.O.V.A. ™ accurately predicts the effectiveness of medication by
comparing T.O.V.A. ™ tests (with and without medication). By administering
the T.O.V.A. ™ on various doses one can titrate dose for best results. It
titrates medication doses to obtain optimal clinical results and
minimize sequellae without costly and long clinical trials. And it
minimizes the need for treatment of overlying, prominent symptoms such
as depression, anxiety, learning and conduct disorders that may “mask”
ADHD.
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Facilitates Case Management and Planning
The T.O.V.A. ™ provides cost-effective monitoring of treatment over
time with yearly retesting to insure continued optimal treatment results
and to determine when treatment is no longer necessary. The School
Intervention Report, which is easily edited, personalized and
individualized, facilitates communications with the school, saving
valuable professional time. And it is an asset when treating substance
abuse, including nicotine dependence, recognizing that over 70% of
chemical dependency treatment failures and many treatment resistant
nicotine dependent cases have underlying, undiagnosed and untreated
ADHD.
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Promotes Cost Savings
The T.O.V.A. ™ can be administered by easily trained assistants in the
primary care physician’s office or in a clinic setting. Referrals to
specialists such as neurologists, psychiatrists and psychologists can be
more specific and cost effective. Successful treatment of ADHD reduces
incidence of accidents and injuries. We now know that attentional
problems can be treated with lower doses of medications rather than the
higher doses needed to suppress behavioral problems. T.O.V.A. ™ use
significantly reduces the costs of medication that may be needed for
many years. Teenagers, adults and older patients generally need much
less (50%) rather than more medication. You can determine when trade
name medications are necessary or generic medications are
sufficient.
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Increases Patient and Family Satisfaction
By providing objective, “state of the art” techniques that patients
want and graphic presentations of results that are easily understood by
patients and family, promoting understanding and compliance with
treatment.
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Provides Objective, Reliable Outcome Criteria
Traditional but questionably effective treatments, new, often more
costly medications, and potential alternative therapies can be evaluated
and compared to medication efficacy.
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The Services of the T.O.V.A. ™® Research Foundation
Provides training for professionals and clinical staff with
newsletters, clinical updates, medical guidelines, seminars and
workshops (with CE credit) with comprehensive information that is
available directly from the experts in ADHD Provides ongoing research
and development such as development of a Home Intervention Report and an
Adult Intervention Report which will provide adjunctive support for
counseling. Encourages and supports over 300 research studies in
attention disorders. In summary, ADHD is over diagnosed and over treated
because many clinicians use outdated as well as unnecessary expensive
procedures. The use of the T.O.V.A. ™, that specifically measures the
important attentional variables, is a cost-effective means of
significantly improving diagnostic accuracy and treatment results while
decreasing per case expenditures.
References available upon request. Please contact us if you have any
questions or comments.
How much does the T.O.V.A. ™ cost?
T.O.V.A. for Windows XP, Vista (all versions), Windows 7 (all versions),Windows 8 & 8.1 and Mac OS $895.00
Visual & Auditory T.O.V.A. ™ $895.00 - comes with 5 free interpretation credits
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Allied Products/Biofeedback Instrument Corp.
255 W. 98th Street
New York, N.Y. 10025
Tel. (212) 222-5665 (5667 Fax)
Email: brotmanp@verizon.net
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