Robert A.

Leark, PhD
Lawrence M. Greenberg, MD
Carol L. Kindschi, RN, MSN
Tammy R. Dupuy, MS
Steven J. Hughes, PhD

The TOVA Company

Ed. No. 844 (February 20, 2008)
T.O.V.A. Professional Manual
R

Test Of Variables of Attention Continuous Performance Test

Robert A. Leark, PhD

Tammy R. Dupuy, MS
Lawrence M. Greenberg, MD
Carol L. Kindschi, RN, MSN
Steve J. Hughes, PhD

The TOVA Company

3321 Cerritos Ave.
Los Alamitos, CA 90720 USA

Phone: 800.PAY.ATTN or 800.729.2886 or 562.594.7700

Fax: 800.452.6919 or 562.594.7770
Referrals: 800.REF.TOVA or 800.733.8682
Email: info@tovatest.com
Web: http://www.tovatest.com/

Edition Number 8.1-23-g7b7caf9 (January 16, 2013)

c Copyright 2011 The TOVA Company, All Rights Reserved.

Test Of Variables of Attention (abbreviated T.O.V.A.) is a registered trademark of The TOVA Company.

No part of this manual may be distributed without permission of The TOVA Company.

Orders of this manual should be directed to:

The TOVA Company

3321 Cerritos Ave.
Los Alamitos, CA 90720, USA
800.PAY.ATTN 800.729.2886 +1.562.594.7700
Fax 800.452.6919 +1.562.594.7770

Printed in the United States of America.

Contents
1 Introduction to the T.O.V.A. 1
1.1 The History of the T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 The T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2.1 T.O.V.A. Variables and Scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

2 Test Materials and Use 8

2.1 Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.2 Hardware . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.3 Sample Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.4 Professional Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.5 Test Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.6 Overview of Test Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.7 Visual T.O.V.A. Test Intructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.8 Administration of Practice Test for the Visual T.O.V.A. . . . . . . . . . . . . . . . . . . . . 11
2.9 Administering a Practice Test After the First Test . . . . . . . . . . . . . . . . . . . . . . . . 12
2.10 Administering the T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.11 Instructions for Administering Auditory T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . 12
2.12 Auditory T.O.V.A. Test Intructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.12.1 Administration of Practice Test for the Auditory T.O.V.A. Test . . . . . . . . . . . . 13
2.13 Administering a Practice Test After the First Test . . . . . . . . . . . . . . . . . . . . . . . . 13
2.14 Administering the Auditory T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

3 Accurate, Precise Timing 15

4 Normative Data 16
4.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
4.2 Normative Data for the Visual T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
4.2.1 For child subjects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
4.2.2 For adult subjects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.2.3 Normative Data for Test Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4.3 Normative Data for Auditory T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.3.1 For child subjects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.3.2 For adult subjects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4.3.3 Normative Data for Test Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

5 Reliability 21
5.1 Internal Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
5.1.1 Condition 1 (Stimulus Infrequent) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
5.1.2 Condition 2 (Stimulus Frequent) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
5.1.3 Standard Errors of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
5.1.4 Internal Consistency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
5.1.5 Test/Retest Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
5.2 Reliability Data for the Auditory T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . . . . . 27
5.2.1 Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
5.2.2 Condition 1 (Stimulus Infrequent) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
5.2.3 Condition 2 (Stimulus Frequent) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
5.2.4 Standard Errors of Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

6 Validity 34
6.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
6.2 Validity Data for the T.O.V.A. (visual) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
6.3 Validity Data for the Auditory T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . . . . . . 49
6.4 Construct Validity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

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T.O.V.A. 8.0 Professional Manual CONTENTS

6.5 Discriminant Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

6.5.1 Culturally Based Data and Special Population Data . . . . . . . . . . . . . . . . . . 52
6.5.2 Special Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

7 Interpretation 59
7.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
7.2 Determination for Valid Test Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
7.3 Analyzing Test Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
7.4 Scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
7.5 Interpretation Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

8 References 62

9 Appendices 65
9.1 Appendix A: Sample T.O.V.A. 8.0 Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
9.2 Appendix B: Sample T.O.V.A. 7.3 Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
9.3 Appendix C: Sample Legacy T.O.V.A. 7.0 Protocol . . . . . . . . . . . . . . . . . . . . . . . 82
9.4 Appendix D: T.O.V.A. 7.x Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
9.5 Appendix E: Mac version 1.3 Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
9.6 Appendix F: Visual Norms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
9.7 Appendix G: Auditory Norms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
9.8 Appendix H: T.O.V.A. Observer Behavior Rating Form . . . . . . . . . . . . . . . . . . . . . 113
9.9 Appendix I: Pearson Product Coefficients, Visual . . . . . . . . . . . . . . . . . . . . . . . . 115
9.10 Appendix J: Pearson Product Coefficients, Auditory . . . . . . . . . . . . . . . . . . . . . . . 120

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List of Tables
1 Test Stimuli Breakdown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2 Age and Gender Distribution by Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3 Age and Gender Distribution of Adult Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
4 Age and Gender Distribution by Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
5 Age and Gender Distribution of Adult Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
6 Within Condition 1 Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
7 Within Condition 1 Omission Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . . . 21
8 Within Condition 1 Commission Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . 21
9 Within Condition 1 Response Time Reliability Coefficients . . . . . . . . . . . . . . . . . . . 22
10 Within Condition 1 Response Time Variability Reliability Coefficients . . . . . . . . . . . . . 22
11 Within Condition 1 D Prime Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . . . 23
12 Within Condition 2 Omission Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . . . 23
13 Within Condition 2 Commission Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . 24
14 Within Condition 2 Response Time (RT) Reliability Coefficients . . . . . . . . . . . . . . . . 24
15 Within Condition 2 Response Time Variability Reliability Coefficients . . . . . . . . . . . . . 25
16 Within Condition 2 D Prime Reliability Coefficients . . . . . . . . . . . . . . . . . . . . . . . 25
17 Table of Weighted Standard Deviation and SEm for Variable Over Condition . . . . . . . . . 26
18 Summary Statistics (Means and Standard Deviations[SD]) for Errors of Omission(OMM),
Errors of Commission (COM), Response Time (RT) and Response Time Variability (RTV) at
Baseline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
19 Internal Consistency (Q1 vs. Q2 and Q3 vs. Q4) Correlations for Errors of Omission, Errors
of Commission, Response Time, and Response Time Variability . . . . . . . . . . . . . . . . 27
20 Total Number of Correct Target Responses (errors of omission and commission) internal con-
sistency correlations for T.O.V.A. at Visit 3 (16 weeks [average] into study) . . . . . . . . . . 28
21 Test-Retest Reliability For Raw Scores Across Visits 1, 2 and 3 . . . . . . . . . . . . . . . . . 28
22 Bland-Altman Procedure to Determine Test-Retest Reliability . . . . . . . . . . . . . . . . . . 29
23 Scores for the 90-Minute Interval (N = 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
24 Scores For The 1-Week Interval (N = 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
25 Within Condition 1 Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . . . . . . . . 30
26 Within Condition 1 Omission Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . . . 31
27 Within Condition 1 Commission Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . 31
28 Within Condition 1 Response Time (ms) Reliability Coefficients(Auditory) . . . . . . . . . . 31
29 Within Condition 1 RT Variability Reliability Coefficients(Auditory) . . . . . . . . . . . . . . 31
30 Within Condition 1 D Prime Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . . . 32
31 Within Condition 2 Omission Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . . . 32
32 Within Condition 2 Commission Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . 32
33 Within Condition 2 Response Time (ms) Reliability Coefficients(Auditory) . . . . . . . . . . 32
34 Within Condition 2 RT Variability Reliability Coefficients(Auditory) . . . . . . . . . . . . . . 33
35 Within Condition 2 D Prime Reliability Coefficients(Auditory) . . . . . . . . . . . . . . . . . 33
36 Table of Weighted Standard Deviation and SEm for Variable Over Condition(Auditory) . . . 33
37 Mean z scores on the T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
38 T.O.V.A. Mean Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
39 Comparison of Classification Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
40 Caffeine Effects in Children* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
41 Visual Factor Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
42 Classification Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
43 Correlation Data Between WISC-III and T.O.V.A. . . . . . . . . . . . . . . . . . . . . . . . . 48
44 Correlation Coefficients Between T.O.V.A. Scores and WAIS-R . . . . . . . . . . . . . . . . . 48
45 Table of Raw Score Means for Normal Condition (NC) and Fake Bad (FB) Instructions . . . 49
46 Auditory Factor Data for the Auditory T.O.V.A. Test . . . . . . . . . . . . . . . . . . . . . . 50
47 Comparison of the Visual and Auditory T.O.V.A. Tests(Adjusted Mean plus/minus 1 SD)* . 50

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T.O.V.A. 8.0 Professional Manual LIST OF TABLES

48 Correlation Coefficients Between Seashore Rhythm Test (SRT) and Auditory T.O.V.A. Omis-
sion Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
49 Means & Standard Deviations by Diagnostic Group . . . . . . . . . . . . . . . . . . . . . . . 52
50 Classification Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
51 T.O.V.A. Results in ADHD and control group . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
52 Means (and Standard Deviations) for T.O.V.A. across Hearing Status Groups . . . . . . . . . 54
53 Comparison of T.O.V.A. Performance between Gifted and Non-gifted with Age and Gender
Controlled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
54 Partial Correlations between IQ and T.O.V.A. Performances with Age and Gender Controlled 55
55 Table of Means for Normal and Fake Bad Instructions . . . . . . . . . . . . . . . . . . . . . . 57
56 Univariate Test of Mean Differences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
57 T.O.V.A. 7.x Calculations: per quarter, half and total . . . . . . . . . . . . . . . . . . . . . . 90
58 Mac v1.3 Calculations: per quarter, half and total . . . . . . . . . . . . . . . . . . . . . . . . 91
59 Norms Summary (See end of this section for reference key.) . . . . . . . . . . . . . . . . . . . 92
60 Norms - Summary, continued (See end of this section for reference key.) . . . . . . . . . . . . 93
61 Visual Norms - Omissions (%)(See end of this section for reference key.) . . . . . . . . . . . . 94
62 Visual Norms - Omissions (%), continued(See end of this section for reference key.) . . . . . . 95
63 Visual Norms - Commissions (%)(See end of this section for reference key.) . . . . . . . . . . 96
64 Visual Norms - Commissions (%), continued. (See end of this section for reference key.) . . . 97
65 Visual Norms - Response Times (ms) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
66 Visual Norms - Response Times (ms), continued . . . . . . . . . . . . . . . . . . . . . . . . . 99
67 Visual Norms - Variability (ms) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
68 Visual Norms - Variability (ms), continued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
69 Visual Norms - D Prime (Perceptual Sensitivity) . . . . . . . . . . . . . . . . . . . . . . . . . 102
70 Visual Norms - D Prime (Perceptual Sensitivity), continued . . . . . . . . . . . . . . . . . . . 103
71 REFERENCE KEY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
72 Auditory Norms - Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
73 Auditory Norms - Omissions (%)(See end of this section for reference key.) . . . . . . . . . . 107
74 Auditory Norms - Commissions (%)(See end of this section for reference key.) . . . . . . . . . 108
75 Auditory Norms - Response Time (ms) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
76 Auditory Norms - Variability (ms) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
77 Auditory Norms - D Prime (Perceptual Sensitivity) . . . . . . . . . . . . . . . . . . . . . . . . 111
78 REFERENCE KEY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
79 Pearson Product Coefficients - Visual - All Variables . . . . . . . . . . . . . . . . . . . . . . . 115
80 Pearson Product Coefficients - Visual - All Variables, continued . . . . . . . . . . . . . . . . . 116
81 Pearson Product Coefficients Visual Condition 1 . . . . . . . . . . . . . . . . . . . . . . . . . 117
82 Pearson Product Coefficients Visual Condition 2 . . . . . . . . . . . . . . . . . . . . . . . . . 118
83 Pearson Product Coefficients - Auditory All Variables . . . . . . . . . . . . . . . . . . . . . . 120
84 Pearson Product Coefficients - Auditory All Variables, continued . . . . . . . . . . . . . . . . 121
85 Auditory Correlation Coefficients Condition 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
86 Auditory Correlation Coefficients Condition 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

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T.O.V.A. 8.0 Professional Manual 1 INTRODUCTION TO THE T.O.V.A.

1 Introduction to the T.O.V.A.

1.1 The History of the T.O.V.A.

The continuous performance test (CPT) is a paradigm first introduced by Rosvold, Mirsky, Sarason, Bran-
some & Beck in the mid-50’s. Their CPT was a visual, language based, sequential A-X task in which the
subject was asked to make a button press whenever they saw an “A” followed by “X” in a stream of char-
acters presented one at a time. Since then, many CPTs have been created primarily for use in research
projects, and a few have been made available commercially for researchers, schools, and clinicians.

The T.O.V.A. (Test of Variables of Attention) began life as a large rack of electronics controlling a tachis-
toscopic shutter and slide projector. This apparatus (nicknamed “Herman” by one of the children in an
early study) was used in our earliest clinical research in 1966, focused on was then called “the Hyperki-
netic Reaction of Childhood” (McMahon, Deem & Greenberg, 1970). This double blind, placebo controlled
study examined the effects of three classes of medications (a psychostimulant, a tranquilizer, and a minor
tranquilizer), and was one of the first to utilize a CPT as an outcome measure in research involving children.

This early CPT introduced some key features found in the T.O.V.A. The stimuli were non-alphanumeric,
non-sequential, and randomly (but infrequently) presented. Even with an accuracy of only ±100 millisec-
onds (±ms), this early CPT showed the efficacy of a psychostimulant (dextroamphetamine) compared to
a tranquilizer (chlorpromazine) in the treatment of hyperkinetic children. It is noteworthy that the class-
room behavior rating scale used (the Conners’ Parent-Teacher Questionnaire) was not useful in showing
medication effects. This study also demonstrated the importance of measuring symptoms of inattention
and hyperactivity separately, underscoring the need to develop appropriate tools to measure each set of
symptoms.

Shortly after the release of the Apple II microcomputer in the late 70’s, the current T.O.V.A. paradigm
(infrequent followed by frequent stimulus conditions) and the electronic T.O.V.A. microswitch were devel-
oped. The new set-up was initially named the “MCA” (for“Minnesota Computer Assessment”). However, a
potential copyright conflict was identified, and the MCA was renamed the “Test of Variables of Attention”
or “T.O.V.A.” During the 80’s, the T.O.V.A. underwent wide-scale norming and was used in a number of
clinical trials.

The DOS/PC version, programmed in the early 80’s, continued the innovative use of two stimulus-frequency
conditions and included tallies of anticipatory responses and commission errors as measures of validity. In
those days, the data were sent directly to Lawrence Greenberg, MD for hand scoring and interpretation.
The Macintosh version, programmed in the early 90’s, and later DOS/PC versions were self-scoring, using
an elaborate algorithm based on data from of some 10,000 clinical cases and numerous studies.

A distribution company, Universal Attention Disorders, Inc, was formed in 1990 with the hiring of full-time
technical and clinical support services and the formation T.O.V.A. Research Foundation.

In the early 1990s, the T.O.V.A. incorporated a second version, the auditory T.O.V.A. (formerly called the
T.O.V.A.-A.). The T.O.V.A. continued to be upgraded with improved user friendliness, development of the
School and Home Intervention Reports, expansion of the normative base to year-by-year, gender-based norms
for children, and the addition of signal detection indices for comparison to an identified-ADHD sample.

Since 2000, the T.O.V.A. has continued to progress. The company changed its name in 2006 to The TOVA
Company, and in 2007 released the T.O.V.A. 7.3. With the release of the T.O.V.A. 8 in 2011, the T.O.V.A.
takes a quantum leap forward. Testing became more accurate with the new T.O.V.A. 8 hardware, “Inter-
ventions” became “Strategies”, and the report now includes the Symptom Exaggeration Index, Attention
Performance Index, and Ex-Gaussian distribution parameters. The External A/V test was introduced, which
allows testing in your OS without rebooting, using the T.O.V.A. USB device to maintain accurate timing.

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The current T.O.V.A. tests measure many more components of auditory and visual information processing
than do earlier CPTs. These tests are laboratory-grade tools that provide precise, direct, and objective
assessment of attention and self-regulation. While many clinicians rely on behavior rating scales, rater
bias and inexperience are frequent contaminants of such measures. The T.O.V.A. test provides a tool to
objectively measure critical aspects of attention, which is a vital part of any broad assessment of attention
and concentration skills.

1.2 The T.O.V.A. Test

The Tests of Variables of Attention (T.O.V.A.) are individually administered computerized tests developed
to assess attention and impulse control in normal and clinical populations. They are commonly used in
conjunction with other clinical tools or diagnostic tests in neuropsychological or psychological evaluations.
The T.O.V.A. was developed to measure attention and impulse control processes in four areas: response
time variability, response time, impulse control (commission errors), and inattention (omission errors).

The visual T.O.V.A.’s stimuli are two easily discriminated geometric figures centered on the computer
screen. A sample of the visual target and nontarget stimuli appears in Figure 1. The stimuli are squares;
some widescreen LCD panel displays may distort the images into the form of rectangles. If this occurs,
we recommend that the display resolution be modified in the computer’s system control panel, or that an
external monitor be used to display the stimuli.

Figure 1: T.O.V.A. Stimuli: Target and Nontarget

The visual T.O.V.A. was normed using stimuli under the following conditions:

• A 12-inch (diagonally measured) monitor

• A stimulus size of roughly 3 inches (measured diagonally)
• An eye-to-monitor distance of roughly 24 - 36 inches, preferably closer to the latter

• Presentation of the stimuli at roughly eye level to the subject

These are the recommended conditions; however, monitor size, monitor resolution and distance from the
subject’s eyes may vary. For a typical distance from a typical display (sized 15 to 17 inches) it is recommended
that the stimuli be sized to about three inches, measured diagonally. Because it may not be always possible

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to achieve this with precision, an acceptable range is around 15% - 30% of the monitor’s size (measured
diagonally), depending on the subject’s distance to the monitor and the size of the screen (the greater the
distance, the larger the desired stimulus). Target size is important for the following reasons:

• Stimuli that are too small (or too far away) can be visually fatiguing. Since the T.O.V.A. is a test of
attention, not visual acuity, the subject must be able to readily discerning the target and nontarget
stimuli for results to be valid.
• Stimuli that are too large (or too close) require large eye sweeps to discern targets from nontargets.
Eye sweeping can slow response time and be visually fatiguing. The subject should be able to see
the complete stimuli and screen all at once, without having to sweep their eyes to discern the tar-
get/nontarget.

Most computer configurations are well within these parameters. However, some screens may not have the
capability to adjust the T.O.V.A.’s screen resolution to an appropriate size. To address situations such as
this, the T.O.V.A. software has built-in scale adjustment settings. See ‘Stimuli settings’ in the T.O.V.A.
8 User’s Manual for details.

It is recommended that, if possible, the user select an option that most closely approximates the three inches
diagonal measurement or 25%-of-screen rule.

Stimuli for the auditory T.O.V.A. test are two easily discriminated audible tones: the target is G above
middle C and the nontarget is middle C, played though external speakers connected to the computer.

In both versions of the T.O.V.A., a stimulus is presented for 100 ms at 2000 ms intervals. The target
stimulus is presented in 22.5% (n = 72) of the trials during the first half of the test (stimulus infrequent
condition) and 77.5% (n = 252) of the trials during the second half (stimulus frequent condition). The
subject is instructed to respond to the target as quickly as possible. The varying target-nontarget ratio
allows for the examination of the effects of differing response demands on response time variability, response
time, inattention and impulsivity.

Specifically, quarters 1 and 2, representing the first half or stimulus infrequent condition, have 36 targets
out of 162 stimuli per quarter (ratio of 1:3.5). Quarters 3 and 4, representing the second half or stimulus
frequent condition, have 126 targets out of 162 stimuli per quarter (ratio of 3.5:1; see Table 1). The targets
are presented in a fixed random sequence. The first half scores refer to the subject’s performance across
quarters 1 and 2 combined, and the second half refers to the combined scores for quarters 3 and 4. The total
score reflects subject’s performance over the entire test. The total test time is 21.6 minutes, which equates
to 10.8 minutes per condition or half, and 5.4 minutes for each of the four quarters.

Table 1: Test Stimuli Breakdown

Quarter Half Total
1 2 3 4 1 2
# Targets 36 36 126 126 72 252 324
# Nontargets 126 126 36 36 252 72 324

The T.O.V.A. software automatically records the subject’s responses, nonresponses, and reaction times and
then calculates raw scores, standard scores, and percentages. The T.O.V.A. Report provides standard scores
for each variable by quarters, halves, and totals, and provides printable reports displaying the subject’s
results in narrative and graphic forms.

In addition to the primary attention variables, secondary indices provide information about the subject’s
performance in several ways: (a) anticipatory responses, (b) multiple responses, (c) post-commission response
time and response time variability, (d) d’ (d-prime), or discriminability, and (e) beta, or response style. A

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discriminate function measure comparing the current subject’s performance to a known-ADHD group, the
Attention Performance Index, is also provided.

1.2.1 T.O.V.A. Variables and Scoring

The following section provides explanatory information on each variable along with the formulas used to
calculate the scores.

Response Time Variability is a measure of the variability in the subject’s reaction time for accurate
responses; that is, the consistency of their speed of responding. The Response Time Variability score is
based on the standard deviation of the mean correct response times.

The Response Time Variability formula is:

Σ( Response Times - Mean Correct Response Time)2

Response Time Variability =
# Correct Responses

Response Time is the average time it takes the subject to respond correctly to a target. Specifically, it is
the amount of time from when a target is presented to when the microswitch is pressed by the subject. The
Response Time score is the average of correct response times, in which the sum of all correct response times
is divided by the number of correct target “hits” and is reported by quarter, half, and total.

The Response Time formula is:

Σ Correct Response Times

Response Time =
# Targets

Errors of Commission occur when the subject fails to inhibit responding and incorrectly responds to a
nontarget, that is, the subject presses the button after a nontarget is presented. The commission score is
calculated as the number of incorrect responses to nontargets (false positives), divided by the number of
nontargets presented minus the number of anticipatory responses made to nontarget stimuli. Commission
errors are considered a measure of impulsivity or behavioral disinhibition.

The formula used to calculate the commission percentage is as follows:

# Commissions
Errors of Commission (or Impulsivity/Disinhibition)= × 100
# Nontargets − # Nontarget Anticipatory Responses

Errors of Omission occur when the subject does not respond to the designated target; that is, the subject
fails to press the T.O.V.A. microswitch button when a target is presented. Omission scores are calculated
as the number of incorrect non-responses to targets (false negatives), divided by the number of targets
presented minus the number of anticipatory responses to targets. Omission errors are considered a measure
of inattention.

The formula used to calculate the omission percentage is as follows:

# Omissions
Errors of Omission (or Inattention) = × 100
# Targets - # Target Anticipatory Responses

The d’ (D Prime) score is a response discriminability score reflecting the ratio of hits to “false alarms”.
The measure is derived from Signal Detection Theory and has been shown to help distinguish non-impaired

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individuals from those diagnosed with attention disorders (Mussgay & Hertwig (1990). The score reflects
the accuracy of target (signal) and nontarget (noise) discrimination and can be interpreted as a measure of
“perceptual sensitivity.” The calculation of D Prime is complex, and is detailed below.

Calculating D Prime (d’)

1. Obtain the Omission and Commission percentage from the quarter, half, or total for which you wish
to calculate D Prime (these can be found in the Results Table).
2. Calculate the Hit Rate and the False Alarm Rate:
Omission Percentage
Hit Rate = 1 −
100

Commission Percentage
False Alarm Rate =
100

• If the Hit Rate is exactly 0, then set the Hit Rate equal to 0.00001
• If the Hit Rate is exactly 1, then set the Hit Rate equal to 0.99999
• If the False Alarm Rate is exactly 0, then set the False Alarm Rate equal to 0.00001
• If the False Alarm Rate is exactly 1, then set the False Alarm Rate equal to 0.99999

3. Calculate the probabilities (called pHit Rate and pFalse Alarm Rate):
pHit Rate = 1 − (Hit Rate)

pFalse Alarm Rate = 1 − (False Alarm Rate)

• If the pHit Rate > 0.5, then subtract the pHit Rate from 1 - i.e., the new pHit Rate = 1 - (old
pHit Rate)
• If the pFalse Alarm Rate > 0.5, then subtract the pFalse Alarm Rate from 1 - i.e., the new pFalse
Alarm Rate = 1 - (old pFalse Alarm Rate)

4. Calculate the Z scores (called zHit Rate and zFalse Alarm Rate):
If you have access to a spreadsheet or statistical program:

• zHit Rate = InverseDistributionFunction(pHit Rate)

• zFalse Alarm Rate = InverseDistributionFunction(pFalse Alarm Rate)
• Skip directly to Part 5

Otherwise (Ref 1),

s
1
Let T = ln
pHit Rate2

2.515517 + 0.802853 × T + 0.010328 × T 2

zHit Rate = T −
1 + 1.432788 × T + 0.189269 × T 2 + 0.001308 × T 3

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s
1
Let T = ln
pFalse Alarm Rate2

2.515517 + 0.802853 × T + 0.010328 × T 2

zFalse Alarm Rate = T −
1 + 1.432788 × T + 0.189269 × T 2 + 0.001308 × T 3

• If the pHit Rate was ≤ 0.5 , multiply the zHit Rate by -1

• If the pFalse Alarm Rate was ≤ 0.5, multiply the zFalse Alarm Rate by -1

5. Calculate D Prime:
D Prime = zFalse Alarm Rate - zHit Rate

(Ref 1: Approximation to the Inverse Normal Distribution Function. The Handbook of Mathematical Functions, Abramowitz
and Stegun, Section 26.2.23)

The Attention Performance Index (API) is a comparison of the subject’s T.O.V.A. performance to an
identified ADHD sample’s performance. The score tells how similar the performance is to the ADHD profile.

The formula used to derive the ADHD score is as follows:

ADHD Score = Response Time Z score (Half 1) + D’ Z score (Half 2) + Variability Z score (Total)

Post-Commission Response Time is the measure of time (in milliseconds) that the subject took to
respond to a target immediately after a commission had been recorded.

The formula used to derive the Post-Commission Response Time is as follows:

Σ Post Commission Response Times

Post Commission Response Time =
# Post Commission Responses

Anticipatory Responses are recorded when the subject presses the microswitch within 150 ms of stimulus
onset (target or nontarget) and represents the subject making a “guess” that the stimulus will be a target—
in effect, a response after the stimulus was presented, but before the subject could have fully perceived
and distinguished the stimulus (known whether the stimulus actually was a target or nontarget). These
responses are not included in calculations of the omission error, commission error, response time or response
time variability scores. The Anticipatory Response score is used as a test validity measure, since such
responses detract from both the number of correct responses possible (impacting the omission score) and
from the number of commission responses possible. The number of anticipatory responses is recorded for each
quarter, half and total. Note that, because subjects who make frequent commission errors tend to respond
more often overall, excessive Anticipatory Responses generally result in fewer omission errors, increased
commission errors, shortened response time, and increased variability., and trails in which anticipatory
responses occur therefore removed from calculation of other scores.

The formula used to calculate the Anticipatory percentage is as follows:

# Anticipatory Responses
Anticipatory = × 100
# Total Stimuli

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Multiple Responses occur when a subject presses the microswitch more than once per stimulus presentation.
The Multiple Responses score reflects the number of stimuli in the given period for which there were multiple
button presses. Multiple Responses differ from Anticipatory Responses in that multiple responses do not
detract from any other variable.

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T.O.V.A. 8.0 Professional Manual 2 TEST MATERIALS AND USE

2 Test Materials and Use

2.1 Software

The T.O.V.A. software is installed on the computer’s hard drive and requires Windows XP (32-bit, SP2 or
above), Vista, or 7, or Mac OS X 10.6.2 or higher. Test administration is performed in the T.O.V.A. Precision
Test Environment (PTE) or in the T.O.V.A. USB device itself during External Audio/Video (EAV) testing,
since modern operating systems are not appropriate for tasks requiring precise and consistent timing. These
testing methods allow consistent and reliable timing down to ±1 ms.

2.2 Hardware

The T.O.V.A. hardware includes the T.O.V.A. USB device and the T.O.V.A. microswitch—containing a
built-in photodiode for display calibration, and the cables required to connect the device to the PC for either
PTE or EAV testing. Use of the T.O.V.A. microswitch removes the timing and ergonomic variability that are
present with the range and variety of input devices that used in typical Windows computer configurations.

The T.O.V.A. runs on most modern PCs. The test is administered via the computer’s display (visual test)
and speakers (auditory test).

• x86 or x86-64 processor running at 1 GHz or better

• 512 MB of memory available

• Minimum of 100 MB hard drive space (enough for the T.O.V.A. with about 250 sessions)
• USB port (on the PC, not via an external hub)
• Screen size must be 10 inches or more.

• PTE testing requires a VESA video mode of 1024 x 768 x 16-bit.

• On Mac systems, PTE testing also requires a CD-ROM drive
• External A/V testing requires an external display (with a standard VGA connection) and external
speakers.

2.3 Sample Populations

The T.O.V.A. has been normed on children and adults, ages 4 to 80+ years. All norms are stratified by age
and gender. Ages are calculated by rounding to the nearest birthday within six months.

The 4- and 5-year-old normative samples for the Visual T.O.V.A. test were gathered using a shorter version,
consisting of the infrequent stimulus condition from quarter 1 and the frequent stimulus condition from
quarter 3.

The full 21.6-minute Visual test was normed on children and adults 6 to 80+ years of age. Adult normative
data are provided in decade groupings (i.e., 30 - 39 years). The Auditory T.O.V.A. test was normed on
children 6 to 19 years.

See section 4 on page 16 for Visual and Auditory normative data.

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2.4 Professional Requirements

The tester must meet the requirements of the state in which the user practices. These requirements vary by
state. It is recommended that the tester investigate laws and professional board guidelines appropriate to
their state.

2.5 Test Administration

Subjects must be able to use the microswitch to respond to the test. The tester must ensure that subjects
are sufficiently able to use the microswitch prior to administering the test.

As with other assessment tools, it is important for the subject and the tester to have developed sufficient
interpersonal rapport prior to test administration. The monitor on which the test is being operated should
be directly in front of the subject, at a comfortable position, easily seen by the subject.

Lighting must not produce glare on the monitor. Seating and environment must be comfortable and appro-
priate for the approximate half-hour testing session.

Outside or environmental distractions, such as intercoms, telephones, and the like should be avoided during
test administration. Headphones should not be used, because the auditory test was normed only with
external stereo speakers. If headphones are used, test results must be interpreted cautiously.

The T.O.V.A. was normed with test administrations occurring between 6 a.m. and 1 p.m., to avoid possible
diurnal variations. If more than one test was administered, the T.O.V.A. was the first test administered.
Note that test order effects have not been studied systematically.

The recommended testing procedure for repeated T.O.V.A. testing in the same day is that there be at least 1
1/2 hours between the start of the first test and the start of the second, to minimize the effects of fatigue. If
there is less than one hour between tests, the second test should be considered invalid, and it is recommend
that the test be repeated on a different day.

Note that normative data was obtained with an observer present in the room at all times during the T.O.V.A.
Even though the observer (test administrator) was not interactive during the testing, the observer was phys-
ically present. We recommend that the tester maintain physical presence throughout testing. If behavioral
cues are needed to assist the subject in staying on task, please make note of the cues and frequency to add
to the behavioral information during the testing session.

Prompting is permitted during the practice test, but not during the actual testing (unless absolutely nec-
essary). This was the format used for the normative study. Some younger subjects may require some
encouragement to continue the task, however interaction should be as minimal as possible.

Please note interactions and frequencies to add to the behavioral information obtained during the testing
session. A “T.O.V.A. Observer Behavior Rating Form” is provided in the appendix (section 9.8 on page
113).

The tester should be familiar with the administration instructions prior to the use of the test. To properly use
the interpreted T.O.V.A. test profile, the tester should be thoroughly familiar with the test scores and their
meaning. Knowledge of attention processes, impulse control, cognitive processes, childhood development,
medical disorders, psychiatric disorders and neuropsychological functioning is essential to the utilization of
the test data.

The T.O.V.A. test does not use language-based stimuli. Since the tests are not language-dependent, instruc-
tions may be given in the subject’s native language.

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2.6 Overview of Test Administration

Figure 2: T.O.V.A. Stimuli: Target and Nontarget

The Visual T.O.V.A. is a visual CPT. Subjects are presented with visual targets and nontargets (See Fig-
ure 2). The subjects are instructed to press the microswitch as quickly as possible after seeing the target
stimulus. They are instructed to not press the switch (i.e., do nothing) when they see the nontarget. The
targets and nontargets are presented in two target-frequency conditions, stimulus infrequent and stimulus
frequent. The stimulus infrequent condition is presented in quarters 1 and 2, and is comprised of 36 targets
and 126 nontargets per quarter. The stimulus frequent condition is presented in quarters 3 and 4, and is
comprised of 126 targets and 36 nontargets per quarter. The duration of the test is 21.6 minutes. Testing is
usually scheduled as a half-hour session. Since the visual T.O.V.A. is a visual continuous performance test,
use of the test with visually impaired subjects is not advised.

The Auditory T.O.V.A. test is an auditory CPT. Subjects are presented with auditory targets and nontargets.
The auditory target sound is G above middle C, and the nontarget sound is middle C. Like the visual test,
two stimulus conditions are employed, stimulus infrequent and stimulus frequent. Subjects are instructed
to press the microswitch as quickly as possible after they hear the target stimulus. They are instructed
to not press the switch (i.e., do nothing) when they hear the nontarget. As with the visual T.O.V.A., the
infrequent stimulus condition is defined by 36 targets and 126 nontargets per quarter in quarters 1 and 2.
The frequent stimulus condition is defined by 126 targets, 36 nontargets per quarter in quarters, 3 and 4.
The test is 21.6 minutes in length. Testing is usually scheduled as a half hour session. Since the test is an
auditory continuous performance test, use of the test with hearing-impaired subjects is not advised.

We recommend that the computer and monitor be turned on with the T.O.V.A. “booted up” and tested
prior to the subject entering the test room. The examiner must enter the necessary demographic information
needed to run the test (See the T.O.V.A. Clinical Manual for additional assistance).

2.7 Visual T.O.V.A. Test Intructions

The T.O.V.A. 8 includes ’Test Instructions’, a multimedia presentation with audio of the instructions,
illustrated by photos and a short sample of the Visual test. When selected, the instructions play from start
to finish automatically. However, if the tester believes the pace of the instructions is too fast or slow for
the subject, the test can be paused and stepped through manually. The test instruction audio can also be
turned off, and the tester may instead read or paraphrase the instructions aloud.

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The Visual test instructions, should you intend to read them, are as follows:

Welcome to the Visual T.O.V.A. Test. Hold the button in your writing hand with your thumb
resting lightly on top of the button, like this. (The image demonstrates the correct way to hold
the microswitch.) When you press the button, let up as soon as you hear the click (The sound
of the button clicking is played); you don’t have to hold it down. Press the button when you’re
ready to continue. (The instructions wait for the microswitch button to be pressed.)
This test measures your ability to pay attention. Two different squares will flash on the screen.
One square has a small black square near the top... (The target stimulus is presented.) ...and
the other has the small square near the bottom. (The non-target stimulus is presented.)
The squares will flash on the screen, like this: (Three trials of the Visual T.O.V.A. test are
presented.)
Press the button as fast as you can every time you see a square with the small square near the
top... (The target stimulus is presented again.) ...and don’t press the button when the small
square is near the bottom. (The non-target stimulus is presented again.)
Once again, press the button only when you see the small square near the top. Don’t guess which
square will flash; make sure you see it before you press the button. Try to balance speed and
accuracy: press the button as fast as you can, but also try not to make any mistakes. If you do
make a mistake, don’t worry: anyone can make a mistake on this test.
Let’s review: Press the button as fast as you can, but only when you see the small square near
the top. When you press the button, only press it once and don’t hold it down. Just ”click” the
button. Finally, don’t go too fast or try to guess; take enough time to see which square it is.

2.8 Administration of Practice Test for the Visual T.O.V.A.

The T.O.V.A. offers a practice test to insure that the subject understands the testing conditions and in-
structions. Note that, since the three-minute practice test was administered before the Visual and Auditory
T.O.V.A. norming data were obtained, it is recommended that it be administered before testing a subject for
the first time. A quick verification of the practice summary data also ensures that the program is operating
correctly before the subject starts a full session.

Before the practice test, a brief set of multimedia instructions will play:

You are about to take a short practice test. After a countdown, the squares will begin to flash.
Remember, be as fast and accurate as you can. Press the button when you’re ready to begin.

Pressing the microswitch button will start the practice test.

The practice test lasts 3 minutes. Observe to be sure the subject is doing it correctly and give prompts freely
early in the practice test. Instruct again if necessary. Rerun practice if necessary until subject understands.

Check the practice test results to ensure the proper response recording and confirm that the subject under-
stands the task. If errors are excessive, repeat the practice test with special instructions and/or reinforcement
that the subject is to attempt to be both fast AND accurate.

Keep notes of observations of distractibility, attentiveness, mood, compliance, activity level, style of perfor-
mance, medications and dosages taken in last 12 hours, etc. A form is provided in the Appendices. These
observations provide behavioral information to go with the data provided in the T.O.V.A. report.

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2.9 Administering a Practice Test After the First Test

In subsequent tests with the same subject, you may run partial practice tests to remind the subject of the
task and to reinforce the goals of speed AND accuracy. However, always look at the summary scores of the
practice test to ensure the test is recording correctly before continuing to the full test. The recommended
testing procedure for sequential T.O.V.A. testing in the same day is that there be at least 1 1/2 hours
between tests to minimize the effects of fatigue.

2.10 Administering the T.O.V.A.

Before the T.O.V.A. test begins, a brief set of multimedia instructions will play:

You are about to take the T.O.V.A. test, which will take about 20 minutes. You might notice
that your eyes get a little tired. Even so, try and do the best job you can. Remember to press the
button as quickly as you can, but only when the small square is near the top. Press the button
when you’re ready to begin.

When the subject presses the microswitch button, the test will start.

Observe and record if the subject is on task, and how the subject is reacting to the test. Do not prompt
unless absolutely necessary; i.e., only if results will be invalid without prompting. Note if prompting was
necessary. A behavioral observation form is provided in the appendix (section 9.8 on page 113).

Observe for multiple responses to stimuli. This can be done by paying attention to the sound of the mi-
croswitch. While the test automatically records multiple responses, observation of the phenomenon for
clinical correlation is advised.

When testing is completed the data will be saved to the T.O.V.A. USB device.

2.11 Instructions for Administering Auditory T.O.V.A. Test

2.12 Auditory T.O.V.A. Test Intructions

The Auditory test instructions are very similar to the Visual above. Again, you may simply play the
instructions as they are, or you may turn off the instruction audio or step through them at a better pace for
the subject.

Welcome to the Auditory T.O.V.A. Test. Hold the button in your writing hand with your thumb
resting lightly on top of the button, like this. (The image demonstrates the correct way to hold
the microswitch.) When you press the button, let up as soon as you hear the click (The sound
of the button clicking is played); you don’t have to hold it down. Press the button when you’re
ready to continue. (The instructions wait for the microswitch button to be pressed.)
This test measures your ability to pay attention. Two different tones will play on the speakers.
One tone is a high note, like this: (The target stimulus plays.) ...and the other is a low note, like
this: (The non-target stimulus plays.) The tones will play every few seconds, like this: (Three
trials of the Auditory T.O.V.A. test are presented.)
Press the button as fast as you can every time you see hear the high note... (The target stimulus
plays again.) ...and don’t press the button when you hear the low note. (The non-target stimulus
plays again.)

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Once again, press the button only when you hear the high note. Don’t guess which tone will
play; make sure you hear it before you press the button. Try to balance speed and accuracy:
press the button as fast as you can, but also try not to make any mistakes. If you do make a
mistake, don’t worry: anyone can make a mistake on this test.
Let’s review: Press the button as fast as you can, but only when you hear the high tone. When
you press the button, only press it once and don’t hold it down. Just ”click” the button. Finally,
don’t go too fast or try to guess; take enough time to decide which tone it is.

2.12.1 Administration of Practice Test for the Auditory T.O.V.A. Test

Like the Visual T.O.V.A., the Auditory T.O.V.A. offers a practice tests to insure that the subject understands
the testing conditions and instructions. The subject is to be fast AND accurate so as not to sacrifice speed
for accuracy or vice versa.

Since a practice test (3 minutes) was administered before the Visual and Auditory T.O.V.A. tests. norming
data were obtained, it is recommended that it be administered before testing a subject for the first time. A
quick verification of the practice summary data also ensures that the program is operating correctly before
the subject starts a full session.

Before the practice test, a brief set of multimedia instructions will play:

You are about to take a short practice test. After a countdown, the tones will begin to play.
Remember, be as fast and accurate as you can. Press the button when you’re ready to begin.

Pressing the microswitch button will start the practice test.

The practice test lasts 3 minutes. Observe to be sure the subject is doing it correctly and use prompts freely
early in the practice test. Instruct again if necessary. Rerun practice if necessary until subject demonstrates
an understanding of the test instructions. If you wish, you can check practice results. If errors are excessive,
repeat practice after discussing the instructions with the subject.

Record your observations of distractibility, attentiveness, mood, compliance, activity level, style of perfor-
mance, medications and dosages taken in previous 12-24 hours, etc. A form for this purpose is provided
in the appendices. These observations provide behavioral information to go with the data provided in the
TOVA report.

2.13 Administering a Practice Test After the First Test

In subsequent tests with the same subject, you may run partial practice tests to remind the subject of the
task and to reinforce the goals of speed AND accuracy. However, always look at the summary scores of the
practice test to ensure the test is recording correctly before continuing to the full test. The recommended
testing procedure for sequential T.O.V.A. testing in the same day is that there be at least 1 1/2 hours
between tests to minimize the effects of fatigue.

2.14 Administering the Auditory T.O.V.A. Test

Before the T.O.V.A. test begins, a brief set of multimedia instructions will play:

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T.O.V.A. 8.0 Professional Manual 2 TEST MATERIALS AND USE

You are about to take the T.O.V.A. test, which will take about 20 minutes. You might notice
that you get a little tired. Even so, try and do the best job you can. Remember to press the
button as quickly as you can, but only when hear the high tone. Press the button when you’re
ready to begin.

When the subject presses the microswitch button, the test will start.

Observe and record if the subject is on task, and how the subject is reacting to the test. Do not prompt
unless absolutely necessary; i.e., only if results will be invalid without prompting. Record if prompted. A
behavioral observation form is provided in the Appendices.

Observe for multiple responses to stimuli. This can be done by paying attention to the sound of the mi-
croswitch. While the test automatically records multiple responses, observation of the phenomenon for
clinical correlation is advised.

When testing is completed the data will be saved to the T.O.V.A. USB device.

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T.O.V.A. 8.0 Professional Manual 3 ACCURATE, PRECISE TIMING

3 Accurate, Precise Timing

Accurate measurement of the subject’s response speed and variability of response speed is crucial for a
CPT to be useful. On any compatible computer system, T.O.V.A. timing errors are controlled to within
±1 millisecond (ms), an unparalleled level of precision for these key parameters. This precision is attained
through a number of technical innovations.

The first of these is the T.O.V.A. microswitch, a standard, precision input device. The inconsistent rate at
which polling of standard input devices occurs means that no mouse or keyboard can be used for testing
with any accuracy.

The second challenge to be overcome were the timing issues presented by complex, multitasking operating
systems. Because of the variable number of background tasks, no CPT program running in a modern OS
(Windows/Mac/Linux) can deliver timing precision.

Earlier versions of the T.O.V.A. 7 took advantage of Windows 95 and 98’s ability to reboot to DOS, where the
T.O.V.A. test could run uninterrupted. The T.O.V.A. 7.3 used a similar method of circumventing Windows,
rebooting to a “Precision Test Environment” (PTE) for testing and then returning, automatically, to your
operating system. The T.O.V.A. 8 brings a new PTE, this time based on a real-time flavor of Linux.

The T.O.V.A. 8 also introduces a second testing method. Instead of circumventing the operating system,
The TOVA Company developed a USB device that could circumvent the PC entirely. The user’s monitor
and speakers plug into the T.O.V.A. USB device, thus creating an independent testing system that, during
testing, relies on the PC only for power. Because this requires an external monitor and speakers (for auditory
testing), we call it External Audio/Video (EAV) testing.

In addition to other hardware and software delays, we discovered one more timing issue: monitor refresh
rates. Older CRT monitors had consistent refresh rates, but modern LCD displays do not. LCDs very widely
from one another, and sometimes do not behave consistently at all.

To maintain timing accuracy, we need to compensate for this variability, and we do this through display
calibration. Our T.O.V.A. 8 microswitch is equipped with a photodiode that, during calibration, measures
the refresh rate of your display, whether it be a separate CRT or LCD display or the screen built into your
laptop. Since we then know, with ±1 millisecond precision, how quickly the image will appear on the screen,
we can record subjects’ response times accurately. If the display simply cannot be calibrated, we know that
the refresh rate is too variable, and we should not use that screen for testing.

None of these technologies are available in any other commercially available CPT.

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T.O.V.A. 8.0 Professional Manual 4 NORMATIVE DATA

4 Normative Data

4.1 Overview

This chapter presents the information concerning the normative data. The chapter is divided into normative
information for each test, visual and auditory. The actual normative data are found in the Appendices. The
data are given in table format across variables, stratified by age and gender.

4.2 Normative Data for the Visual T.O.V.A.

4.2.1 For child subjects

The subjects in the original normative data (Greenberg & Waldman, 1993) came from randomly selected
classrooms in grades 1, 3, 5, 7 and 9. The schools were suburban public schools in or near Minneapolis,
Minnesota. The ages of the children in this sample ranged from 6 to 16 years (see Table 2) and were
primarily Caucasian (99%, 1% other). Subjects were excluded if they met any of the following criteria: a
deviant classroom behavior rating defined by a score of greater than 2 standard deviations below average on
the Conners Parent-Teacher Questionnaire, Abbreviated form; current use of psychoactive medication; or if
they were receiving Special Education services. All testing was done in the mornings to control for possible
diurnal effects.

Table 2: Age and Gender Distribution by Sample

Group Original Sample Additional Sample Total Sample

Age 4 - 5
Males NA 36 36
Females NA 36 36
Age 6 - 7
Males 99 0 99
Females 100 1 101
Age 8 - 9
Males 90 0 90
Females 99 0 99
Age 10 - 11
Males 90 0 90
Females 82 0 82
Age 12 - 13
Males 53 51 104
Females 59 59 118
Age 14 - 15
Males 41 74 115
Females 56 50 106
Age 16 - 17
Males NA 40 40
Females NA 47 47
Age 18 - 19
Males NA 57 57
Females NA 120 120

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Table 3: Age and Gender Distribution of Adult Sample

Group Sample Size

Age 20 -29
Male 19
Female 30
Age 30 - 39
Male 4
Female 22
Age 40 -49
Male 14
Female 19
Age 50 - 59
Male 8
Female 16
Age 60 - 69
Male 12
Female 24
Age 70 - 79
Male 12
Female 39
Age 80+
Male 8
Female 23

Additional normative data was later collected from 571 subjects. This sample consisted of 73 children, ages
4 to 5, and 498 subjects, ages 12 to 19 years (Greenberg & Crosby, 1992; also shown in Table 2). This
sample consisted of children from an early-education screening project, public grade schools (in randomly
selected classrooms), and a public high school. The early-education and grade-school children were from
suburban public schools. The high school was located in a rural Minnesota community, and those subjects
were primarily Caucasian (99%, 1% other). Exclusion rules were the same as those described above for the
original normative sample. The 4 and 5 year old subjects were administered a shorter version of T.O.V.A.,
consisting of only one quarter for each condition (stimulus infrequent and stimulus frequent), quarters #1
and #3. All testing was done in the mornings to control for possible diurnal effects.

4.2.2 For adult subjects

The original T.O.V.A. adult normative sample consisted of 250 subjects, age 20 and older. The sample
consisted primarily of persons of Caucasian ethnicity (99%, 1% other), and it was comprised of undergrad-
uate students enrolled in three Minnesota liberal arts colleges and persons residing in nearby communities.
Subjects were excluded from the study based upon current use of psychoactive medication, history of CNS
disorder, or history of CNS injury (see Table 3 for demographic information of sample).

4.2.3 Normative Data for Test Variables

Greenberg & Waldman (1993) noted mean score differences for gender across age-groups for percentage of
omission errors, percentage of commission errors, and mean response time. Males showed a higher percentage
of omission errors than females (F (1,771) = 13.42, p < .001). Males also displayed more commission errors
than females (F (1,771) = 65.61, p < .001). The curvilinear decrease with age in percentage of commission

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T.O.V.A. 8.0 Professional Manual 4 NORMATIVE DATA

errors differed significantly between the two halves. The interactions of both linear (F (1,771) = 15.80, p <
.001) and quadratic (F (1,771) = 27.48, p < .001) components of age with test half were significant. While
the decrease in commission errors with age in the first half was flat with linear and curvilinear components
virtually absent, in the second half the curvilinear decrease was much more dramatic. In addition, the
significant differences for males to have more commission errors than females was greater in the second than
the first half (F (1,771) = 57.45, p < .001).

Females showed a slower mean Response Time (F (1,771) = 21.18) p < .001), especially in younger ages,
and a steeper linear decrease with age than males (slope = -.35 for females and -.29 for males; F (1,770) =
9.70, p < .001). Response time variability decreased curvilinearly with age (F (1,771) = 174.41, p < .001
for the linear trend); (F (1,771) = 84.75, p < .001 for the quadratic trend). Response time variability was
greater (F (1,771) = 68.74, p < .001), and the age decrease was steeper and more curvilinear (F (1,771) =
31.53, p < .001 for the linear trend); (F(1,771) = 18.67, p < .001 for the quadratic trend), in the second half
than in the first half (Greenberg & Waldman, 1993). Effects on response time variability also differed by
quarter. Response time variability was greater (F (1,773) = 82.96, p < .001), and the linear decrease with
age was steeper (slope = .33) for quarters 2 and 4 and -.28 for quarters 1 and 3; (F (1, 773) = 32.90, p <
.001 for the linear trend), in quarters 2 and 4 than in quarters 1 and 3. No gender differences were found
for response time variability (Greenberg & Waldman, 1993).

The means and standard deviations for percentage of omission errors, percentage of commission errors,
response time, response time variability, and d prime across age groups by gender are provided in Appendices
C and D. These tables represent the pool of the original sample, N = 775, (Greenberg & Waldman, 1993) and
additional sample, N = 821, (Greenberg & Crosby, 1992A) for a total sample size of 1596 for ages ranging
from 4 to 80 years (1346 children, 250 adults).

4.3 Normative Data for Auditory T.O.V.A.

4.3.1 For child subjects

The subjects for the normative sample (N = 2551) were recruited from elementary and high schools in three
metropolitan Minneapolis suburban public schools and were predominately Caucasian (99%, 1% other). Age
and gender distribution are shown in Table 4. Subjects were excluded from the sample if they met any of
the following: a deviant classroom behavior rating defined by a score of greater than 2 standard deviations
above the mean on the Conners Parent-Teacher Questionnaire, Abbreviated form; current use of psychoactive
medication; or receiving Special Education services. Ages of the sample ranged from 6 - 19 years. As with
the visual T.O.V.A., all testing was done in the mornings to minimize diurnal effects.

It is important to note that the auditory stimulus version of the test has been normed on children aged 6 -
19 years. Our preliminary testing of the auditory version with 4 and 5 years olds indicated that this auditory
task was too difficult for the children at this age, even when using the shorter (i.e., quarters 1 and 3 only)
version.

4.3.2 For adult subjects

Limited additional normative data is available for the adult sample in Table 5. Testing adult subjects is
to be considered experimental for the auditory version. The normative study will be made available upon
completion.

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Table 4: Age and Gender Distribution by Sample

Group Total Sample Group Total Sample

Age 6 Age 13
Males 85 Males 98
Females 90 Females 91
Age 7 Age 14
Males 92 Males 100
Females 82 Females 101
Age 8 Age 15
Males 97 Males 98
Females 108 Females 90
Age 9 Age 16
Males 104 Males 94
Females 100 Females 87
Age 10 Age 17
Males 106 Males 99
Females 107 Females 107
Age 11 Age 18
Males 96 Males 101
Females 104 Females 101
Age 12 Age 19
Males 87 Males 22
Females 94 Females 10

Table 5: Age and Gender Distribution of Adult Sample

Group Sample Size

Age 20 +
Male 54
Female 75

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4.3.3 Normative Data for Test Variables

To maintain consistency between visual and auditory tests, two-year age groups were used (i.e., 6 to 7, 8 to
9, etc.). Age and gender differences for each variable were examined.

Similar to the visual stimulus test, significant main effects were found for age for all six performance indices.
Further testing indicated that for commission, response time, and response time variability, all three contrasts
were significant: quarter 1 vs. quarter 2 (p < .01 for commissions, p < .001 for response time and response
time variability); quarter 3 vs. quarter 4 (p < .001 for all three variables); and quarter 1 and 2 vs. quarters
3 and 4 (p < .001 all three variables). A different set of contrasts was found to be significant for omission
errors: quarter 1 vs. quarter 2: quarters 1 and 2 vs. quarters 3 and 4 (p < .001 for both contrasts). For
d’ (d prime), the following two comparisons were significant: quarters 3 vs. quarter 4; quarters 1 and 2 vs.
quarters 3 and 4 (p < .001). Significant age effects were observed for omissions, commissions, response time,
response time variability (p < .001 for each).

Results of analysis for effects of gender found that males had: (1) significantly higher commission errors (p
< .001); and (2) shorter response times [i.e., lower mean response time scores] (p < .001). No main effects
for gender were noted for omissions, response time variability and d prime.

Gender by quarter interactions were noted for commissions (p < .001), response time (p < .001), response
time variability (p < .01) and d prime (p < .01).

The means and standard deviations for percent of omission errors, percent of commission errors, response
time, response time variability and d’ across age groups by gender are provided in the Appendices.

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T.O.V.A. 8.0 Professional Manual 5 RELIABILITY

5 Reliability

5.1 Internal Reliability

Internal Reliability Chronbach alpha, split half and Kuder-Richardson reliability coefficients, traditionally
reported as measures of a test’s consistency, are not appropriate for timed tasks such as the T.O.V.A.
(Anastasi, 1988). To calculate reliability coefficients for the test, Pearson product coefficients (r ) were
computed for all variables across both conditions. Pearson correlation coefficients (r ) were computed for all
variables across the two conditions, as shown in Tables 6 - 16. As can be seen in the tables, the two time
epochs represent consistent measures within each condition.

Table 6: Within Condition 1 Reliability Coefficients

Variable Q1 : Q2 Q3 : Q4
Omission .72 .70
Commission .79 .82
Response Time (ms) .93 .93
RT Variability (ms) .70 .86
D Prime .52 .72

5.1.1 Condition 1 (Stimulus Infrequent)

The reliability coefficients for the stimulus infrequent condition (quarters 1 and 2) support that the variables
are consistent within each variable over the condition, yet distinct between each variable.

Table 7: Within Condition 1 Omission Reliability Coefficients

Condition 1 Omission Reliability

Q1 : Q2 .72
Q1 : H1 .92
Q1 : Total .79
Q2 : H1 .93
Q2 : Total .85
H1 : Total .88

Table 8: Within Condition 1 Commission Reliability Coefficients

Condition 1 Commission Reliability

Q1 : Q2 .79
Q1 : H1 .95
Q1 : Total .88
Q2 : H1 .93
Q2 : Total .80
H1 : Total .71

Between-variable coefficients support the contention that the variables capture different components of vari-
ance. The relationship between percentage of omission and percentage of commission coefficients, while

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Table 9: Within Condition 1 Response Time Reliability Coefficients

Condition 1 Response Time (ms) Reliability

Q1 : Q2 .93
Q1 : H1 .98
Q1 : Total .90
Q2 : H1 .98
Q2 : Total .91
H1 : Total .89

Table 10: Within Condition 1 Response Time Variability Reliability Coefficients

Condition 1 Response Time (ms) Variability Reliability

Q1 : Q2 .70
Q1 : H1 .89
Q1 : Total .80
Q2 : H1 .94
Q2 : Total .84
H1 : Total .92

statistically significant (p < .01), are not generally robust. The relationship between percentage of omissions
to the other variables fails to demonstrate a robust level of commonness.

Percentage of commissions to response time comparisons failed to find statistical significance for all vari-
able relationships (see Table ?? in the Appendices). Those that did find statistical significance were not
robust with ranges from .05 to .12. Commission to response time variability relationships, while statistically
significant (p < .001), supported a limited relationship between the two variables.

Response time and response time variability relationships were statistically significant (p < .001), and the
data supported the relationship between the two variables, as one would predict. For the two variables, the
within-quarter relationships are generally stronger than the between-quarter relationships.

5.1.2 Condition 2 (Stimulus Frequent)

Condition 2 data followed that of condition 1. Within-variable coefficients were generally stronger than those
between variables.

The coefficient for percentage of commission errors between quarters 3 and 4, r = .82, indicates a consistent
relationship.

Between-variable reliability coefficients followed suit with those of condition 1. The between-variable coeffi-
cients are not as robust as the within-variable ones. Again, the variables across the condition are measuring a
small degree of commonness. The exception is where one would expect, between response time and response
time variability. These two variables showed the expected closeness of task measure with coefficients ranging
from .70, response time quarter 3 to variability quarter 4, to .80, response time total to variability half 2.

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Table 11: Within Condition 1 D Prime Reliability Coefficients

Condition 1 D Prime Reliability

Q1 : Q2 .52
Q1 : H1 .81
Q1 : Total .56
Q2 : H1 .82
Q2 : Total .55
H1 : Total .72

Table 12: Within Condition 2 Omission Reliability Coefficients

Condition 2 Omission Reliability

Q3 : Q4 .70
Q4 : H2 .92
Q3 : Total .79
Q4 : H2 .93
Q4 : Total .85
H2 : Total .88

5.1.3 Standard Errors of Measurement

Standard errors of measurement (SEM ) were calculated for the standard scores based upon the above relia-
bility coefficients. A pooled (weighted average) standard deviation was calculated to determine the quarter-
to-quarter combined standard deviation. This pooled (weighted average) standard deviation was used in the
calculation of the SEM for each variable. Only those comparisons which would logically be made for the
test data were calculated. SEM for within condition within variable comparison were calculated; between
condition were not calculated due to the nature of the test. Table 17, below, provides the pooled (weighted
average) standard deviation and SEM .

5.1.4 Internal Consistency

Llorente, Voigt, Jensen, Fraley, Heird & Rennie (2008) re-examined the internal consistency of the T.O.V.A.
within an increased sample size of 63 ADHD children. The ages of the children ranged from 6 to 12. The
study participants were strictly diagnosed to meet the DSM-IV diagnostic criteria or ADHD. Llorente, et
al. used a diagnostic rule insisting that each participant in the study had to meet at least 5 out of the 6
diagnostic criteria for the Inattention criteria dealing with inattention within the DSM-IV ADHD criterion.
A no medication baseline T.O.V.A. was given to all children and the baseline test data was used to determine
the internal consistency of the T.O.V.A.

Table 18 provides the mean raw error totals and raw time in milliseconds for each quarter. Table 19
provides the internal consistency coefficients (Pearson product-moment correlation coefficients). The number
of subjects found within the table differs from the total number of participants in that some subject data
was invalid, per the study’s authors.

The Llorente, et al. (2008) study reports robust internal consistency for the T.O.V.A. The coefficients
were slightly less than we report with this manual, however, the sampling for each study differed. Our
reported internal consistencies (see above) were based on the normative data taken from healthy sample

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Table 13: Within Condition 2 Commission Reliability Coefficients

Condition 2 Commission Reliability

Q3 : Q4 .82
Q3 : H2 .94
Q3 : Total .90
Q4 : H2 .96
Q4 : Total .89
H2 : Total .93

Table 14: Within Condition 2 Response Time (RT) Reliability Coefficients

Condition 2 RT (ms) Reliability

Q3 : Q4 .93
Q3 : H2 .98
Q3 : Total .98
Q4: H2 .98
Q4 : Total .97
H2 : Total .99

(i.e., non-ADHD) children. The Llorente et al. coefficients are based on children strictly diagnosed as
ADHD. The authors note that the use of a strictly homogeneous cohort base most likely had a negative
effect on the magnitude of the correlations observed. Nonetheless, the range of the internal consistency
coefficients reported is robust. The data support the internal consistency of the TOVA within normative
and ADHD clinical samples.

5.1.5 Test/Retest Reliability

In addition to examining internal consistency of the T.O.V.A., Llorente, Amado, Voigt, Berretta, Fraley,
Jensen & Heird (2001) evaluated temporal stability and reproducibility of individual test scores. The study
utilized 49 strictly diagnosed Attention Deficit Hyperactive Disorder (ADHD) children. The mean age of
the cohorts was 9.5 years with a standard deviation of 1.5 years. Age range of the participants was from 6
to 12 years. The children were evaluated three times over four months.

Pearson product moment correlations (rxy ) were calculated across three time intervals for errors of omission,
errors of commission, response time and response time variability. The coefficients are in Table 21. The
coefficients indicate moderate test-retest correlation across several test periods. While the coefficients may
be moderate, they are not unexpected in that the participants were children diagnosed with ADHD, rather
than normal controls. Variability is expected within the ADHD group scores with less variability expected
in normal control groups. To understand this further, the study authors then examined the repeatability of
individual test scores within this same ADHD sample.

Llorente et al. (2001) used a Bland-Altman procedure to determine the limits of score agreement between the
individual scores of each scale (omission, commission, response time and response time variability) between
each of the visits (V1 -V2 , V1 -V3 , and V2 -V3 ). Differences between the test scores from each of the two visits
were used to evaluate the limits of agreement.

The data from the Bland-Altman procedure are provided in Table 22. The result of their analysis does
indicate that the errors scores (omission and commission) had increased differences between test administra-

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Table 15: Within Condition 2 Response Time Variability Reliability Coefficients

Condition 2 RT Variability Reliability

Q3 : Q4 .87
Q3 : H2 .95
Q3 : Total .95
Q4 : H2 .97
Q4 : Total .96
H2 : Total .99

Table 16: Within Condition 2 D Prime Reliability Coefficients

Condition 2 RT Variability Reliability

Q3 : Q4 .87
Q3 : H2 .95
Q3 : Total .95
Q4 : H2 .97
Q4 : Total .96
H2 : Total .99

tions. The response time and response time variability scores displayed less bias associated with increased
differences, thus exhibiting greater reproducibility of individual scores. Llorente et al. conclude that the
analysis yielded less agreement than observed for the entire sample (test-retest reliability coefficients). The
variability found within the reproducibility analysis is most likely due to the nature of variability of atten-
tion and concentration found in ADHD itself. The authors also add that the T.O.V.A. test scores should
be interpreted in context of a subject’s history, neuropsychological test profile as well as neurobehavioral
characteristics. This position is consistent with that proposed in the first edition of this manual.

To further understand the test-retest reliability Leark, Wallace & Fitzgerald (2004) investigated the matter
using two different time intervals: 90 minutes and 1 week. The two intervals were selected for several reasons.
Greenberg, Kindschi, Dupuy & Corman (1996) had recommended using the T.O.V.A. to monitor medication.
The second time frame was chosen as it reflected what may occur in a typical clinical setting.

Study 1: 90-minute Test-Retest Interval

31 children, ages ranging from 6 through 14.2 years (overall M = 10.00 years, SD = 2.66 years) were
administered the T.O.V.A. and then underwent a second administration at 90-minutes. Participants for the
study were excluded if there was any history of central nervous system impairment, loss of consciousness,
psychiatric disorder, or use of prescribed medication or over-the-counter medication affecting attention.

A two-tailed Pearson product moment correlation was utilized to determine the relationship between first
and second administrations. The analysis yielded significant positive correlations overall T.O.V.A. scores
(Table 23).

The correlation coefficients were then used to calculate the standard error of measurement (SEM ) for each
T.O.V.A. score. The SEM values are also located in Table 23.

To determine if there were practice effects, a series of paired Student t-tests were conducted over each of
the four scores. Statistically significant mean score differences were found for the commission and response
time scores. The commission scores were about 12 points higher on the second administration. The response
time scores were slightly lower for the second administration. Each of the commission scores were within

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Table 17: Table of Weighted Standard Deviation and SEm for Variable Over Condition

Variable Q1: Q 2 Q3: Q 4

SD SEM SD SEM
Omission 5.34 2.80 5.16 2.72
Commission 2.71 1.25 16.44 8.66
Response Time (ms) 109.11 29.23 104.35 54.99
Variability 38.75 21.33 62.34 32.85
D Prime 1.37 1.20 1.73 0.91

Table 18: Summary Statistics (Means and Standard Deviations[SD]) for Errors of Omission(OMM), Errors
of Commission (COM), Response Time (RT) and Response Time Variability (RTV) at Baseline

OMM COM RT RTV

Mean (SD) Mean (SD) Mean (SD) Mean (SD)
Q1 2.3 (3.7) 3.9 (6.8) 579.6 (126) 165. (64.4)
Q2 4.4 (6.2) 4.1 (7.1) 638.2 (174.3) 170. (65.6)
Q3 14.9 (24.9) 8.7 (5.5) 533. (144) 204.5 (83.8)
Q4 18.7 (28.7) 10.3 (6.1) 547.3 (175.5) 236. (112)
From: Llorente, A.M., Voight, R, Jensen, C.L., Fraley, J.K., Heird, W.C. & Rennie, K.M. (2008). The Test of Variables of Attention (TOVA): Internal
Consistency (Q1 vs. Q2 and Q3 vs. Q4)) in Children with Attention Deficit/Hyperactivity Disorder (ADHD). Child Neuropsychology, 14. 314-322.

the normal limits range but do reflect actual differences obtained. The differences obtained on the response
time are slight (about 4 points) yet reached statistical significance. The significant difference noted on the
response time score is most likely related to the group variance within the second administration itself, as the
SD is larger. Nonetheless, test users are encouraged to use caution when using the T.O.V.A. in 90-minute
test intervals often reported in clinical settings.

The data indicate satisfactory test-retest reliability for the 90-minute interval. The use of at least one SEM
difference is highly recommended when comparing T.O.V.A. test scores for medication purposes. This will
help account for test score fluctuations that may reflect random error rather than medication change. The
use of at least two SEM scores will provide even a more stable predictor of test scores when using the
medication titration method.

Study 2: 1-week interval

For this study 33 children (20 males, 13 females) were administered the T.O.V.A. at one week intervals
(+ 2 days). The ages of the sample ranged from 6 to 14.5 years (M = 10.10 years, SD = 2.59). The
grade range was from first through eighth grade (M = 4.33 grade level, SD = 2.5). The participants had
to have normal or corrected vision, as well as the time for the testing session. The testing was conducted
at the child’s school (Southern California private and public schools). Participants for the study were
excluded if there was any history of central nervous system impairment, loss of consciousness, psychiatric
disorder, or use of prescribed medication or over-the-counter medication affecting attention. All tests were
administered following standardized procedures. Each participant was administered the T.O.V.A. once then
re-administered the test approximately seven days later at the same time of the day as the first administration.

A two-tailed Pearson product moment correlation was utilized to determine the relationship between the test
variables over the two time intervals. The results of the analysis indicate positive and significant correlations
between the two administrations across all four of the T.O.V.A. scores (Table 24). As with the 90-minute
interval study, the correlations were then used to determine the standard error of measurement (SEM ) for
each of the scores.

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Table 19: Internal Consistency (Q1 vs. Q2 and Q3 vs. Q4) Correlations for Errors of Omission, Errors of
Commission, Response Time, and Response Time Variability

Errors of Omission n=57

Q1 Q2 Q3 Q4
Q1 1.00
Q2 .74 1.00
Q3 .52 .69 1.00
Q4 .55 .70 .94 1.00

Errors of Commission n=58

Q1 Q2 Q3 Q4
Q1 1.00
Q2 .53 1.00
Q3 .32 .44 1.00
Q4 .12 .22 .76 1.00

Response Time n=58

Q1 Q2 Q3 Q4
Q1 1.00
Q2 .77 1.00
Q3 .63 .80 1.00
Q4 .55 .71 .69 1.00

Response Time Variability

Q1 Q2 Q3 Q4
Q1 1.00
Q2 .55 1.00
Q3 .55 .60 1.00
Q4 .49 .63 .58 1.00
From: Llorente, A.M., Voight, R, Jensen, C.L., Fraley, J.K., Heird, W.C. & Rennie, K.M. (2008). The Test of Variables of Attention (TOVA): Internal
Consistency(Q1 vs. Q2 and Q3 vs. Q4)) in Children with Attention Deficit/Hyperactivity Disorder (ADHD). Child Neuropsychology, 14. 314-322.

Practice effects were also examined using the same paired Student t-test method. As with the 90-minute
interval study, statistically significant mean score differences were found for the commission mean scores.
Similar to the 90-minute interval study, the commission score increased by about a 12 point margin. Non-
significant mean score differences were found for the three remaining scores. Response time mean scores did
not differ significantly as was found for the 90-minute interval.

The data from the study does indicate that the T.O.V.A. has highly stable test-retest reliability at one-week
intervals with the healthy school aged children. The data from the Leark, Wallace & Fitzgerald study reflect
more stable measures of reliability over the shorter time intervals. This finding is not unusual as Anastasi &
Urbina (1997) have reported that test-retest coefficients are typically more stable over shorter time periods
than those reported within the Llorente et al. study.

5.2 Reliability Data for the Auditory T.O.V.A. Test

5.2.1 Reliability

Like the visual version, the auditory version is a timed test. This makes traditional reliability coefficients,
such as Chronbach alpha or split half, inappropriate (Anastasi, 1988). To calculate reliability coefficients for

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Table 20: Total Number of Correct Target Responses (errors of omission and commission) internal consistency
correlations for T.O.V.A. at Visit 3 (16 weeks [average] into study)

Test segment (n) (rxy )

Half 1 vs. Half 2 49 0.93**
Half 1 vs. Total 49 0.96**
Half 2 vs. Total 49 0.99**
** significant at .001 (two-tailed test)
From: Llorente, A. M., Amado, A.J., Voigt, R.G., Berretta, M.C., Fraley, J.K., Jensen, C.L. & Heird, W.C. (2001). Internal consistency, temporal stability,
and reproducibility of the Test of Variables of Attention in children with attention-deficit hyperactive disorder. Archives of Clinical Neuropsychology, 16,
535-546.

Table 21: Test-Retest Reliability For Raw Scores Across Visits 1, 2 and 3

Visit 1 Visit 2 Visit 3

Errors of Omission
Visit 1 1.00
Visit 2 0.51** 1.00
Visit 3 0.61** 0.58** 1.00
Errors of Commission
Visit 1 1.00
Visit 2 0.71** 1.00
Visit 3 0.58** 0.69** 1.00
Response Time
Visit 1 1.00
Visit 2 0.73** 1.00
Visit 3 0.70** 0.82** 1.00
Response Time Variability
Visit 1 1.00
Visit 2 0.75** 1.00
Visit 3 0.66** 0.72** 1.00
** Significant at the .0.1 level (two-tailed test).
From: Llorente, A. M., Amado, A.J., Voigt, R.G., Berretta, M.C., Fraley, J.K., Jensen, C.L. & Heird, W.C. (2001). Internal consistency, temporal stability,
and reproducibility of the Test of Variables of Attention in children with attention-deficit hyperactive disorder. Archives of Clinical Neuropsychology, 16,
535-546.

the test, Pearson product coefficients (r ) were computed for all variables across both conditions. Tables 25 -
35 provide the Pearson product coefficients (r ) for all variables across the two conditions, stimulus infrequent
(quarters 1 and 2) and stimulus frequent (quarters 3 and 4). Since the table presents a large amount of data,
two additional tables were prepared to divide the information by the two conditions. These additional tables
present within condition correlations. Tables are presented for the stimulus infrequent condition (quarters
1 and 2), and for the stimulus frequent condition (quarters 3 and 4). Complete tables including between
conditions are in the Appendices.

5.2.2 Condition 1 (Stimulus Infrequent)

The Condition 1 percentage of omission errors coefficient value for quarters 1 and 2 was r = .8082. The value
indicates that the test measures percentage of omission errors between the two quarters over the condition
consistently.

The percentage of commission errors coefficient value comparing quarter 1 and 2 was r = .87. Like omission
errors, commission errors across the two quarters for this test condition are measured with consistency.

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Table 22: Bland-Altman Procedure to Determine Test-Retest Reliability

Lower Mean difference Upper

Errors of omission
Visit 1 - Visit 2 -97.3 -1.57 94.2
Visit 1 - Visit 3 -112.5 -13.6 85.2
Visit 2 - Visit 3 -110.6 -12.4 85.8
Errors of commission
Visit 1 - Visit 2 -21.3 5.91 33.1
Visit 1 - Visit 3 -26.1 8.57 43.3
Visit 2 - Visit 3 -23.1 5.17 33.4
Response Time
Visit 1 - Visit 2 -209.2 -27.7 153.8
Visit 1 - Visit 3 -245.4 -43.3 158.7
Visit 2 - Visit 3 -196.1 -24.5 147.2
Response Time Variability Visit 1 - Visit 2 -93.3 3.70 100.7
Visit 1 - Visit 3 -135 -9.04 116.9
Visit 2 - Visit 3 -135.4 -15.6 104.1
Llorente, A. M., Amado, A.J., Voigt, R.G., Berretta, M.C., Fraley, J.K., Jensen, C.L. & Heird, W.C. (2001). Internal consistency, temporal stability, and
reproducibility of the Test of Variables of Attention in children with attention-deficit hyperactive disorder. Archives of Clinical Neuropsychology, 16,
535-546.

Table 23: Scores for the 90-Minute Interval (N = 31)

First Time Second Time

T.O.V.A. Score M SD M SD r SEM
Omission 95.95 15.40 96.95 14.68 .70 8.22
Commission 95.29 14.32 107.12* 11.54 .78 7.03
Response Time 96.66 15.43 92.36* 20.07 .84 6.00
Response Time Variability 99.94 16.43 101.48 20.12 .87 5.41
* p < .05
From: Leark, R. A., Wallace, D.R. & Fitzgerald, R (2004). Test-Retest Reliability and Standard Errors of Measurement for the Test of Variables of
Attention (T.O.V.A.) with healthy school aged children. Assessment, 4, 285-289.

The Response time (mean response time) coefficient comparing quarter 1 and 2 was r = .91. The two
quarters show a high degree of consistency across the two time epochs.

The Response time (RT) Variability coefficient value for quarter 1 and 2 was r = .75. The variability of
mean response time is fairly consistent across the two time epochs over the same condition.

5.2.3 Condition 2 (Stimulus Frequent)

Within condition reliability coefficients for condition 2 found percentage of omission errors between quarters
3 and 4, r = .94. Like condition 1, the two time periods are measuring the same task consistently.

Percentage of commission errors between quarters 3 and 4 to reliability coefficient, r = .83. The two quarters
measure with consistency.

Mean response time for quarters 3 and 4, r = .88. The two time epochs are consistent in their measurement
of mean response time.

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Table 24: Scores For The 1-Week Interval (N = 33)

First Time Second Time

T.O.V.A. Score M SD M SD r SEM
Omission 90.39 21.85 91.42 21.86 .86 5.61
Commission 92.39 19.95 105.88 15.37 .74 7.65
Response Time 94.63 15.55 90.85 21.05 .79 6.87
Response Time Variability 97.70 18.32 98.64 20.94 .87 5.41
* p < .01
From: Leark, R. A., Wallace, D.R. & Fitzgerald, R (2004). Test-Retest Reliability and Standard Errors of Measurement for the Test of Variables of
Attention (T.O.V.A.) with healthy school aged children. Assessment, 4, 285-289.

Table 25: Within Condition 1 Reliability Coefficients(Auditory)

Variable Q 1: Q 2 Q 3: Q 4
Omission .81 .94
Commission .87 .83
Response Time (ms) .91 .88
RT Variability .75 .87
D Prime .63 .74

5.2.4 Standard Errors of Measurement

Standard errors of measurement (SEM ) were calculated for the standard scores based upon the above relia-
bility coefficients. A pooled (weighted average) standard deviation was calculated to determine the quarter
to quarter combined standard deviation. This pooled weighted standard deviation was used in the calcula-
tion of the SEM for each variable. SEM for within condition comparisons were calculated, between condition
were not calculated due to the nature of the test. Only those comparisons which would logically be made
for the test data were calculated. SEM for within condition within variable comparison were calculated.
Between conditions were not calculated due to the nature of the test. Table 36 provides the pooled weighted
standard deviations and SEM for the auditory version data.

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Table 26: Within Condition 1 Omission Reliability Coefficients(Auditory)

Condition 1 Omission Reliability

Q1 : Q2 .81
Q1 : H1 .94
Q1 : Total .73
Q2 : H1 .96
Q2 : Total .79
H1 : Total .99

Table 27: Within Condition 1 Commission Reliability Coefficients(Auditory)

Condition 1 Commission Reliability

Q1 : Q2 .87
Q1 : H1 .96
Q1 : Total .86
Q2 : H1 .97
Q2 : Total .88
H1 : Total .90

Table 28: Within Condition 1 Response Time (ms) Reliability Coefficients(Auditory)

Condition 1 RT Reliability
Q1 : Q2 .91
Q1 : H1 .98
Q1 : Total .85
Q2 : H1 .98
Q2 : Total .88
H1 : Total .88

Table 29: Within Condition 1 RT Variability Reliability Coefficients(Auditory)

Condition 1 RT Variability Reliability

Q1 : Q2 .75
Q1 : H1 .91
Q1 : Total .80
Q2 : H1 .95
Q2 : Total .83
H1 : Total .87

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Table 30: Within Condition 1 D Prime Reliability Coefficients(Auditory)

Condition 1 D Prime Reliability

Q1 : Q2 .63
Q1 : H1 .87
Q1 : Total .67
Q2 : H1 .87
Q2 : Total .68
H1 : Total .75

Table 31: Within Condition 2 Omission Reliability Coefficients(Auditory)

Condition 2 D Prime Reliability

Q3 : Q4 .95
Q3 : H2 .98
Q3 : Total .98
Q4 : H2 .98
Q4 : Total .98
H2 : Total .99

Table 32: Within Condition 2 Commission Reliability Coefficients(Auditory)

Condition 2 Commission Reliability

Q3 : Q4 .83
Q3 : H2 .95
Q3 : Total .78
Q4 : H2 .96
Q4 : Total .71
H2 : Total .77

Table 33: Within Condition 2 Response Time (ms) Reliability Coefficients(Auditory)

Condition 2 RT Reliability
Q3 : Q4 .88
Q3 : H2 .98
Q3 : Total .97
Q4 : H2 .95
Q4 : Total .94
H2 : Total .99

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Table 34: Within Condition 2 RT Variability Reliability Coefficients(Auditory)

Condition 2 RT Variability Reliability

Q3 : Q4 .87
Q3 : H2 .96
Q3 : Total .95
Q4 : H2 .95
Q4 : Total .94
H2 : Total .99

Table 35: Within Condition 2 D Prime Reliability Coefficients(Auditory)

Condition 2 D Prime Reliability

Q3 : Q4 .74
Q3 : H2 .89
Q3 : Total .87
Q4 : H2 .92
Q4 : Total .89
H2 : Total .97

Table 36: Table of Weighted Standard Deviation and SEm for Variable Over Condition(Auditory)

Variable Q1: Q 2 Q3: Q 4

SD SEM SD SEM
Omission 5.34 2.34 5.16 1.31
Commission 2.54 0.93 16.44 6.78
Response Time (ms) 107.11 31.83 104.35 36.30
Variability 85.03 42.62 62.34 22.87
D Prime 1.73 1.05 1.73 0.88

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6 Validity

6.1 Overview

Validity refers to a test’s ability to adequately measure what it purports to measure and how well it does
in measuring it. The T.O.V.A. was designed to measure variables that have been found to be important to
differentiating ADHD subjects from normals.

6.2 Validity Data for the T.O.V.A. (visual)

Criterion validity: Criterion validity refers to the extent to which a measurement corresponds to an accurate
measure of in interest, also known as the criterion. One example of criterion related validity was a study
by Greenberg & Waldman (1993). They investigated ADHD, UADD (Undifferentiated ADD, DSM-III-R),
Conduct Disorder (CD) and non-disordered control (NC) subjects performance on the visual stimulus version
of the test. They analyzed group performance differences across the variables of in five different ways: 1.)
group performance differences; 2.) group performance controlling for gender and age; 3.) group performance
as a function of age; 4.) group performance differences as a function of test condition; and 5.) group
performance differences as a function of test quarter.

On the first analysis, for measures of in attention, they found that the ADHD and ADD groups made more
omission errors (t (896) = 4.10, p ≤ .001) and showed greater response time variability (t (896), p ≤ .001)
than the CD and NC groups. The ADHD group made more omission errors (t (896) = 2.38, p ≤. 018)
and showed greater response time variability (t (896) -3.97, p ≤ .001) than the UADD group No significant
differences were found between CD and NC groups.

Differences between the ADHD and CD groups were found on measures of impulsivity. ADHD subjects made
more commission errors (t (896) = 3.97, p ≤ .001) and more anticipatory errors ( t (896) =3.65, p ≤ .001)
than the UADD and NC groups. The UADD group made more commission errors than the NC (t (896) =
2.51, p ≤ .012). No significant differences were found on the anticipatory response variable. Response Time
differences were noted with the ADHD group having significantly higher mean response times than the NC
(p ≤ .001). The CD had higher mean response times than the NC (p ≤ .019), as well.

When controlling for age and gender, Greenberg and Waldman (1993) found that the ADHD and UADD
groups made more omission errors (t (894) = 3.51, p ≤.001) and showed greater response time variability
(t (894) = 6.07, p ≤ .007) than the CD and NC groups. The ADHD group showed greater response time
variability than the UADD group (t (894) = 2.76, p ≤ .006). The CD group showed greater response
time variability than the NC (t (894) = 4.92, p ≤ .001) but no differences were noted for omission errors.
The group differences for inattention were similar after partialing out the effects of age and gender with
the exception that CD groups showed greater response time variability to NC and only a trend for group
differences was noted for omission errors for the ADHD and UADD groups. When controlling for age and
gender, ADHD and CD groups made more commission errors (t (894) = 3.69, ≤ .001) and anticipatory
errors (t (894), p ≤ .001) than the UADD and NC groups. UADD made more commission errors than the
NC (t (894) = 2.48, ≤ .013), but no differences were found for anticipatory errors. Response time group
differences were found with the CD group having higher mean response times (all p < .001). ADHD and
UADD groups had higher mean response times than the NC (p ≤ .001).

When looking at the function of age, the differences between ADHD and UADD groups and the CD and NC
groups in the number of omission errors varied as a function of age (t (894) = 3.92, p ≤ .001). The differences
were larger in younger than in older children. Differences between ADHD and CD and the UADD and NC
differences for anticipatory errors varied as a function of age (t (894) 1 = 1.97, p ≤ .001). More anticipatory
errors were found in older than younger children. Mean response time differences were not found to very by
age.

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Test condition differences (stimulus infrequent, first half; stimulus frequent, second half) were examined.
After controlling for age and gender, Greenberg and Waldman (1992c) found the indices of attention, impul-
sivity and mean response time different according to the differential response demands of the test. ADHD
and UADD groups’ greater omission errors (t (804) = 2.96, p ≤ .003) and response time variability (t (894)
= 2.90, p = .004) relative to the CD and NC groups was more pronounced during the second half (stimulus
frequent). The difference between the ADHD and UADD groups in the number of omission errors (t (894) =
1.98, p = .048) and the response time variability (t (894) = 2.30, p = 0.22) were also greater in the later half.
None of the patient group differences in commission errors or mean response time difference significantly by
condition.

To further examine effects of condition, group differences were analyzed by quarter, after controlling for
age and gender. ADHD and UADD group differences were found for response time variability (t (894)
= 2.92, p = 004). Greater response time variability was found in the second and forth quarters than in
the first and third quarters. The Greenberg & Waldman (1992c) study concluded that ADHD and UADD
groups were more inattentive, whereas the ADHD and CD groups were more impulsive, consistent with
the DSM-IIIR conceptualization of the disorders. The ADHD group was more impulsive than the UADD
group, and the UADD group was more impulsive than the NC group. Condition differences suggest that the
response demands of the stimulus frequent condition tended to exacerbate inattention in those participants
who already had problems in that domain. Figures 2 to 7 display these group differences.

Figure 3: Group Differences by Total Omissions

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Figure 4: Group Differences in Total Response Time Variability (ms)

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Figure 5: Group Differences in Commission Errors Total Commission Errors (%)

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Figure 6: Groups Differences in Total Anticipatory Errors (%)

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Figure 7: Group Differences in Omission Errors by Half

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Figure 8: Group Differences in Response Time Variability By Half

Forbes (1998) reported that his sample of 117 children with ADHD/ADD differed significantly on omission
errors, response time, response time variability and number of multiple responses [F (5,140) = 5.60, p <.
001) compared to a comparison group. The comparison group was comprised of age-matched children with
oppositional defiant disorder, conduct disorder, adjustment disorders and learning disorders (n = 29). For
this study, Forbes used z scores (standardized scores) in the calculations. Table 37 provides the data from
this study.

Semrud-Clikeman & Wical (1999) evaluated attentional difficulties in children with complex partial seizures
(CPS), children with ADHD, children with combined CPS and ADHD and normal controls. Each received
the T.O.V.A. and those with ADHD also received the T.O.V.A. post medication. The baseline 3 (group)
by 4 (T.O.V.A. scores) ANOVA yielded significant main effects for the T.O.V.A. [F (3, 82) = 6.906, p ≤
.001]. Post-hoc analysis indicated that the CPS/ADHD group performed the lowest (poor performance).
The CPS and ADHD groups also performed poorer than normal control participants across all omission,
commission, response time and response time variability (p ≤ .01). Post medication analysis revealed that
the CPS/ADHD group improved following methylphenidate dosage (from -3.5 standard deviations to -1.5
standard deviations). The ADHD group mean T.O.V.A. scores were reported as normalized (no specific
scores were reported within the article).

The study by Mautner, Thakkar, Kluwe & Leark (2002) also provided support for criterion related validity.
Their study investigated the both the relationship of ADHD among children with neurofibromatosis type I
(nf1) and the treatment of those children. The four groups included those with nf1, nf1 with ADHD, ADHD

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Table 37: Mean z scores on the T.O.V.A.

TOVA ADHD/ADD (n=117) Other (n=29) F(df =1,144)
Score M SD M SD
Omission .74 3.50 .01 .35 7.10*
Commission 1.03 2.34 .28 1.08 2.83
Response Time 1.37 1.29 .41 1.30 12.71**
Response Time Variability 2.58 2.31 .58 .99 20.67**
# Multiple Responses 1895 27.89 4.59 6.38 7.54*
* p <.01 **p < .001
From: Forbes, G.B. (1998). Clinical utility of the Test of Variables of Attention (TOVA) in the diagnosis of
Attention Deficit Hyperactivity Disorder. Journal of Clinical Psychology, 54(4), 461-476.

Table 38: T.O.V.A. Mean Scores

T.O.V.A. Nf1-ADHD Nf1 no ADHD ADHD Normal
Score M SD M SD M SD M SD
Omission 97.10 17.12 104.04 5.96 77343 23.09 104.29 5.47
Commission 68.50 25.19 104.73 8.04 98.21 9.30 104.14 7.98
RT 76.65 20.92 104.54 7.90 79.00 13.69 105.79 8.89
RTV 80.25 20.92 105.08 6.31 73.29 29.87 109.36 11.06
RT = Response Time, RTV = Response Time Variability.
From: Mautner, V.F., Thakkar, S., Kluwe, L. & Leark, R.A. (2002). Treatment of ADHD in
neurofibromatosis type 1. Developmental Medicine & Child Neurology, 44 (3) 164-170.

without nf1, and normal control participants. The T.O.V.A. scores were poorer in the nf1 with ADHD and
ADHD groups than the nf1 no ADHD and normal controls (Table 38).

Sensitivity & Specificity: Sensitivity refers to the test’s ability to correctly identify true ADHD cases, while,
specificity refers to the test’s ability to correctly identify normal individuals. The higher a test’s sensitivity,
the greater the ability to function as a diagnostic or screening tool as it would detect those likely to have
ADHD. The higher the test’s specificity, the less likely it would be for the test to incorrectly classify a normal
as not normal. In other words, a high specificity would decrease false positives. There is a balance between
sensitivity and specificity, when one value increases, the other decreases. The cost of errors in either direction
(missing ADHD cases due to lower sensitivity, or, conversely, over-diagnosing ADHD due to low specificity)
must be carefully weighed.

To study this for the T.O.V.A., Greenberg & Crosby (1992B) examined 73 subjects (62 males, 11 females), all
diagnosed by senior faculty level university psychiatrists or psychologists independent of the study. The sub-
jects were screened for co-existing psychiatric problems such as depression, conduct disorder or oppositional
defiant disorder through the use of history, interview, psychological testing (not including the T.O.V.A.) and
teacher rating scales (CPTQ-A and ACTeRs). Only those with a diagnosis of ADHD alone were included
in the study. The diagnosis was made independent of test performance. The subjects had all been referred
to the Clinic for Attention Deficit Disorders at the University of Minnesota. The subjects’ scores for each
of the five measures were converted to standard scores (z score) based upon normative data for age and
gender. A one-way MANOVA was then used to compare z scores for the ADHD sample to the normative
sample, and univariate tests of significance were also performed. For this study, two alternate approaches
to classification were used, discriminant analysis and equal weighting of standardized scores using summed
standardized scores. For both approaches, a random sample of one-half of the ADHD and the normative
samples were selected. Analysis performed yielded 2 distinct cut-off points to achieve “false positive” rates
of 10% (0.90 specificity) and 20% (0.80 specificity). The identical cutoff points were then applied to the

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remaining sample and sensitivity indices recomputed.

Initial discriminant analysis, with prior probabilities set to sample size, found that anticipatory errors failed
to contribute significantly to the regression equation, due largely to a substantial correlation (r = .55) to
errors of commission. Thus, a subsequent analysis with the four variables (errors of omission, errors of
commission, response time and response time variability) was done. The discriminant analysis of the first
randomly selected sample (384 normals, 36 ADHD) revealed that the four variables were significantly able to
predict group membership (canonical correlation = .56; Wilks’ lambda = .68; p < .001). All four variables
were significantly correlated to the discriminant function with values ranging from .42 (errors of commission)
to .98 (response time variability). The .80 specificity cutoff point for the first sample was .34, and those
scoring above this value were considered target cases. The resulting sensitivity based on this cutoff was .69.
The .90 specificity cutoff point for this sample was .79 with a corresponding sensitivity of .67.

Discriminant function scores were then computed for the remaining sample using the regression weights from
the first analysis. The cutoff points, determined from the first analysis, were applied to this sample. The
.80 specificity (cutoff = .34) produced a sensitivity of .73 and specificity of .73; the .90 specificity ( cutoff =
.79) yielded a sensitivity of .68 and specificity of .85. Figure 8 demonstrates the sensitivity and specificity
analysis graphically.

Figure 9: Sensitivity and Specificity: Discriminant Analysis. From Specificity And Sensitivity Of The Test
Of Variables Of Attention (Greenberg & Crosby, 1992C)

For the second model of classification, equal weighting scores were computed for the first sample (384 normals,
36 AHDH). These was done by summing standardized scores (z ) for each of the four variables. Cutoff points
for 0.80 and 0.90 specificity were determined, yielding cutoff points of 1.94 and 3.42, respectively. A sensitivity
rate of .76 was achieved for the 0.80 cutoff, and, .60 for the 0.90 cutoff.

The second sample equal weighting classification analysis was done using the established cutoff points. The
0.80 specificity cutoff yielded an overall sensitivity of .72 and specificity of .85; the 0.90 specificity yielded
overall sensitivity of .61 and specificity of .94. Figure 9 demonstrates the standardized scores of the sensitivity
and specificity graphically.

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Table 39: Comparison of Classification Methods

1st Sample 2nd Sample

Method Sensitivity Specificity* Sensitivity Specificity
.69 .80 .73 .73
.67 .90 .68 .85
Discriminant Analysis Equal Weighting
.76 .80 .72 .85
.60 .90 .61 .94
*Specificity rates for Sample 1 chosen a priori. Specificity And Sensitivity Of The Test Of Variables Of
Attention (Greenberg & Crosby, 1992C)

Figure 10: Sensitivity and Specificity: Summed Standardized Scores*

*Specificity And Sensitivity Of The Test Of Variables Of Attention (Greenberg & Crosby, 1992C)

Comparison of the two approaches is presented in Table 39. The sensitivity for the initial sample is higher
for the discriminant analysis at the 0.90 specificity level. Somewhat surprisingly, the sensitivity for the equal
weighting approach is higher at the 0.80 specificity level. The findings suggest that both weighted scoring via
discriminant analysis and equal weighting via summed standardized scores produced respectable and similar
levels of sensitivity and specificity.

Greenberg & Crosby (1992C) recommend a cutoff point of 1.94 for nonclincal screening settings (such as
schools or work places). This resulted in a sensitivity of .72 and specificity of .85 (based upon sample two),
yielding a minimum of false positives (28%). Rating scales could further reduce this “false positive” rate.
For clinical settings, a cutoff of 3.42 is recommended. This resulted in sensitivity of .61 and specificity of .94
with a minimal number of “false positives” (6%). The higher rate of false negatives (39%) would be reduced
by clinical history, rating scales and other psychological tests.

A second study, (Greenberg & Crosby, 1992C) examined sensitivity and specificity in 105 children (86 males,
19 females; ages 6 to 15) with carefully diagnosed ADHD (diagnosis made by senior faculty level university
psychiatrists or psychologists independent of the study). These subjects were also reported in the Greenberg
& Crosby (1992A) study. The normative sample was comprised of 954 age similar children (471 males, 483

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females).

The first series of analysis was carried out using Receiver Operator Characteristic (ROC) Analysis (Murphy,
Berwick, Weinstein, Borus, Budman, & Klerman, 1987). ROC analysis can be used to calculate the overall
predictive performances of a score by assessing the score’s diagnostic accuracy (true positives vs false nega-
tives) over a continuum of scores. For this study, the scores for the omission errors, commission errors, mean
response time, response time variability (variability), d prime and beta for first half, second half and total
were converted to z scores (to control for effects of age and gender). Then a ROC analysis was conducted
on each of the three scores for each variable to identify the scores that yielded the highest overall predictive
performance. Next, a ROC analysis was conducted on combinations of “highly predictive” scores. These
combinations represented theoretical elements of attention that are most strongly implicated in ADHD. The
following combination score proved to have superior overall predictive performance: Mean Response Time
(1st half) + D Prime (2nd half) + Variability (total).

Thus, the formula used to calculate the ADHD Score is:

ADHD Score = Response Time z score (half 1) + D’ z score (half 2) + Variability z score (total)

The last step of the procedure involved creating a series of contingency tables so that the sensitivity and
specificity associated with each value of the combination score could be evaluated. Through examination of
the tables, a cutoff score was identified that resulted in the highest overall test performance (equal diagnostic
sensitivity and specificity). The cutoff score that was chosen yielded a sensitivity of .80 (i.e., false negatives
@ 20%) and a specificity of .80 (i.e., false positives @ 20%).

The ROC analysis differs from the discriminant function analysis in that the latter produces prediction
equations with item weights that often vary from sample to sample. The ROC analysis creates an analysis
both theoretically based and yet able to be cross validated across diverse groups of individuals. Thus,
ROC, the more conservative measure, is the more appropriate analysis since CPT norm samples are not
representative of the general population.

Comparison of the two studies (discriminate function and ROC), yields overall discrimination abilities at
minimum of .80 sensitivity and .80 specificity for the test across both analyses.

In another study, Teichner, Ito, Glod, & Barber (1996) examined the movement abnormalities in seated
children with ADHD while engaged in a derivative of the T.O.V.A. Movement patterns of 18 boys with
ADHD (9.3 + 2.4 yrs) and 11 normal controls (8.6 + 1.8 yrs) were recorded using an infrared motion
analysis system that tracked the position of four markers 50 times per second to a resolution of 0.04 mm.
Their results found that boys with ADHD moved their head 2.3 times more often than normal children (p
< .002); moved 3.4 times as far (p <.01); covered a 3.8 fold greater area (p < .001); and had a more linear
and less complex movement pattern (p < .00004). ADHD boys responded more slowly (response time) and
had higher response time variability scores than the controls.

Bernstein, Carroll, Crosy, Perwien, Go, and Benowitz (1994) examined the acute effects of caffeine on learn-
ing, performance and anxiety in normal prepubertal children. 21 children were examined in a double-blind,
placebo-controlled crossover design, studied during four sessions, each 1 week apart, under four conditions:
baseline; placebo; 2.5mg/kg caffeine; and 5.0 mg/kg caffeine. Using randomized order of placebo and two
dosages of caffeine, the children were tested in tests of attention, manual dexterity, short-term memory and
processing speed. The T.O.V.A. was found to be sensitive to caffeine dosage on two of the four test variables.
Table 40 presents this information.

Greenberg & Waldman (1993) investigated ADHD, UADD (Undifferentiated ADD, DSM III-R), CD (Con-
duct Disordered), and nondisordered control (NC) subjects performance on the visual stimulus version of the
test. The researchers analyzed group performance differences across the variables in five different ways: group
performance differences; group performance controlling for gender and age; group performance as function
of age; group performance differences as a function of test condition; and group performance differences as

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Table 40: Caffeine Effects in Children*

Placebo 2.5mg/k Caffeine 5.0 mg/k Caffeine ANOVA Random Regression P
X SD X SD X SD F df Est. Caf
OmisErr 7.9 17.8 4.0 13.5 1.5 3.2 2.86 2,38 .070 - 1.55 .005
ComErr 1.7 2.7 1.3 1.9 1.7 2.9 0.56 2,38 .577 0.02 - .866
RT 498.3 130.7 490.4 93.2 478.3 106.8 0.32 2,38 .726 - 2.67 .619
V-RT 159 61.4 135 52.6 121.2 46.4 8.33 2,38 .001 - 8.48 <.01
* from: Bernstein, Carroll, Crosby, Perwien, Go, & Benowitz (1994). “Caffeine Effects on Learning,
Performance, And Anxiety in Normal Aged School Children”. Journal of the American Academy Child
Adolescent Psychiatry, 33:3, March/April.

a function of test quarter.

On the first analysis, for measures of inattention, they found that the ADHD and ADD groups made more
omission errors (t (896) = 4.10, p < .001), and showed a greater response time variability (t (896) = 594, p
< .001) than the CD and NC groups. The ADHD group made more omission errors (t (896) = 2.38, p <
.018) and showed greater response time variability (t (896) = 3.62, p < .001) than the UADD group. No
significant differences were found between the CD and NC groups.

Differences between the ADHD and CD groups were found on measures of impulsivity. ADHD subjects
made more commission errors (t (896) = 3.97, p < .001) and more anticipatory errors (t (896) = 3 .65, p
< .001) than the UADD and NC groups. The UADD group made more commission errors than the NC (t
(896) = 2.51, p < .012). No significant differences were found on the anticipatory response variable.

Response time differences were noted with the ADHD group having significantly higher mean response times
than the NC (p < .001). The CD had higher mean response times than the NC (p < .018), as well.

When controlling for age and gender, Greenberg and Waldman (1993), again, found that again, the ADHD
and UADD groups made more omission errors (t (894) = 3.51, p < .001) and showed greater response time
variability (t (894) = 6.07, p < .001) than the CD and NC groups. The ADHD showed greater response
time variability than the UADD group (t (894) = 2.76, p < .006). The CD group showed greater response
time variability than the NC (t (894) = 4.92, p < .001) but no differences were noted for omission errors.
The group differences for inattention were similar after partialing out the effects of age and gender with
the exception that CD group showed greater response time variability to NC and only a trend for group
differences was noted for omission errors for the ADHD and UADD groups.

Again, when controlling for age and gender, ADHD and CD groups made more commission errors (t (894) =
3.69, p < .001) and anticipatory errors (t (894) = 3.19, p < .001) than the UADD and NC groups. UADD
made more commission errors than the NC (t (894) = 2.48, p < .013), but no differences were found for
anticipatory errors. Response time group differences were found with the CD group having higher mean
response times (all p < .001). ADHD and UADD groups had higher mean response times than NC (p <
.001).

When looking at the function of age, the differences between ADHD and UADD groups and the CD and NC
groups in the number of omission errors varied as a function of age (t (894) = 3.92, p < .001). The differences
were larger in younger than in older children. Differences between ADHD and CD and the UADD and NC
differences for anticipatory errors varied as a function of age (t (894) = 1.97, p < .001). More anticipatory
errors were found in older than in younger children. Mean response time group differences were not found
to vary by age.

Test condition differences (stimulus infrequent, first half; stimulus frequent, second half) were examined.
After controlling for age and gender, Greenberg & Waldman (1992C), found the indices of attention, impul-
sivity and mean response time differed according to the differential response demands of the test. ADHD

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Table 41: Visual Factor Data

Variable Factor 1 Factor 2 Factor 3 Variable Factor 1 Factor 2 Factor 3 Variable Factor 1 Factor 2 Factor 3
Var. Total .915 RT Q1 .748 Com Q3 -.707
Var Half2 .892 D Half2 -.735 Com Half2 -.699
Var Q4 .869 D Q4 -.719 RT Jhalf2 .664
Var Q3 .860 RT Total .709 RT Q4 .635
Var Half1 .842 D Half1 -.965 Com Q4 -.635
Var Q2 .798 D Q1 -.669 Com Q1 -.587
RT Q2 .791 RT Q3 .666 Om Total .721
RT Half1 .783 D Q2 -.661 Om Half1 .717
D Total -.761 D Q3 -.653 Om Q3 .702
Var Q1 .759 Com Total -.750 Om Half2 .690
Om Q1 .673

and UADD groups’ greater omission errors (t (894) = 2.96, p = .003) and response time variability (t (894)
= 2.90, p = .004) relative to the CD and NC groups was more pronounced during the second half, stimulus
frequent. The difference between the ADHD and UADD groups in the number of omission errors (t (894) =
1.98, )p = .048) and the response time variability (t (894) = 2.30), p = 0.22) were also greater in the later
half. None of the patient group differences in commission errors or mean response time differed significantly
by condition.

To further examine effects of condition, group differences were analyzed by quarter, after controlling for age
and gender. ADHD and UADD group differences were found for response time variability (t (894) = 2.92,
p = .004). Greater response time variability was found in the second and fourth quarters than in the first
and third quarters. ADHD and UADD groups and CD and NC group differences were found for response
time variability differed by test half and quarter (t (894) = 2.97, p = 0.14).

Greenberg & Waldman (1992C) concluded that the ADHD and UADD groups were more inattentive, whereas
the ADHD and CD groups were more impulsive, consistent with the DSM III-R conceptualization of the
disorders. The ADHD group was more impulsive than the UADD group, and the UADD was more impulsive
than the NC group. Condition differences suggest that the response demands of the stimulus frequent
condition tended to exacerbate inattention in those patients who already have problems in that domain.
Figures 2 to 7 display these group differences.

Factor Data: Data for the percentage of omission errors, percentage of commission errors, mean response
time, response time variability and d prime over both conditions were entered into a principle components
varimax rotation factor analysis (N=1468). Three significant factors emerged: Factor 1.) response time
(mean response time, response time variability) and d prime (hit to miss ratio); Factor 2.) percentage of
commission errors; and Factor 3.) percentage of omission errors. Visual factor loadings for each are presented
in Table 41.

The factor data supports the contention that the test is measuring distinct variables: response time, impul-
sivity and inattention.

Discriminant Analysis: In a separate analysis from the data reported above, Forbes (1998) reported the
T.O.V.A. correctly classified 80% of the ADHD group and 72% of the other group. This result was obtained
by using criteria on any one or more T.O.V.A. scores exceeding 1.5 standard deviations below expectation.
This data is similar to that reported within the sensitivity and specificity section (see above).

Another study of the discriminant abilities of the T.O.V.A. was reported by Leark, Dixon, Allen & Llorente
(2002) used 44 ADHD children and 44 aged matched subjects randomly selected from the T.O.V.A. normative
sample. Their analysis used raw test data to classify subjects using group (ADHD, normative) as the criteria.
This analysis yielded an overall 84.1% original group classification rate. The normal group was correctly
classified 93.2% of the time. The ADHD group was correctly classified at 75% (Table ??).

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Table 42: Classification Results

Predicted Group Membership
Normal ADHD
Original Group Percent Count Percent Count
Normal 93.2 41 6.8 3
ADHD 25 11 75 33
From: Leark, R.A., Dixon, D. Allen, M. & Llorente, A. (2002). Cross-validation of the diagnostic hit rates
and performance differences between ADHD and normative groups of children on the Test of Variables of
Attention. Poster paper presented at the 20th Annual Meeting of the National Academy of
Neuropsychology, Orlando, FL.

These studies along with the sensitivity and specificity data indicate that the T.O.V.A. to be highly predictive
in correctly classifying those with attention problems. As with all tests, we do not encourage the use of the
T.O.V.A. to be used alone in the clinical diagnosis of ADHD. History, interviews, behavior rating scales are
all essential components of an ADHD workup.

Relationship of T.O.V.A. (visual) to measures of intelligence: In an earlier edition of the T.O.V.A. Clinical
Guide (Greenberg, Kindschi, Dupuy & Corman, 1996) as well as in workshops, Greenberg, et al. had sug-
gested that scores to the T.O.V.A. were related to measures of intelligence. The nature of these suggestions
came at the clinical experience of the author (Greenberg). These also made rational sense towards test in-
terpretation strategies especially in light of interpreting test scores related to medication titration. However,
these suggestions were just that, suggestions and did not have statistical support for them. Since then,
several studies have been reported which indicate that the T.O.V.A. test scores are not influenced by the
intelligence of the examinee.

For example, Chae (1999) compared T.O.V.A. (visual) test scores to the performance of 44 children referred
for ADHD symptoms on the Wechsler Intelligence Scale for Children, 3rd revision (WISC-III). The children
were not on medication during any of the testing. The results of his analysis are reported in Table 43. Non-
significant correlations were shown between the total scores for the T.O.V.A. commission, response time
and response time variability and the WISC-III Full Scale IQ (FSIQ), Verbal IQ (VIQ) and Performance IQ
(PIQ). A negative correlation was found between the omission score and the PIQ and FSIQ. A negative but
non-significant correlation was also shown between omission score and the VIQ.

The trend towards negative correlation between omission score and PIQ performance was further analyzed
using the subtests that comprise the PIQ. This analysis yielded a significant negative correlation between
total omission score and Picture Arrangement (-.502, p < .01) and Object Assembly (-.540, p < .01). No
other significant correlations were found between PIQ subtests and T.O.V.A. performance. The same trend
toward negative correlation was noted on the correlation between VIQ subtests and omission total scores.
The only significant correlation between total T.O.V.A. scores and VIQ subtests was found between omission
and the Information subtest (-.462, p <.01). The data from Chae’s study indicates that the T.O.V.A. scores
are related only slightly to intellectual processing. In particular, for these ADHD participants as their
omission scores increased (poorer sustained attention) the performance on the WISC-III declined.

Using college aged participants, Weyandt, Mitzlaff & Thomas (2002) compared age-matched controls to
referrals to a college ADHD clinic. Each was administered the T.O.V.A. and the Wechsler Adult Intelligence
Scale-Revised (WAIS-R). Their analysis (Table 44) yielded non-significant correlation coefficients between
T.O.V.A. scores and WAIS-F FSIQ. Further, an additional analysis yielded non-significant correlation coeffi-
cients between the T.O.V.A. scores and the WAIS-R factor derived summary scores: Verbal Comprehension
(VC), Perceptual Organization (PO) and Freedom from Distractibility (FD). Weyandt, Mitzlaff & Thomas
concluded that intelligence is unrelated to performance on continuous performance tests.

Fake Bad Test Bias: Leark, Dixon, Hoffman & Huynh (2001) investigated how intentionally faking bad would

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Table 43: Correlation Data Between WISC-III and T.O.V.A.

WISC-III Omission Commission RT RTV
FSIQ -.440* -.006 -.161 -.249
PIQ -.458* -.507 -.141 -.161
VIQ -.202 -.003 -.221 -.274
PC .113 .156 .154 .170
PA -.502** -.082 -.073 -.252
BD -.198 .031 -.208 -.216
OA -.540** -.074 -.279 -.315
CD .125 .141 .171 .182
SS .009 .207 .126 .077
INF -.462* -.150 -.121 -.284
SIM -.313 -.024 -.138 -.137
ARI -.265 .011 -.170 -.206
VOC -.205 .041 -.017 -.120
COM -.126 .107 .058 .000
DS -.078 .047 -.256 -.131
* p <.05, ** p < .01. RT = Response Time, RTV = Response Time Variability, PC = Picture Completion,
PA = Picture Arrangement, BD = Block Design, OA = Object Assembly, CD = Coding, SS = Symbol
Search, INF = Information SIM = Similarities, ARI = Arithmetic, VOC = Vocabulary, COM =
Comprehension, DS = Digit Span.
From: Chae, P. K. (1999) Correlation study between WISC-III scores and TOVA performance. Psychology
in the Schools, 36(3), 179-175.

Table 44: Correlation Coefficients Between T.O.V.A. Scores and WAIS-R

T.O.V.A. Score FSIQ VC PO FD
Omission -.075 -.055 -.156 -.001
Commission .130 .152 .022 .050
RT .059 .023 -.121 .016
RTV .023 -.030 -.121 .068
Note: All correlation coefficients were non-significant. RT = Response Time, RTV = Response Time
Variability, FSIQ = Full Scale IQ, VC = Verbal Comprehension, PO = Perceptional Organization, FD =
Freedom from Distractibility.
From: Weyandt, L.L., Mitzlaff, L. & Thomas, L. (2002). The relationship between intelligence and
performance on the Test of Variables of Attention (TOVA). Journal of Learning Disabilities, 35(2), 114-120.

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Table 45: Table of Raw Score Means for Normal Condition (NC) and Fake Bad (FB) Instructions

Omission Commission RT RTV D Prime

NC FB NC FB NC FB NC FB NC FB
Q1 M 8.49 22.66* 1.92 11.24t 441.78 530.00 111.44 201.55** 6.67 3.82**
SD 22.27 26.51 4.59 18.92 175.32 190.08 114.20 134.68 2.73 2.97
Q2 M 9.26 26.32* 1.56 10.06t 444.22 602.11** 114.91 223.24** 6.74 3.53**
SD 23.76 29.74 4.02 17.59 179.52 238.56 139.57 107.82 2.54 2.69
Q3 M 6.35 24.77* 12.86 26.24t 370.56 491.50 106.78 215.71** 4.73 2.14**
SD 19.72 27.84 12.09 18.82 125.21 236.05 106.78 133.69 1.97 1.90
Q4 M 6.57 25.52* 11.46 24.61t 361.28 471.38** 105.16 207.12** 4.81 2.16**
SD 18.33 26.3 11.03 16.6 126.98 188.79 100.62 119.38 2.13 1.91
H1 M 8.87 24.49* 1.74 10.68t 442.22 566.67 113.16 220.38** 6.30 3.44**
SD 22.89 27.47 4.26 18.21 174.97 212.82 119.33 119.68 2.50 2.63
H2 M 6.46 25.14* 12.11 25.37t 365.17 481.89** 108.18 217.14** 4.47 2.00**
SD 19.84 26.94 10.89 16.09 122.63 210.62 101.91 123.52 1.78 1.75
Total M 6.99 25.00* 3.99 13.77t 381.00 500.39** 115.50 227.11** 4.89 2.46**
SD 19.63 26.83 5.18 16.91 127.85 205.37 105.12 118.13 1.81 1.84
RT = Response Time, RTV = Response Time Variability, * Paired Mann-Whitney U test, p <.003
Bonferroni corrected, ** Paired Student’s t test, p <.03 Bonferroni corrected, t Paired Mann-Whitney U
test, p <.02 Bonferroni corrected.
From: Leark, R.A., Dixon, D., Hoffman, T., & Huynh, D. (2001). Fake bad test response bias effects on
the Test of Variables of Attention. Archives of Clinical Neuropsychology, 17, 335-342.

affect T.O.V.A. test performance. Two groups of age-matched college control participants were used with
counter-balanced test order. One group was administered the T.O.V.A. under standard administration,
followed by a second administration with standardized instructions to subtly fake bad. The other group
took the initial administration with the instruction to subtly fake bad, then the standard administration of
the test. The analysis of test-order yielded non-significant findings indicating that the instruction to fake
bad provided the difference. Given there were non-significant effects for test-order, the two groups were then
combined into fake bad (FB) and normal conditions (NC). Group mean score differences were analyzed using
student t-tests for all four of the T.O.V.A. scores over each quarter, half and the total score. The analysis
yielded significant mean score differences between the two groups with the FB group having excessively
higher scores nearly across all quarters, halves and total score (Table 45). The study affirmed that the
test is subject to intentional fake bad test bias. Professionals are encouraged to evaluate for malingered or
intentional fake bad response bias when excessively high scores are obtained on the test.

6.3 Validity Data for the Auditory T.O.V.A. Test

Factor Data: As was done with the visual version of the test, the percentage of omission errors, percentage
of commission errors, mean response time, response time variability and d prime across both conditions by
quarter, halves and totals were entered into a principal components factor analysis with a varimax rotation
(N=2,551). The factor analysis yielded five loadings accounting for 86% of the variance. These five factors
were: Factor 1) response time (mean response time and response time variability); Factor 2) percentage
of commission errors stimulus frequent condition (quarters 3 & 4, 2nd half) and D Prime; and, Factor 3)
percentage of omissions stimulus frequent condition (quarter 3, quarter 4 & second half; Factor 4) percentage
of commission errors stimulus infrequent (quarters 1 & 2, 1st half); and, Factor 5) percentage of omission
errors stimulus infrequent condition (quarter 1, quarter 2 and first half). Table 46 illustrates factor data for
the Auditory T.O.V.A. test.

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Table 46: Auditory Factor Data for the Auditory T.O.V.A. Test

Variable Factor 1 Factor 2 Factor 3 Factor 4 Variable Factor 1 Factor 2 Factor 3 Factor 4 Factor 5
RT Total .937 D’ Q4 -.800
RT Half 2 .915 D’ Total -.782
RT Q4 .895 D’ Q3 -.779
RT Q3 .894 Com Q3 .751
RTQ2 .844 Om Half 2 .852
RT Half 1 .842 Om Q3 .843
RT Q1 .796 Om Total .839
Var Total .727 Om Q4 .834
Var Half 2 .702 Com Half 1 .955
Var Q3 .682 Com Q2 .927
Var Q4 .677 Com Q1 .918
Var H1 .672 Com Total .813
Var Q2 .633 Om Half 1 .653
Var Q1 .605 Om Q1 .629
D’ Half 2 -.835 Om Q2 .615
Com Half 2 .814 D’ Half1 -.597
Com Q4 .802

Table 47: Comparison of the Visual and Auditory T.O.V.A. Tests(Adjusted Mean plus/minus 1 SD)*

Variable Visual (N=1331) Auditory (N=2551) F Value, Significance

Omission 2.06±5.49 3.99±10.92 F(1,3878) = 41.89, p <.001
Commission 5.73±5.11 2.41±5.23 F(1,3878) = 419.66, p <.001
Response Time 445.00±117.93 586.28 ±139.31 F(1,3878) = 1601.14, P <.001
Variability 137.67±62.78 183.46±79.85 F(1,3878) = 556.94, P <.001
D Prime 4.79±1.45 5.29±1.86 F(1,3878) = 105.58, P <.001
*Results of analyses of covariance controlling for age and gender.

In comparison to visual test version, the auditory version factor data partial out commission errors across
the two conditions. Stimulus frequent percentage of commission errors emerged separate from stimulus
infrequent percentage of commission errors. This separation was not found for percentage of omission errors
across the conditions.

6.4 Construct Validity

An analysis of covariance (ANCOVA) controlling for age and gender was performed to compare total variable
scores between tests (see Table 47). A higher mean of percentage of omission errors was found with the
auditory test, having twice as high of omission errors than visual (3.99 ±10.92; 2.06 ±5.49). Mean percentage
of commission errors were higher for the visual test (5.73 ±5.11; 2.41 ±5.23). Mean response times were
faster for the visual test (445.00 ms ±117.93; 586.28 ms ±139.31). Response time variability was greater for
the auditory than the visual (183.46 ±79.85; 137.61 ±62.78). All mean score between test differences were
significant (p < .001).

To understand the uniqueness of the Auditory T.O.V.A. test, Dixon & Leark (1999) compared the perfor-
mances of 30 college aged participants on the Auditory T.O.V.A. test and two measures from the Halstead
Reitan Neuropsychological Battery (HRNB). The HRNB has two measures purported to measure sustained
attention. These are the Seashore Rhythm Test (SRT) and the Speech Sounds Perception Test (SSPT). The
SRT requires the participant to differentiate between pairs of rhythmic beats over thirty trials. There are

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Table 48: Correlation Coefficients Between Seashore Rhythm Test (SRT) and Auditory T.O.V.A. Omission
Scores
Omission Score SRT
Q1 .42*
Q2 .43*
Q3 .44*
Q4 .27ns
H1 .42*
H2 .38*
Total .48*
* p = .05, ns = non-significant correlation.
From: Dixon, D. & Leark, R.A. (1999). Construct Validation of the Test of Variables of Attention -
Auditory: Comparison to Reitan’s Model of Attention. Poster presentation at the American Association for
the Advancement of Sciences 168th Annual Conference. Anaheim, CA January.

no breaks within the test and the stimuli are presented at a fairly rapid pace. The instructions require the
individual to identify if the pairs are the same or different. The SSPT is comprised of sixty spoken vowel
consonant nonsensical word blends, all of which are variations of the “ee” sound. The stimuli are played over
a cassette tape with volume adjustment to user’s preference. Reitan maintains (1985) that the test requires
the maintenance of sustained attention through the 60 items. Given that the Auditory T.O.V.A. test, SSPT
and SRT require differing presentation of stimuli, only the Omission scores were used. Speed of processing
is not a variable of either the SRT or the SSPT. Thus, response time and response time variability were not
used for this study. A correlation analysis was done which yielded significant correlations between omission
scores and SRT. However, the Omission Quarter 4 scores were not significantly correlated with SRT. None
of the commission scores reached statistically significant correlation with the SRT. The SSPT was not signif-
icantly correlated the neither the omission nor commission scores of the Auditory T.O.V.A. test, (Table 48).
Dixon & Leark noted that the correlation between the omission scores of the Auditory T.O.V.A. test and the
SRT made rational sense in that both instruments require immediate and sustained attention to task. The
failure to find a statistically significant correlation between the SSPT and the Auditory T.O.V.A. test also
makes rational sense in that the two tasks present stimuli in non-related methods. The correlation between
the SRT and Auditory T.O.V.A. test supports the sustained attention construct of the omission score.

6.5 Discriminant Function

Validity Studies: Leark, Dixon, Allen & Llorente (2000) reported cross validation data on diagnostic hit
rates between ADHD and normal control subjects. In their study, 44 children (mean age = 8.77 years, SD =
0.42O diagnosed with ADHD were compared to aged matched control subjects (mean age = 8.64 years, SD =
0.49) randomly selected from the T.O.V.A. norm base. Mann-Whitney U tests were conducted to compare
mean group ranks for the raw Omission and Commission scales. Statistically significant differences were
found between the ADHD and control groups (p ¡ .001) with the ADHD group having higher mean rank raw
scores (i.e., poorer test performance). Student t-tests were conducted on the raw response time (RT) and the
raw response time variability (RTV). Statistically significant mean score differences were found between the
ADHD and control subject groups (p ¡ .05). The ADHD group had slower response speed and also had greater
variability of response time than did the normal control group. To assess for the ability of the T.O.V.A.
to classify subjects into correct diagnostic groupings, a discriminant function analysis was performed using
the raw Total test score (Omission Total, Commission Total, Response Time Total and Response Time
Variability Total). This yielded an overall correct original group classification rate of 84.1%. The normal
control group was 41 of 44 correctly classified (93.2%) and 3 of 44 incorrectly classified (6.8%). The ADHD
sample classification yielded 33 of 44 correctly identified (75%) and 11 of 44 incorrectly classified (25%). The

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classification data is slightly less than reported above, however, the Leark, Dixon, Allen & Llorente study
used raw performance scores while the other studies reported above utilized z score conversions. Given that
the Leark et al. study used age matched samples, z score conversion was not as essential as it was in the
earlier reported studies.

Table 49: Means & Standard Deviations by Diagnostic Group

Normal ADHD
Mean (SD) Mean (SD)

Total Omission Errors 1.77 (2.63) 26.68 (36.94**)

Total Commission Errors 9.91 (7.84) 25.27 (16.01**)
Total Response Time (ms) 488.61 (93.47) 555.41 (115.91*)
Total RT Variability (ms) 167.66 (40.93) 207.86 (55.59*)
*p < .05 **p < .001
From: Leark, R.A., Dixon, D., Allen, M. Llorente, A.M. (2000) Cross Validation of Diagnostic Hit Rates & Performance Differences between ADHD and
Normative Groups of Children on the Test of Variable of Attention. Poster paper presentation at the 20th Annual Meeting of the National Academy of
Neuropsychology. Orlando, FL.

Table 50: Classification Results

Predicted Group Membership

Normal ADHD
Original Group Percent Count Percent Count

Normal 93.2% 41 6.8% 3

ADHD 25.0% 11 75. % 33
From: Leark, R.A., Dixon, D., Allen, M. Llorente, A.M. (2000) Cross Validation of Diagnostic Hit Rates & Performance Differences between ADHD and
Normative Groups of Children on the Test of Variable of Attention. Poster paper presentation at the 20th Annual Meeting of the National Academy of
Neuropsychology. Orlando, FL.

6.5.1 Culturally Based Data and Special Population Data

Cultural Based Data: There have been studies reporting on the use of the T.O.V.A. in non-English speaking
cultural groups. These studies compared T.O.V.A. test score differences between ADHD and normal control
groups. For example, Wada, Yamashita, Matsuishi, Ohtani & Kato (2000) found the T.O.V.A. to be useful
in the diagnosis of Japanese male children with ADHD. Wada, et al. compared a group of 17 Japanese male
children (age range 6 to 12) to aged-matched normal Japanese male children. The authors reported that the
group of Japanese male children with ADHD had statistically significant differences across the four TOVA
scales (Table 51). Wada et al. were careful to use raw scores to compute their analysis noting that the
standard score model used within the software itself is based upon the normative sample collected within
the United States.

Xueni & Yufeng (2000) reported the results of their investigation into the applicability of the T.O.V.A. on
ADHD children in China. 56 ADHD children and 16 normal controls were tested using the visual T.O.V.A.
Baseline testing was used and the authors reported significant differences between the Chinese children with
ADHD and the Chinese normal controls across all T.O.V.A. scores. Xueni & Yufeng reported a sensitivity
of diagnosis was 85.71% and specificity of 87.5%. The authors concluded that the T.O.V.A. has application
in China and encouraged is use in research and clinical practice.

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Table 51: T.O.V.A. Results in ADHD and control group

First Half Second Half

Q1 Q2 Q3 Q4
Mean (SD) Mean (SD) Mean (SD) Mean (SD)

Omission errors:
ADHD 7.67 (8.90) 18.15 (23.72) 10.81 (13.09) 11.065 (12.78)
Control 0.58 (2.54**) 0.43 (1.04**) 0.87 (2.01**) 1.37 (3.12**)

Commission errors:
ADHD 6.53 (12.79) 3.81 (5.99) 33.41 (19.11) 36.34 (21.79)
Control 0.96 (1.04**) 0.79 (1.63*) 3.41 (9.85**) 19.48 (12.00**)

Response Time (ms):

ADHD 589.94 (184.52) 631.35 (210.93) 523.76 (181.91) 526.94 (176.48)
Control 451.13 (86.48**) 488.15 (12.86**) 416.47 (79.92**) 428.31 (101.98**)

RT Variability (ms):
ADHD 172.35 (70.50) 183.00 (78.80) 221.41 (103.29) 236.82 (114.35)
Control 96.00 (34.43**) 98.31 (39.77**) 109.31 (49.11**) 132.26 (55.83**)
ADHD n = 17 Control n = 19
*p < .05 **p < .01
From: Wada, N., Yamashita, Y., Matsuishi,T., Ohtani, Y. & Kato, H. (2000) The Test of Variables of Attention (TOVA) is useful in the diagnosis of Japanese
male children with attention deficit hyperactivity disorder. Brain & Development, 22, 378-382.

6.5.2 Special Populations

Deaf Subjects: Evaluation of deaf children or adults is fraught with language, cultural and procedural dif-
ficulties (Parasnis, Samar & Berent, 2003). These authors point out that test materials and instructions
are generally not available in a signed of bilingual format, nor are deaf population norms readily available
for most assessment tools. There is some evidence that deafness leads the visual attention system to re-
organize itself in order to adapt to optimize visual alerting (Bavelier, Tomann, Hutton, Mitchell, Corina,
Liu & Neville, 2000; Parasnis & Samar, 1985). These researchers point out that heightened sensitivity to
novel visual events in the deaf individual’s periphery becomes an important factor that individual’s ability
to process information. To further understand this and how this adaption impacts performance on the visual
T.O.V.A., Parasnis, Samar & Berent examined 44 prelingually deaf and 38 normal-hearing college students
with no known history of ADHD. In addition to the T.O.V.A., the participants also were given an adult
rating scale for attention deficits, a nonverbal measure of intelligence and the Symbol Digit Modalities Test.
Their data (see Table 52) indicates that no statistically significant differences were found between the deaf
and hearing groups for Omissions, Response Time and Response Time Variability. However, the deaf group
showed significant evidence of greater impulsivity than the hearing subjects. The deaf group had twice the
number of commission errors and was nearly three times higher in their number of anticipatory responses
compared to the hearing group. The deaf group had a significant reduction in the rate of correct responses
in the Total and for both halves. Further, the deaf group d0 was significantly lower than for the hearing
group. The reduced d0 raises a cautionary flag is it suggests the deaf may have a reduce attention to the
T.O.V.A. stimuli. The authors conclude that caution is advised when assessing deaf children. This caution
is both for behavior rating scales as well as the visual T.O.V.A.

Gifted Children: The T.O.V.A. was standardized using participants with normal range intelligence. Weyandt,
Mitzlaff & Thomas (2002) reported that in their college aged sample of normal range IQ students there
were no significant correlations between the T.O.V.A. and WAIS-R Full Scale, Verbal an Performance IQ
scores. No significant correlations were found for the WAIS-R Freedom from Distractibility Score either.

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Table 52: Means (and Standard Deviations) for T.O.V.A. across Hearing Status Groups

Omission Commission RT RTV d0 Correct Anticipatory

Responses Responses
Total:
Deaf 3.55 12.21 314.93 74.30 4.20 286.87 28.32
(17.13) (10.03) (57.66) (33.65) (0.68) (40.37) (42.63)

Hearing 2.21 5.50** 329.41 71.77 4.51 307.21** 10.79**

(8.55) (5.04) (62.22) (18.73) (0.48) (19.30) (16.21)

Half 1:
Deaf 0.30 1.05 340.30 58.12 4.67 70.16 1.16
(0.80) (1.25) (56.82) (15.18) (0.24) (2.51) (4.11)

Hearing 0.12 0.32** 354.72 58.94 4.71 71.53** 0.09

(0.41) (0.32) (72.39) (72.39) (0.15) (083.) (0.09)

Half 2:
Deaf 3.26 11.16 307.21 74.15 3.56 216.71 27.16
(17.14) (9.38) (63.07) (38.31) (1.04) (38.61) (40.04)

Hearing 2.09 5.18** 321.64 70.56 3.72 235.68** 10.71**

(8.57) (4.80) (62.58) (20.48) (0.79) (19.03) (16.22)
Deaf n = 44 Hearing n = 38
**p < 0.01
From: Parasnis, I,, Samar, V. J., & Berent, G.P. (2003). Deaf Adults without Attention Deficit Hyperactivity Disorder Display Reduced Perceptual Sensitivity
on Elevated Impulsivity on the Test of Variables of Attention. Journal of Speech, Language & Hearing Research, Vol. 46, 1166-1183.

However, Chae (1999) reported significant negative correlation between the T.O.V.A. Omission and WISC-
III Performance and Full Scale IQ scores (-.458 and -.440, respectively) in a cohort of40 children aged 6 to
17 years. Chae concludes that normal range intelligence seems unrelated to tasks measured by the T.O.V.A.

However, there are at least two studies, which indicate that individuals with higher IQ scores respond
differently to the T.O.V.A. than do the subjects within the normative range of intelligence. Chae, Kim &
Noh (2003) reported on their study of differences between a sample of gifted (n = 106) and non-gifted (n
= 71) children. ANCOVA was used to compare the differences between the gifted and non-gifted children
with age and gender used as covariates (consistent with T.O.V.A. normative data). The results of the
ANCOVA (Table 53) indicate that there were significant differences between the two groups for Omission
errors, Response Time Variability, sensitivity (d0 ) and for the ADHD score. Gifted children performed
better than non-gifted children in attending target stimuli, showing consistent response patterns to targets
and discriminating target from non-target. No significant difference was found for Response Time (NOTE:
the authors did not provide for any table of mean scores for the T.O.V.A. within the article). Chae,
Kim & Noh did report significant negative correlations between KEDI-WISC (a Korean version of the
WISC) for FIQ, VIQ and PIQ intelligence measures and TOVA Omission, Commission, Response Time
Variability, d0 , and ADHD scores (Table 54), none for Response Time. Chae, Kim & Noh’s data indicates
that intelligence is related to T.O.V.A. performance in gifted children, whereas, intelligence seems less related
to T.O.V.A. performance for normal range IQ. The study also indicates that use of the T.O.V.A. outside of
the standardization assumptions should be done with caution.

Rosengren (2004) examined whether children who met the criteria for giftedness would perform differently on
the visual T.O.V.A. than subjects in the respective normative sample. The sample consisted of 90 children,

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Table 53: Comparison of T.O.V.A. Performance between Gifted and Non-gifted with Age and Gender
Controlled

Variance Sum of Squares DF Mean Square F

Omission 1313.83 1 1313.83 45.54***
Commission 51080.00 1 51080.00 4.11*
Response Time 21607.43 1 21607.43 2.71
RT Variability 29824.03 1 29824.03 19.32***
d0 59.54 1 59.54 67.56***
ADHD score 85.74 1 85.74 12.89**
*p < .05 **p < .01 ***p < .001
From: Chae, P.K., Kim, J.H., & Noh, K.S. (2003) Diagnosis of ADHD Among Gifted Children in Relation to KEDI-WISC and T.O.V.A. Performance. Gifted
Child Quarterly, Vol. 47, 3, 192-201.

Table 54: Partial Correlations between IQ and T.O.V.A. Performances with Age and Gender Controlled

Omission Commission RT RTV d0 ADHD

Full IQ −0.52*** −0.17* −0.12 −0.30*** 0.50*** 0.27***
Verbal IQ −0.48*** −0.13 −0.11 −0.25** 0.41*** 0.20*
Performance IQ −0.46*** −0.19* −0.12 −0.32*** 0..52*** 0.33***
*p < .05 **p < .01 ***p < .001
From: Chae, P.K., Kim, J.H., & Noh, K.S. (2003) Diagnosis of ADHD Among Gifted Children in Relation to KEDI-WISC and T.O.V.A. Performance. Gifted
Child Quarterly, Vol. 47, 3, 192-201.

59 male, 32 female between five and eleven year of age (mean = 9.3 years, SD = 1.4). The criterion for
eligibility for participation was an IQ score of a minimum of 120. The results from Rosegren’s initial analysis
yielded significant differences between raw performance measures for Omission, Response Time and Response
Time Variability, but not for Commission or d0 (TABLE XXXXXXX). The magnitude of the effect size for
these differences was medium for Omission and large for the remaining three scales. An analysis for gender
differences also held for the same finding, gifted males and gifted females performed significantly different
than the normative data. Gifted males and gifted females both performed significantly different on Omission,
Response Time, Response Time Variability and d0 . To determine if age impacted performance by these gifted
children, Rosegren separated the subjects into two groups, ages 6 to 8 and ages 9 to 11. The analysis of
differences between raw T.O.V.A. performances by age group yielded significant differences between the
two groups. The analysis yielded significant age – related findings with the younger subjects performing s
slower, less consistent, more impulsive and less attentive than the older children. It should be noted that
Rosegren’s findings here are similar to the T.O.V.A. normative base. Younger children perform differently
than older children, hence the age-based norm scoring by the T.O.V.A. However, Rosegren further examined
his data and found that when compared to the same T.O.V.A. normative age grouping, the gifted children
performed significantly different from the T.O.V.A. norms. Specifically, the finding that the younger gifted
children performed differently than the older children remained consistent. Further, the younger children
were significantly different than age matched norm data. Thus, higher IQ does impact T.O.V.A. performance
for younger children but not so for older children (TABLE XXXXXXXX)

Rosengren’s (2004) findings along with those from Chae, Kim & Noh (2003) raise a cautionary flag for use
of the T.O.V.A. with individuals with higher than normal IQ

Valid Effort and Motivation: The validity of responses to the items on any psychological or neuropsycholog-
ical test is anchored to appropriate levels of effort to attend to the task at hand. With this in mind, several
studies have demonstrated the effects of poor effort or intentional test response bias on T.O.V.A. scores.
Leark, Dixon, Hoffman & Huynh (2002) investigated the effects of simulated faking (bad) on the T.O.V.A.

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36 volunteer college students were randomly placed into two groups. One group received the T.O.V.A. with
normal instructions (NC), and then was instructed to simulate a subtly bad T.O.V.A. performance (FB).
The other group received the same simulated subtly bad T.O.V.A. performance, then was administered the
T.O.V.A. with standard instruction. Test order was found to be non-significant. The two groups were then
merged to determine the effects of purposeful simulated fake bad performance. An analysis for group mean
between the NC and FB instructions found significant differences across all of the T.O.V.A. scores for the
four quarters, each half and the Total (Table 55) The FB group had excessive amounts of omission and
commission errors, a greater response time mean (i.e., slower to respond) and had greater variance around
their mean response times. The authors encouraged caution towards interpreting as valid any T.O.V.A.
performance with an excessive number of either Omission or Commission errors, or extremely variant scores
on Response Time and Response Time Variability.

Henry (2005) also examined poor effort on the T.O.V.A. Henry used 50 adult subjects with reported mild
head injury who were involved in personal injury litigation along with two subjects who were referred for
evaluation of a disability status. Each was administered with neuropsychological evaluation which included
the T.O.V.A. In addition to the neuropsychological examination, symptom validity testing (SVT) was
conducted on each subject. The SVTs administered included the Test of Memory Malingered (TOMM),
Word Memory Test (WMT) or the Computerized Assessment of Response Bias (CARB). A retrospective
data analysis allowed the subjects to be classified into twogroups, a probable malingering group (PM)
or a not malingering group (NM). The subjects were placed into the PM group on the basis of scoring
below published cutoff scores for the TOMM, WMT or the CARB. The analysis indicated the PM group
to performed significantly worse than the NM group on the T.O.V.A. (Table 56). Given this difference,
Henry then performed a series of classification analyses to determine the classification threshold wherein
an individual whose predicted probability exceeds the threshold is truly classified as malingering. Henry
determined that using a classification of three or more errors on the Omission scale as malingering, the
corresponding predicted hit rate is 0.26. Application of this criterion produced then an overall hit rate of
84.6% and correctly classifies 88.5% of the malingerers (i.e., sensitivity) and 80.8% on the non-malingerers
(i.e., specificity).

Hughes, Leark, Henry, Robertson & Greenberg (2008) provided a further analysis of the Leark (2002) and
Henry (2005) data and created a different model of interpretative rules. Hughes, et al., formulated a symptom
validity rule based upon the individual’s response time. In this model, Commission Error Response Time
(CERT), Correct Response Response Time (CRRT) and Post-Commission Error Response Time (PCERT)
were used to develop hit rates of likely invalid performance. The model, CERT<CRRT<PCERT, is based
upon the relationship (i.e., CERT<CRRT;CERT<PCERT; CRRT<PCERT) each increases the likelihood
of invalid responding. Hughes, et al. reported that when using these rules (CERT<CRRT; CERT<CERT;
and CRRT<PCERT) to discern valid/invalid performance 95% of the Leark (2002) fake bad data set had
at least 2 error violations. None of the “good” data had any rule violations. However, when the symptom
validity rules were used in a data set of children and adolescent subjects, the rule model did not show any
clear relationship. Thus, while very helpful in determining effort validity/invalidity in adults, the model is
not appropriate for children or adolescences. This rule system was then further developed and incorporated
in the T.O.V.A. rule algorithms and is the basis for the Symptom Exaggeration Index currently used with
the T.O.V.A. reporting software.

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Table 55: Table of Means for Normal and Fake Bad Instructions

Omissiona Commissionb RTc RTVc d0

NC FB NC FB NC FB NC FB NC FB

Q1:
χ 8.49 22.66* 1.92 11.24*** 441.78 530.00 111.44 201.55 6.67 3.82**
SD 22.27 26.51 4.59 18.92 175.32 190.08 114.20 134.68 2.73 2.97

Q2:
χ 9.26 26.32* 1.56 10.06*** 444.22 602.11** 114.91 223.24 6.74 3.53**
SD 23.76 29.74 4.02 17.59 179.52 238.56 139.57 107.82 2.54 2.69

Q3:
χ 6.35 24.77* 12.86 26.24*** 370.56 491.50 106.78 215.71** 4.43 2.14**
SD 19.72 27.84 12.09 18.82 125.21 236.05 106.78 133.69 1.97 1.90

Q3:
χ 6.57 25.52* 11.46 24.61*** 361.28 471.39** 105.16 207.12** 4.81 2.16**
SD 18.33 26.30 11.03 16.86 126.98 188.79 100.62 119.38 2.13 1.91

H1:
χ 8.81 24.49* 1.74 10.68*** 442.22 566.67 113.16 220.38** 6.3 3.44**
SD 22.89 27.47 4.26 18.21 174.97 212.82 119.33 119.67 2.50 2.63

H2:
χ 6.46 25.14* 12.11 25.37*** 365.17 481.89** 108.18 217.14** 4.47 2.00**
SD 18.94 26.94 10.89 16.09 122.63 210.62 101.91 125.52 1.78 1.75

T:
χ 6.99 25.00* 3.99 13.77*** 381.00 500.39** 115.50 227.11** 4.89 2.46**
SD 19.63 26.83 5.28 16.91 127.85 205.37 105.12 118.13 1.81 1.84
NC = Normal Instruction FB = Fake Bad Instruction
a
Percentage of omission errors made
b
Percentage of commission errors made
c
Time in millisecond
* Paired Mann-Whitney U test, p < .003, Bonferroni corrected
** Paired Student’s t-test, p < .03, Bonferroni corrected
*** Paired Mann-Whitney U test, p < .02, Bonferroni corrected
From: Leark, R.A., Dixon, D., Hoffman, T., & Huynh, D. (2002). Fake Bad Test Response Bias Effects on the Test of Variables of Attention. Archives of
Clinical Neuropsychology, 17, 35.342.

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Table 56: Univariate Test of Mean Differences

Mean SD t (df) p D
Omission:
PM 54.50 71.95 3.75 0.001 0.73
NM 1.62 2.97 (25)

Commissions:
PM 20.77 39.30 1.69 0.10 0.34
NM 7.58 6.74 (27)

Response Time:
PM 602.62 249.03 3.87 <0.001 0.83
NM 397.12 105.46 (34)

Response Time Variability:

PM 230.42 94.14 5.76 <0.001 1.28
NM 109.92 50.17 (38)
n = 26
From: Henry, G.K. (2005). Probable Malingering and Performance on the Test of Variables of Attention. The Clinical Neuropsychologist, 19, 121-129.

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T.O.V.A. 8.0 Professional Manual 7 INTERPRETATION

7 Interpretation

7.1 Overview

This chapter presents an overview of the interpretation of the T.O.V.A. test. Basic interpretation guidelines
for determination of invalid profiles (cases), use of the ADHD Score, and other information important to test
interpretation are also addressed. This chapter does not provide information relevant to printing the test
results from your computer. Information on using the T.O.V.A. software program and generating T.O.V.A.
reports is found in the T.O.V.A. User’s Manual .

7.2 Determination for Valid Test Profile

Several general guidelines exist for determining whether or not a test profile is valid. For test interpretation
purposes, a case is usually invalid if it meets at least one of the following:

1. Response time (RT) equals 0 (zero) for any one quarter, half or total.

If a Response Time of 0 (zero) is recorded for any quarter, half or total, the test is considered to be invalid.
A RT of 0 (zero) may indicate: 1) The subject had not pressed the microswitch/scorebox button during the
examination; or 2) The microswitch/scorebox was not been properly connected to the computer. Literally,
the zero response time score indicates that no responses were recorded. When this occurs, the test cannot
accurately calculate any true omissions or true commissions, as the button on the microswitch has not been
pressed (or if not connected properly, no response was recorded even if the button was pressed). Omissions
will be artificially elevated, commissions artificially reduced, and response time variability eliminated.

2. Response Time Variability (V) equals 0 (zero) for any one quarter, half or total.

Either the subject did not press the button on the microswitch/scorebox during the test, or the mi-
croswitch/scorebox was not been properly connected to the computer. Theoretically, it is improbable that
the subject was able to sustain a consistent response time without any variance to the mean response time.
Thus, as with Rule 1, the test is considered invalid.

3. Test Interrupted.

While the test can be interrupted by the examiner during the test, the remainder of the test, once restarted,
is considered invalid. Stopping a continuous performance test violates the standardization followed in the
normative study. We recommend that the subject be retested on a different morning. We do not recommend
restarting a test on the same day due to the fact that this was not done during the normative sampling.

4. Excessive Anticipatory Responses (≥ 10%).

If an anticipatory response score equal to or greater than 10% is recorded for a quarter, all variables for
that specific quarter may be invalid and must be interpreted cautiously. Anticipatory responses artifi-
cially decrease omission errors and response time, and increase commission errors and variability. See the
T.O.V.A. Clinical Manual (2007) for interpretation guidelines.

5. Omission Error for any quarter, half or total equals 100%.

If the percentage of omission errors for any one quarter, half or total equals 100%, the subject missed majority
of the targets for that quarter, half or total test. If this occurs, it is likely that the subject may not have
correctly understood the test directions, or the subject may not have cooperated for the task.

6. Commission errors for any quarter, half or total equals 100%.

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If the percentage of commission errors for any one quarter, half or total equals 100% this indicates that
the subject has pressed the button for all of the nontargets for that time period. If this occurs, it is likely
that 1.) the subject may not have correctly understood the test instructions; 2.) the subject may not have
cooperated; or 3.) the microswitch/scorebox may not have been functioning properly.

7.3 Analyzing Test Data

From a report generated by the T.O.V.A. software program, first examine the totals for significant findings.
Then examine and compare halves to determine whether there are significant findings and their clinical
implications.

1) Review Half 1. This is the “boring” task (stimulus infrequent condition), and the “under aroused” have
difficulty maintaining attention and control. If this half is symptomatic, Notes to the Clinician will include
statements about increasing toward-task stimulation, decreasing time on-task, introducing activity, etc.

2) Review Half 2.This is the active or high response demand task (stimulus frequent condition), and the
“over stimulated” have difficulty. Of course, everyone (normals included) tends to be faster and make many
more commission errors than in half 1. If this half is symptomatic, Notes to the Clinician will contain
statements about decreasing distractions and pace, etc.

3) If results both half 1 and 2 are significantly below average or if the person has difficulty with
both halves, the Notes to the Clinician will contain suggestions for interventions for both conditions.

4) Review results quarter by quarter. The quarters within and across halves should be examined next.
If there is a significant change (worsening) within a half, the possibility of a short (5-6 minute) attention
span in that kind of task or possibly a 12-15 minute attention span overall should be considered, if the
change is between quarters 3 and 4. If it appears that quarter 3 is worse than quarter 4, look for a change-
of-set problem at the beginning of quarter 3 by examining the response by response option. This could be
indicative of excessive obsessive-compulsive traits or anxiety. (See the T.O.V.A. Clinical Manual for more
information.).

If it appears that quarter 1 is worse than quarter 2, this could be indicative of excessive anxiety. Look for
game (or test taking) strategy influences or changes. For some individuals being fast is more important than
making fewer errors, and visa-versa. Some individuals may dramatically slow down to reduce errors in half
2 while others may speed up, as if losing control. The T.O.V.A. program will label significant discrepancies
between commission errors and response time in the section “Notes to the Clinician” so the results could
be interpreted and the person can be debriefed. For example, if someone were deliberately slow to avoid
errors, the response time could be significantly deviant and the error rate significantly better than average.
However, it would not necessarily follow that the person had an attention problem (or depression). If there
is an absence of an apparent test taking strategy, sometimes the protocol looks disorganized or erratic with
no discernible consistency or pattern. It may reflect the presence of a significant mental illness or the
performance of a strategist who changes strategy frequently and attempts to “beat” the test. It would be
helpful to debrief the subject.

5) If significantly high omission errors (i.e. standard scores 80 or less), the Notes to the Clinician should
have a prompt, look for clusters of omission errors in the response by response option to determine whether
narcolepsy, seizures, etc., might be possible.

The response by response option allows the examination of each response recorded throughout the test. It
can be viewed on screen or printed out as needed.

The four columns of information presented are:

1)Target or non-target

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2) Response type:

Correct response, correct non-response, omission, commission, post-commission response, user interrupt, and
button error.

3) Response time (ms)

Note: A significantly deviant performance does not necessarily make a diagnosis of ADHD.

7.4 Scoring

The software electronically records all subject responses, nonresponses, and response times of the mi-
croswitch. A sample report protocol is presented in the Appendices. All variables are presented, with
summary of raw scores, calculated standard deviation scores and z scores for quarters, halves, and totals.

The scoring process is a sub-menu driven option within the software, easily performed after the testing
is complete. The software saves unscored and scored data on the computer hard drive (by default unless
another drive is selected).

7.5 Interpretation Rules

1. O + C + RT + V ≥ −3.6 std dev and O + RT + V ≥ −2.6

2. O or RT or V > -2 std dev (< 70 std score)

3. O + RT + V ≥ −3 std dev

4. If O + RT + V > -2 and < -3 std dev, borderline condition

5. If RT ≥ −2 std dev (≤ 70 std score), and O and V each > -1 std dev (<85 std score), and C < -2 std
dev (>70 std score)

6. If RT ≥ −2 std dev (≤ 70 std score), O and V each < -1 std dev (> 85 std score), and C < -2 std dev
(> 70 std score), compatible with depression and/or attention deficit

7. If any two (O, RT, V) ≥ −1.5 std dev (≤ 77.5 std score)

8. If any two (O, RT, V) > -1 and < -1.5 std dev (77.5 - 84 std score), borderline condition

9. If ≥ 13 years old, and C ≥ −2 std dev (≤ 70 std score)

10. If >13 years old, and C ≥ −1.5 and <-2 std dev (77.5 - 71 std score), and O, RT, and/or V ≥ −1.5 std
dev (<77.5 std score)

11. If ?≥ 13 years old, and C ≥ −1.5 std dev (≤ 77.5 std score), and two others are > -1 and < -1.5 std dev
(84 - 77.5 std score)

(O = omission errors, C = commission errors, RT = response time, V = variability)

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8 References

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Anastasi, A. & Urbina, S. (1997). Psychological testing (7th edition). Upper Saddle River, NJ: Prentice
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Burnstein, M.D., G., Carroll, PhD, M., Crosby, PhD, R., Perwien, B.A., A., Go, M.D., F. & Benowitz,
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Chae, P. K. (1999) Correlation study between WISC-III scores and TOVA performance. Psychology in the
Schools, 36(3), 179-175.

Chae, P.K., Kim, J.H., & Noh, K.S. (2003) Diagnosis of ADHD Among Gifted Children in Relation to
KEDI-WISC and T.O.V.A. Performance. Gifted Child Quarterly, Vol. 47, 3, 192-201.

Cronbach, L.J., Gleser, G.C., Nanda, H., & Rajaratnam, N. (1972) The Dependability of Behavioral Mea-
surements: Theory of Generalizability for Scores and Profiles. John Wiley & Sons, Inc., New York.

Dixon, D.& Leark, R.A. (1999). Construct Validation of the Test of Variables of Attention - Auditory:
Comparison to Reitan’s Model of Attention. Poster presentation at the American Association for the Ad-
vancement of Sciences 168th Annual Conference. Anaheim, CA January.

Erickson, W.D. , Yellin, A.M., Hopwood, J.H., Realmuto, G. R. & Greenberg, L.M. (1984). The effects of
neuroleptic on attention in adolescent schizophrenics. Biological Psychiatry, 19:745-753.

Forbes, G. B. (1998). Clinical Utility of the Test of Variables of Attention (TOVA) in the diagnosis of
Attention-Deficit Hyperactive Disorder. Journal of Clinical Psychology, 54(4), 481-476.

Gordon, S. & Asher, M. (1994). Meeting the ADD Challenge: A Practical Guide for Teachers. Research
Press: Chanpagin, Il.

Greenberg, M.D., L. M. & Crosby, PhD, R. D. (1992A). A Summary of Developmental normative Data on
the T.O.V.A. Ages 4 to 80+. Unpublished manuscript.

Greenberg, M.D., L. M. & Crosby, PhD, R. D. (1992B). The assessment of Medication Effects in Attention
Deficit Disorder Using the Test of Variables of Attention (T.O.V.A.) Manuscript submitted for publication.

Greenberg, M.D., L. M. & Crosby, PhD, R. D. (1992C). Specificity and Sensitivity of the Test of Variables
of Attention (T.O.V.A.). Manuscript submitted for publication.

Greenberg, M.D., L. M. & Waldman, PhD, I. D. (1993). Developmental Normative Data on The Test of
Variables of Attention (T.O.V.A.). Journal of Child and Adolescent Psychiatry, 34, 6, pp. 1019-1030.

Henry, G.K. (2005). Probable Malingering and Performance on the Test of Variables of Attention. The
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Hughes, S. J., Leark, R.A., Henry, G.K., Robertson, E.L. & Greenberg, L.M. (2008). Using the TOVA to
Detect Deliberate Poor Performance During Assessment of Attention. Poster paper at the American College
of Clinical Neuropsychology Annual Conference. Boston, MA. July.

Leark, R.A., Dixon, D., Hoffman, T.,& Huynh, D. (2001). Fake bad test response bias effects on the Test of
Variables of Attention. Archives of Clinical Neuropsychology, 17, 335-342.

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Leark, R.A., Dixon, D. Allen, M.& Llorente, A. (2002). Cross-validation of the diagnostic hit rates and per-
formance differences between ADHD and normative groups of children on the Test of Variables of Attention.
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Leark, R. A., Wallace, D.R. & Fitzgerald, R (2004). Test-Retest Reliability and Standard Errors of Mea-
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Llorente, A. M., Amado, A.J., Voigt, R.G., Berretta, M.C., Fraley, J.K., Jensen, C.L. & Heird, W.C. (2001).
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Tramontana, M, & Hooper, S.R. (Eds). Advances in Child Neuropsychology Vol. III. PP. 119-171.

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of the dementia in late-onset metachromatic leukodystrophy. Neurology, 44 (April): 662-665.

Shapiro, PhD, E.G., Lipton, MD, M.E., & Krivit, MD, PhD, W. (1992). White matter dysfunction and its
neurological correlates: A longitudinal study of a case of metachromatic leukodystrophy treated with bone
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Teicher, MD, PhD, M., Ito, MD, PhD, Y., Glod, PhD, C., & Barber, MD, N. (1996) “Objective Measurement
of Hyperactivity and Attentional Problems in ADHD”. Journal of American Academy of Child Adolescent
psychiatry, March, 35:3, PP. 334-342.

Wada, N., Yamashita, Y., Matsuishi,T., Ohtani, Y. & Kato, H. (2000) The Test of Variables of Attention
(TOVA) is useful in the diagnosis of Japanese male children with attention deficit hyperactivity disorder.
Brain & Development, 22, 378-382.

Waldman, PhD, I.D. & Greenberg, M.D., L. M. (1992). Inattention and Impulsivity Discriminate Among
Disruptive Behavior Disorders. Manuscript submitted for publication.

Weyandt, L.L., Mitzlaff, L.& Thomas, L. (2002). The relationship between intelligence and performance on
the Test of Variables of Attention (TOVA). Journal of Learning Disabilities, 35(2), 114-120.

Xueni, Li & Yufeng, Wang (2000). A Preliminary Application of Test of Variables of Attention in China.

Yellin, A.M. (1980). A Standard Visual Stimulus for Use in Studies on Attention-Deficit Disorders: Toward
the Development of Standardized Sustained and Selective Attention Tests. Research Communications in
Psychology, Psychiatry, and Behavior, 5, pp. 137-143.

Yellin, A.M., Hopwood, J.H., & Greenberg, L.M. (1982). Adults and adolescents with attention deficit disor-
der (ADD): Clinical and behavior responses to psychostimulants. Journal of Clinical Psychopharmacology,
3:133-136.

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9 Appendices

9.1 Appendix A: Sample T.O.V.A. 8.0 Protocol

Figure 11: T.O.V.A. 8 Introduction

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Figure 12: T.O.V.A. 8 Summary

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Figure 13: T.O.V.A. 8 Response Patterns

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Figure 14: T.O.V.A. 8 Analyzed Data

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Figure 15: T.O.V.A. 8 Analyzed Data (Graphs)

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Figure 16: T.O.V.A. 8 Tabulated Data

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Figure 17: T.O.V.A. 8 Error Graphs

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Figure 18: T.O.V.A. 8 Histograms

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Figure 19: T.O.V.A. 8 Raw Data Graphs

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Figure 20: T.O.V.A. 8 Raw Data Tables

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9.2 Appendix B: Sample T.O.V.A. 7.3 Protocol

Figure 21: T.O.V.A. 7.3 Interpretation (Table Of Contents)

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Figure 22: T.O.V.A. 7.3 Interpretation (Form 1)

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Figure 23: T.O.V.A. 7.3 Interpretation (Form 2)

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Figure 24: T.O.V.A. 7.3 Interpretation (Form 3)

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Figure 25: T.O.V.A. 7.3 Interpretation (Form 4)

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Figure 26: T.O.V.A. 7.3 Interpretation (Form 5)

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Figure 27: T.O.V.A. 7.3 Interpretation (Form 6)

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9.3 Appendix C: Sample Legacy T.O.V.A. 7.0 Protocol

Figure 28: T.O.V.A. 7.0 Interpretation (Table Of Contents)

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Figure 29: T.O.V.A. 7.0 Interpretation (Form 1)

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Figure 30: T.O.V.A. 7.0 Interpretation (Form 2)

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Figure 31: T.O.V.A. 7.0 Interpretation (Form 3)

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Figure 32: T.O.V.A. 7.0 Interpretation (Form 4)

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Figure 33: T.O.V.A. 7.0 Interpretation (Form 5)

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Figure 34: T.O.V.A. 7.0 Interpretation (Form 6)

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Figure 35: T.O.V.A. 7.0 Interpretation (Form 7)

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9.4 Appendix D: T.O.V.A. 7.x Calculations

Table 57: T.O.V.A. 7.x Calculations: per quarter, half and total

# Omissions
Omissions: Percentage (000.00%) # Targets−# Anticipatories × 100%

Subject’s % Omissions−Norm Table % Omissions

Standard Deviation (0.00) Norm Table % Omissions Standard Deviation

Standard Score (000) 100 − (Subject’s % Omissions Std. Dev. × 15)

# Commissions
Commissions: Percentage (000.00%) # Targets - # Anticipatories × 100%

Subject’s % Commissions−Norm Table % Commissions

Standard Deviation (0.00) Norms Table % Commissions Standard Deviation

Standard Score (000) 100 − (Subject’s % Commissions Std. Dev. × 15)

P
(Correct Response Times)
Response Time: Mean (000 ms) # Correct Responses

Subject’s mean RT−Norm Table Mean RT

Standard Deviation (0.00) Norm Table RT Standard Deviation

Standard Score (000) 100 − (Subject’s RT Std. Dev. × 15)

q Pn
xi −(Mean Correct RT)2
Variability: Mean (000 ms) i=0
# Correct Responses

Subject’s Variability−Norm Table Variability

Standard Deviation (0.00) Norm Table Variability Standard Deviation

Standard Score (000) 100 − (Subject’s Variability Std. Dev. × 15)

Limits: Standard Deviation: Values limited to −5 ≤ Standard Deviation ≤ 5

Standard Score: Thus by formula, 25 ≤ Standard Score ≤ 175.

Miscellaneous:
Quarters: Targets,NonTargets:

1 and 2 36,126
3 and 4 126,36
T Scores: 50 + (Standard Deviation + 10)

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9.5 Appendix E: Mac version 1.3 Calculations

Table 58: Mac v1.3 Calculations: per quarter, half and total

# Omissions
Omissions: Percentage (000.00%) # Targets−# Anticipatories × 100%

Number # Omissions Errors

# Commissions
Commissions: Percentage (000.00%) # NonTargets−# NonTarget Anticipatories × 100%

Number # Commissions Errors

# Correct Responses
Correct Responses: Percentage (000.00%) # Targets × 100%

Number # Correct Responses

P
Correct Response Times
Mean (000 ms) # Correct Responses

q Pn
xi −Mean Correct RT2
Variability (000 ms) i=0
# Correct Responses

# correct NonResponses
Correct Nonresponses: Percentage (000.00%) # NonTargets × 100%

Number # Correct NonResponses

# Anticipatories
Anticipatories: Percentage (000.00%) # Total Stimuli × 100%

Number # Anticipatory Errors

Multiples: Number # Multiple Errors

Post Commission Number # Post Commission Responses

Responses:
P
Post Commission Response Times
Mean (000 ms) # Post Commission Responses

q Pn 2
i=0 xi −Mean PC RT
Variability (000 ms) # Post Commissions

User Interrupts: Number #

Button Errors: Number #

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9.6 Appendix F: Visual Norms

Table 59: Norms Summary (See end of this section for reference key.)

Omission Commission Response Time Variability D PRIME: Hit/

Errors(%): Errors(%): (ms) (SD, ms) False Alarm
Inattention Impulsivity Rate
Years of Age M ean ± SD M ean ± SD M ean ± SD M ean ± SD M ean ± SD]
Age 4
Male (N=24) 28.81 ± 20.51 17.34 ± 12.54 783.42 ± 87.71 330.08 ± 65.98 1.68 ± 0.69
Female (N=26) 33.38 ± 21.06 10.75 ± 7.46 826.69 ± 104.27 325.46 ± 91.67 1.86 ± 0.84
Age 5
Male (N=66) 14.17 ± 11.90 10.27 ± 6.92 723.69 ± 147.40 262.94 ± 63.33 2.59 ± 0.65
Female (N=80) 14.95 ± 12.92 6.91 ± 7.05 767.90 ± 126.78 260.4 ± 55.69 2.93 ± 0.98
Age 6
Male (N=19) 8.95 ± 7.80 10.37 ± 6.85 604.32 ± 120.24 236.95 ± 54.41 2.96 ± 0.94
Female (N=23) 8.87 ± 9.77 6.78 ± 4.16 667.00 ± 74.27 248.04 ± 38.79 3.10 ± 0.70
Age 7
Male (N=61) 6.54 ± 7.55 10.97 ± 8.47 558.70 ± 108.12 223.15 ± 54.93 3.19 ± 1.04
Female (N=61) 4.00 ± 4.30 6.89 ± 5.02 608.28 ± 99.87 215.87 ± 47.89 3.84 ± 1.20
Age 8
Male (N=36) 2.17 ± 2.94 8.61 ± 5.23 487.19 ± 86.14 176.92 ± 47.66 4.22 ± 1.24
Female (N=38) 1.87 ± 2.46 6.61 ± 4.28 544.34 ± 79.54 192.79 ± 37.89 4.31 ± 1.19
Age 9
Male (N=57) 4.35 ± 14.22 9.39 ± 6.52 458.56 ± 80.75 161.74 ± 43.81 4.25 ± 1.44
Female (N=55) 1.07 ± 1.50 6.53 ± 4.17 498.80 ± 71.53 164.82 ± 38.17 4.71 ± 1.23
Age 10
Male (N=33) 2.45 ± 6.87 7.70 ± 3.20 402.15 ± 58.04 137.39 ± 39.30 4.60 ± 1.29
Female (N=34) .53 ± .90 5.65 ± 4.23 438.47 ± 74.24 138.32 ± 38.78 5.39 ± 1.41
Age 11
Male (N=55) 1.93 ± 7.28 8.69 ± 5.34 379.33 ± 66.01 123.82 ± 33.70 4.69 ± 1.48
Female (N=60) .68 ± 1.26 6.65 ± 4.16 412.80 ± 71.07 130.95 ± 34.36 5.06 ± 1.17
Age 12
Male (N=37) .68 ± 1.15 6.34 ± 3.82 389.92 ± 73.81 125.05 ± 37.09 4.97 ± 1.15
Female (N=49) .53 ± .92 4.59 ± 4.16 410.29 ± 80.96 122.33 ± 40.89 5.34 ± 1.26
Age 13
Male (N=66) .67 ± 1.44 4.93 ± 3.93 379.74 ± 60.77 108.35 ± 33.71 5.16 ± 1.22
Female (N=69) .55 ± 1.39 3.81 ± 2.85 379.71 ± 56.85 103.09 ± 29.61 5.14 ± 1.14
Age 14
Male (N=46) .31 ± .47 3.97 ± 3.31 383.43 ± 65.82 104.70 ± 35.07 5.32 ± 1.05
Female (N=36) .2710 ± .65 2.95 ± 2.60 383.36 ± 62.93 100.39 ± 34.64 5.71 ± 1.12
Age 15
Male (N=61) .69 ± 1.31 3.64 ± 2.82 361.15 ± 53.54 96.59 ± 27.34 5.25 ± 1.19
Female (N=58) .41 ± .82 3.45 ± 3.39 374.41 ± 61.85 90.93 ± 22.71 5.63 ± 1.42

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Table 60: Norms - Summary, continued (See end of this section for reference key.)

Age 16
Male (N=22) .77 ± 1.42 4.19 ± 4.54 354.82 ± 51.97 91.59 ± 25.77 5.16 ± 1.36
Female (N=29) .72 ± 1.42 2.87 ± 2.46 379.62 ± 60.33 100.83 ± 32.13 5.56 ± 1.31
Age 17
Male (N=18) .2710 ± .30 2.79 ± 3.11 377.89 ± 45.92 95.94 ± 27.72 5.63 ± 1.51
Female (N=18) .38 ± .75 2.21 ± 2.26 376.72 ± 48.55 89.56 ± 20.04 5.88 ± 1.08
Age 18
Male (N=32) .35 ± .42 3.86 ± 3.04 373.94 ± 64.20 89.84 ± 29.15 5.18 ± 1.04
Female (N=66) .35 ± .80 3.21 ± 2.87 402.44 ± 60.60 86.58 ± 23.18 5.49 ± 1.08
Age 19
Male (N=25) .07 ± .1810 2.17 ± 1.52 404.04 ± 56.86 82.92 ± 20.07 6.24 ± 1.00
Female (N=54) .58 ± 1.81 3.73 ± 3.38 403.52 ± 49.63 86.06 ± 23.46 5.44 ± 1.14
Age 20 - 29
Male (N=19) .37 ± .72 4.81 ± 3.48 383.58 ± 52.36 83.53 ± 20.86 5.30 ± 1.08
Female (N=30) .55 ± 1.21 2.29 ± 2.66 421.07 ± 71.26 88.63 ± 29.06 5.89 ± 1.25
Age 30 - 39
Male (N=4) .00 ± .0110 1.62 ± 1.05 355.25 ± 72.94 64.00 ± 12.83 6.49 ± 0.36
Female (N=22) .14 ± .2510 1.77 ± 1.56 369.77 ± 53.53 81.36 ± 24.57 6.05 ± 0.96
Age 40 - 49
Male (N=14) .02 ± .0810 2.76 ± 1.80 331.93 ± 31.25 66.14 ± 11.60 6.29 ± 0.84
Female (N=19) .06 ± .1310 1.88 ± 2.01 405.32 ± 66.85 81.89 ± 21.06 6.21 ± 0.85
Age 50 - 59
Male (N=8) .19 ± .2810 2.16 ± 1.22 442.88 ± 46.85 75.38 ± 11.55 5.71 ± 1.02
Female (N=16) .15 ± .3210 1.85 ± 2.33 432.06 ± 41.57 79.56 ± 17.37 6.20 ± 1.22
Age 60 - 69
Male (N=12) .10 ± .2410 1.95 ± 2.22 447.17 ± 35.92 86.50 ± 22.93 6.19 ± 0.91
Female (N=24) .22 ± .3110 2.69 ± 2.53 442.75 ± 57.71 81.67 ± 16.73 5.76 ± 1.23
Age 70 - 79
Male (N=12) 1.47 ± 2.22 4.17 ± 3.32 476.75 ± 55.65 107.08 ± 33.85 4.77 ± 1.35
Female (N=39) .73 ± 1.71 2.55 ± 2.03 480.23 ± 50.35 97.87 ± 26.33 5.21 ± 1.01
Age 80 and up
Male (N=8) 2.47 ± 2.47 5.83 ± 3.87 502.25 ± 68.44 128.88 ± 21.68 3.80 ± 0.58
Female (N=23) 2.12 ± 3.11 3.50 ± 3.64 509.57 ± 63.09 115.00 ± 48.39 4.63 ± 1.21

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 Table 61: Visual Norms - Omissions (%)(See end of this section for reference key.)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 4
Male (N=24) 32.75 ± 18.04 27.68 ± 22.54 28.81 ± 20.51
Female (N=26) 41.56 ± 27.96 31.04 ± 20.30 33.38 ± 21.06
Age 5

The TOVA Company

Male (N=66) 16.09 ± 12.60 13.62 ± 12.61 14.17 ± 11.90
Female (N=80) 15.96 ± 16.26 14.66 ± 13.83 14.95 ± 12.92
Age 6
Male (N=19) 4.84 ± 5.58 9.53 ± 9.07 7.21 ± 7.79 12.11 ± 11.24 7.11 ± 6.61 9.58 ± 8.66 8.95 ± 7.80
Female (N=23) 7.91 ± 11.24 9.26 ± 12.23 7.52 ± 7.73 10.39 ± 12.42 8.61 ± 11.52 8.96 ± 9.88 8.87 ± 9.77
Age 7
Male (N=61) 5.10 ± 11.19 7.98 ± 12.13 5.18 ± 6.41 8.10 ± 9.60 6.46 ± 11.32 6.59 ± 7.57 6.54 ± 7.55
T.O.V.A. 8.0 Professional Manual

Female (N=61) 3.97 ± 6.62 3.70 ± 4.18 3.38 ± 4.51 4.97 ± 5.80 3.74 ± 4.32 4.11 ± 4.82 4.00 ± 4.30
Age 8
Male (N=36) 1.894 ± 3.05 2.724 ± 4.05 1.61 ± 2.09 2.53 ± 4.53 2.31 ± 3.19 1.97 ± 3.09 2.17 ± 2.94
Female (N=38) 1.74 ± 2.344 2.344 ± 3.05 1.18 ± 1.86 2.53 ± 4.57 1.97 ± 1.95 1.82 ± 2.79 1.87 ± 2.46
Age 9
Male (N=57) 4.81 ± 15.59 3.51 ± 13.29 4.42 ± 16.36 4.49 ± 14.42 4.09 ± 13.43 4.35 ± 14.59 4.35 ± 14.22
Female (N=55) 1.444 ± 3.70 1.33 ± 2.074 .762 ± 1.22 1.42 ± 2.45 1.29 ± 2.39 1.046 ± 1.60 1.07 ± 1.50
Age 10
Male (N=33) 3.42 ± 8.06 3.36 ± 9.08 3.12 ± 12.52 1.30 ± 2.08 3.33 ± 8.06 2.18 ± 7.00 2.45 ± 6.87
Female (N=34) .65 ± 2.004 .764 ± 2.10 .41 ± .782 .682 ± 1.01 .71 ± 1.71 .41 ± .786 .53 ± .90
Age 11
Male (N=55) 1.754 ± 7.18 2.55 ± 8.17 2.04 ± 10.61 1.85 ± 4.43 2.07 ± 7.67 1.91 ± 7.30 1.93 ± 7.28
Female (N=60) 1.134 ± 3.15 1.024 ± 2.05 .452 ± .87 .752 ± 1.32 1.00 ± 2.22 .52 ± 1.036 .68 ± 1.26
Age 12
Male (N=37) .53 ± 1.954 .984 ± 1.83 .582 ± .88 .93 ± 1.71 .70 ± 1.54 .72 ± 1.246 .68 ± 1.15
Female (N=49) .61 ± 1.394 .83 ± 1.614 .442 ± .85 .572 ± 1.49 .72 ± 1.27 .50 ± 1.036 .53 ± .92
Age 13
Male (N=66) .68 ± 1.974 .76 ± 1.484 .562 ± 1.43 .86 ± 1.85 .71 ± 1.50 .67 ± 1.566 .67 ± 1.44
Female (N=69) .33 ± 1.054 .614 ± 2.02 .572 ± .92 .632 ± 2.26 .47 ± 1.43 .56 ± 1.416 .55 ± 1.39
Age 14
Male (N=46) .37 ± 1.124 .36 ± .954 .322 ± .79 .25 ± .532 .358 ± .73 .29 ± .536 .31 ± .47
Female (N=36) .08 ± .464 .16 ± .674 .412 ± 1.03 .30 ± .772 .10 ± .368 .31 ± .826 .2710 ± .65

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Age 15
Male (N=61) .47 ± 1.764 1.894 ± 6.04 .662 ± 1.07 .392 ± 1.24 1.18 ± 3.33 .53 ± 1.026 .69 ± 1.31
Female (N=58) .29 ± 1.004 .58 ± 1.144 .36 ± .722 .572 ± 1.58 .42 ± .78 .40 ± .976 .41 ± .82
9

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T.O.V.A. 8.0 Professional Manual 9 APPENDICES

Table 62: Visual Norms - Omissions (%), continued(See end of this section for reference key.)

Age 16
Male (N=22) .63 ± 1.194 .63 ± 1.704 .762 ± 1.26 .87 ± 2.27 .63 ± 1.11 .816 ± 1.69 .77 ± 1.42
Female (N=29) .864 ± 2.98 .77 ± 2.344 .772 ± 1.64 .632 ± 1.15 .81 ± 2.61 .70 ± 1.276 .72 ± 1.42
Age 17
Male (N=18) .46 ± 1.074 .00 ± .004 .35 ± .492 .22 ± .462 .238 ± .53 .29 ± .306 .2710 ± .30
Female (N=18) .62 ± 1.524 .15 ± .654 .13 ± .302 .622 ± 1.55 .39 ± .80 .37 ± .906 .38 ± .75
Age 18
Male (N=32) .17 ± .684 .17 ± .684 .37 ± .492 .42 ± .752 .178 ± .59 .40 ± .486 .35 ± .42
Female (N=66) .21 ± .744 .29 ± .994 .31 ± .602 .432 ± 1.48 .258 ± .69 .37 ± .996 .35 ± .80
Age 19
Male (N=25) .00 ± .014 .11 ± .564 .10 ± .262 .06 ± .322 .068 ± .288 .08 ± .206 .07 ± .1810
Female (N=54) .21 ± .734 .62 ± 1.844 .542 ± 2.05 .712 ± 2.47 .41 ± 1.16 .626 ± 2.23 .58 ± 1.81
Age 20 - 29
Male (N=19) .29 ± .884 .29 ± .884 .332 ± .97 .462 ± 1.00 .298 ± .58 .40 ± .886 .37 ± .72
Female (N=30) .56 ± 1.854 .37 ± .964 .262 ± .82 .87 ± 2.14 .46 ± 1.17 .57 ± 1.346 .55 ± 1.21
Age 30 - 39
Male (N=4) .00 ± .014 .00 ± .014 .00 ± .012 .00 ± .012 .00 ± .018 .00 ± .016 .00 ± .0110
Female (N=22) .25 ± .824 .13 ± .594 .11 ± .282 .14 ± .312 .198 ± .49 .13 ± .236 .14 ± .2510
Age 40 - 49
Male (N=14) .00 ± .014 .00 ± .014 .06 ± .212 .00 ± .012 .008 ± .018 .03 ± .116 .02 ± .0810
Female (N=19) .00 ± .014 .15 ± .644 .13 ± .302 .00 ± .012 .07 ± .328 .06 ± .156 .06 ± .1310
Age 50 - 59
Male (N=8) .35 ± .984 .35 ± .984 .10 ± .282 .20 ± .562 .358 ± .64 .15 ± .306 .19 ± .2810
Female (N=16) .17 ± .694 .00 ± .014 .25 ± .632 .10 ± .402 .09 ± .358 .17 ± .356 .1510 ± .32
Age 60 - 69
Male (N=12) .00 ± .014 .00 ± .014 .20 ± .492 .07 ± .232 .00 ± .018 .13 ± .316 .10 ± .2410
Female (N=24) .35 ± .944 .23 ± .784 .33 ± .662 .07 ± .222 .298 ± .71 .20 ± .396 .2210 ± .31
Age 70 - 79
Male (N=12) .23 ± .804 1.16 ± 2.504 1.19 ± 1.81 2.18 ± 3.42 .69 ± 1.26 1.69 ± 2.56 1.47 ± 2.22
Female (N=39) .21 ± .754 1.21 ± 2.694 .81 ± 1.63 .652 ± 2.20 .71 ± 1.52 .736 ± 1.82 .73 ± 1.71
Age 80 and up
Male (N=8) 3.13 ± 3.77 3.47 ± 4.39 2.58 ± 1.93 1.88 ± 2.61 3.30 ± 3.92 2.23 ± 2.15 2.47 ± 2.47
Female (N=23) 1.574 ± 3.63 1.21 ± 2.344 1.83 ± 3.11 2.83 ± 5.82 1.39 ± 2.78 2.33 ± 3.73 2.12 ± 3.11

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 Table 63: Visual Norms - Commissions (%)(See end of this section for reference key.)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 4
Male (N=24) 12.60 ± 14.18 33.91 ± 18.61 17.34 ± 12.54
Female (N=26) 6.23 ± 8.16 26.60 ± 14.60 10.75 ± 7.46
Age 5

The TOVA Company

Male (N=66) 5.33 ± 6.79 27.55 ± 15.95 10.27 ± 6.92
Female (N=80) 3.85 ± 7.82 17.64 ± 12.01 6.91 ± 7.05
Age 6
Male (N=19) 4.26 ± 5.49 3.05 ± 4.77 29.74 ± 16.47 39.95 ± 18.07 3.63 ± 5.16 34.84 ± 16.58 10.37 ± 6.85
Female (N=23) 2.39 ± 3.87 1.91 ± 3.33 20.17 ± 11.73 27.70 ± 14.26 2.00 ± 3.25 23.96 ± 11.52 6.78 ± 4.16
Age 7
Male (N=61) 4.61 ± 7.57 3.66 ± 8.57 31.38 ± 18.61 41.16 ± 18.24 4.03 ± 7.86 36.25 ± 17.33 10.97 ± 8.47
T.O.V.A. 8.0 Professional Manual

Female (N=61) 2.72 ± 4.67 1.39 ± 2.33 21.05 ± 14.55 28.98 ± 16.67 1.95 ± 3.46 25.02 ± 14.41 6.89 ± 5.02
Age 8
Male (N=36) 3.72 ± 4.60 1.72 ± 2.84 24.81 ± 12.98 35.42 ± 17.19 2.58 ± 3.74 30.08 ± 13.91 8.61 ± 5.23
Female (N=38) 1.92 ± 2.55 .82 ± 1.61 23.00 ± 16.39 29.34 ± 15.26 1.345 ± 1.95 26.18 ± 14.80 6.61 ± 4.28
Age 9
Male (N=57) 3.60 ± 4.30 2.35 ± 4.15 28.14 ± 17.83 37.82 ± 21.11 2.89 ± 4.11 32.74 ± 18.82 9.39 ± 6.52
Female (N=55) 1.89 ± 2.94 1.02 ± 1.79 20.15 ± 13.54 30.24 ± 16.28 1.38 ± 2.31 25.24 ± 14.08 6.53 ± 4.17
Age 10
Male (N=33) 1.97 ± 1.40 .88 ± 1.11 26.45 ± 12.67 34.06 ± 12.99 1.27 ± 1.04 30.15 ± 11.38 7.70 ± 3.20
Female (N=34) 2.00 ± 2.61 .761 ± 1.21 18.59 ± 14.88 22.71 ± 15.56 1.26 ± 1.83 20.59 ± 14.08 5.65 ± 4.23
Age 11
Male (N=55) 2.62 ± 2.65 1.65 ± 2.12 28.67 ± 19.01 36.18 ± 19.40 2.09 ± 2.27 32.42 ± 18.49 8.69 ± 5.34
Female (N=60) 2.05 ± 2.17 1.07 ± 1.40 21.65 ± 14.81 28.22 ± 16.88 1.42 ± 1.73 24.85 ± 14.71 6.65 ± 4.16
Age 12
Male (N=37) 1.15 ± 1.51 .781 ± 1.29 23.60 ± 14.95 27.35 ± 15.93 .91 ± 1.285 25.50 ± 14.01 6.34 ± 3.82
Female (N=49) .83 ± 1.10 .561 ± .86 16.16 ± 15.25 21.15 ± 18.78 .57 ± .895 18.70 ± 16.50 4.59 ± 4.16
Age 13
Male (N=66) 1.57 ± 2.16 .761 ± .89 17.80 ± 14.09 19.22 ± 17.18 1.155 ± 1.40 18.46 ± 14.45 4.93 ± 3.93
Female (N=69) .771 ± 1.05 .541 ± .84 14.47 ± 12.52 16.29 ± 12.76 .64 ± .865 15.37 ± 12.21 3.81 ± 2.85
Age 14
Male (N=46) .78 ± 1.08 .681 ± .90 15.36 ± 12.96 15.30 ± 14.33 .72 ± .855 15.35 ± 12.81 3.97 ± 3.31
Female (N=36) .581 ± 1.01 .371 ± .671 10.98 ± 9.18 12.48 ± 11.78 .46 ± .695 11.77 ± 9.92 2.95 ± 2.60

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Age 15
Male (N=61) .721 ± 1.23 .451 ± .83 14.27 ± 10.65 14.80 ± 12.22 .56 ± .925 14.56 ± 10.74 3.64 ± 2.82
Female (N-58) .731 ± 1.08 .24 ± .541 13.38 ± 14.04 14.89 ± 13.89 .45 ± .665 14.12 ± 13.41 3.45 ± 3.39
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 Table 64: Visual Norms - Commissions (%), continued. (See end of this section for reference key.)

Age 16
Male (N=22) 1.19 ± 1.76 .611 ± .88 15.15 ± 15.78 16.29 ± 18.47 .90 ± 1.245 15.72 ± 16.58 4.19 ± 4.54
Female (N=29) .571 ± .95 .36 ± .621 9.87 ± 9.32 12.74 ± 10.69 .47 ± .755 11.30 ± 9.24 2.87 ± 2.46
Age 17
Male (N=18) .711 ± 1.36 .26 ± .541 9.72 ± 12.14 12.04 ± 13.10 .49 ± .905 10.88 ± 12.17 2.79 ± 3.11
Female (N=18) .621 ± 1.00 .31 ± .481 6.48 ± 7.13 10.19 ± 10.74 .46 ± .645 8.33 ± 8.52 2.21 ± 2.26
Age 18

The TOVA Company

Male (N=32) .55 ± .741 .691 ± 1.14 14.41 ± 13.00 16.84 ± 15.18 .62 ± .645 15.19 ± 12.54 3.86 ± 3.04
Female (N=66) .48 ± .681 .441 ± .79 12.16 ± 12.50 13.43 ± 12.82 .46 ± .615 12.82 ± 12.15 3.21 ± 2.87
Age 19
Male (N=25) .41 ± .611 .16 ± .321 8.33 ± 5.50 9.22 ± 8.44 .29 ± .315 8.78 ± 6.36 2.17 ± 1.52
Female (N=54) .711 ± 1.05 .511 ± .93 14.40 ± 14.72 14.87 ± 13.49 .61 ± .855 14.63 ± 13.38 3.73 ± 3.38
Age 20 - 29
T.O.V.A. 8.0 Professional Manual

Male (N=19) .75 ± .721 .751 ± .93 18.71 ± 13.70 19.30 ± 16.16 .75 ± .665 19.01 ± 14.22 4.81 ± 3.48
Female (N=30) .37 ± .741 .401 ± .93 9.26 ± 10.43 8.70 ± 11.60 .38 ± .625 8.98 ± 10.58 2.29 ± 2.66
Age 30 - 39
Male (N=4) .00 ± .011 .20 ± .401 6.94 ± 4.81 6.94 ± 5.78 .10 ± .205 6.94 ± 4.39 1.62 ± 1.05
Female (N=22) .14 ± .311 .611 ± 1.75 5.18 ± 5.24 8.08 ± 7.90 .38 ± .875 6.63 ± 5.84 1.77 ± 1.56
Age 40 - 49
Male (N=14) .51 ± .591 .28 ± .391 9.33 ± 7.11 12.70 ± 9.42 .40 ± .355 11.01 ± 7.32 2.76 ± 1.80
Female (N=19) .84 ± 1.82 .671 ± 1.80 6.14 ± 4.95 5.56 ± 4.44 .755 ± 1.78 5.85 ± 4.28 1.88 ± 2.01
Age 50 - 59
Male (N=8) .601 ± .92 .30 ± .411 6.25 ± 5.51 10.07 ± 6.95 .45 ± .395 8.16 ± 5.11 2.16 ± 1.22
Female (N=16) .741 ± 1.80 .20 ± .541 5.73 ± 6.21 7.64 ± 8.70 .47 ± 1.125 6.68 ± 6.96 1.85 ± 2.33
Age 60 - 69
Male (N=12) .601 ± .96 .26 ± .521 7.41 ± 10.14 7.18 ± 7.05 .43 ± .605 7.29 ± 8.27 1.95 ± 2.22
Female (N=24) .631 ± .84 .33 ± .571 10.30 ± 10.05 10.53 ± 11.38 .48 ± .635 10.42 ± 10.13 2.69 ± 2.53
Age 70 - 79
Male (N=12) 1.46 ± 2.03 1.26 ± 1.71 13.89 ± 9.02 14.12 ± 10.01 1.365 ± 1.75 14.00 ± 8.95 4.17 ± 3.32
Female (N=39) 1.00 ± 1.24 .49 ± .721 9.54 ± 7.69 8.19 ± 7.73 .74 ± .845 8.87 ± 7.05 2.55 ± 2.03
Age 80 and up
Male (N=8) .99 ± .92 1.49 ± 1.56 20.83 ± 12.60 22.92 ± 17.43 1.24 ± .945 21.88 ± 14.71 5.83 ± 3.87
Female (N=23) 1.62 ± 2.71 .761 ± 1.45 10.75 ± 11.70 12.44 ± 10.36 1.195 ± 2.03 11.59 ± 10.37 3.50 ± 3.64

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9

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 Table 65: Visual Norms - Response Times (ms)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 4
Male (N=24) 896.79 ± 114.19 725.42 ± 74.63 783.42 ± 87.71
Female (N=26) 911.85 ± 150.15 801.38 ± 102.03 826.69 ± 104.27
Age 5

The TOVA Company

Male (N=66) 805.88 ± 158.20 699.76 ± 149.94 723.69 ± 147.40
Female (N=80) 834.94 ± 134.51 748.91 ± 131.64 767.90 ± 126.78
Age 6
Male (N=19) 642.53 ± 111.13 696.37 ± 144.04 584.63 ± 123.85 586.11 ± 121.16 669.05 ± 121.66 585.11 ± 120.83 604.32 ± 120.24
Female (N=23) 706.17 ± 94.35 764.48 ± 114.98 648.22 ± 79.10 648.09 ± 83.97 735.13 ± 96.26 647.74 ± 78.43 667.00 ± 74.27
Age 7
Male (N=61) 609.13 ± 103.16 652.57 ± 123.35 543.30 ± 116.95 534.39 ± 112.93 630.62 ± 108.85 538.87 ± 110.85 558.70 ± 108.12
T.O.V.A. 8.0 Professional Manual

Female (N=61) 655.16 ± 102.72 691.89 ± 105.57 591.02 ± 103.20 587.25 ± 113.71 673.51 ± 99.51 589.25 ± 106.33 608.28 ± 99.87
Age 8
Male (N=36) 530.44 ± 75.32 566.61 ± 87.97 475.36 ± 90.45 463.39 ± 101.67 548.61 ± 77.61 469.42 ± 92.25 487.19 ± 86.14
Female (N=38) 589.03 ± 83.95 615.39 ± 90.16 522.34 ± 90.57 533.74 ± 89.86 602.50 ± 80.48 527.95 ± 86.62 544.34 ± 79.54
Age 9
Male (N=57) 512.70 ± 73.40 547.75 ± 79.09 439.81. ± 85.77 433.86 ± 97.86 530.37 ± 73.67 437.67 ± 88.09 458.56 ± 80.75
Female (N=55) 552.42 ± 77.01 583.89 ± 79.39 476.69 ± 72.17 481.64 ± 86.88 568.25 ± 73.36 478.96 ± 76.25 498.80 ± 71.53
Age 10
Male (N=33) 440.91 ± 59.25 476.58 ± 63.75 385.67 ± 61.71 387.18 ± 69.62 458.82 ± 57.90 386.15 ± 61.48 402.15 ± 58.04
Female (N=34) 488.21 ± 67.69 506.62 ± 83.11 424.06 ± 74.68 419.53 ± 90.49 497.38 ± 73.11 421.74 ± 78.61 438.47 ± 74.24
Age 11
Male (N=55) 424.82 ± 57.55 452.64 ± 68.79 365.25 ± 69.53 358.25 ± 76.57 439.45 ± 61.47 362.15 ± 71.52 379.33 ± 66.01
Female (N=60) 458.60 ± 62.94 486.07 ± 73.95 401.58 ± 77.84 389.98 ± 77.60 472.75 ± 66.69 395.82 ± 75.66 412.80 ± 71.07
Age 12
Male (N=37) 432.86 ± 63.18 442.76 ± 81.61 382.84 ± 80.15 368.97 ± 81.40 437.81 ± 69.14 376.14 ± 78.21 389.92 ± 73.81
Female (N=49) 463.90 ± 78.84 467.73 ± 77.58 394.33 ± 81.08 395.39 ± 94.64 465.82 ± 75.85 394.96 ± 85.47 410.29 ± 80.96
Age 13
Male (N=66) 412.23 ± 57.49 433.98 ± 74.54 368.89 ± 65.22 365.70 ± 66.32 423.15 ± 62.50 367.41 ± 62.90 379.74 ± 60.77
Female (N=69) 420.65 ± 62.87 445.68 ± 72.40 365.54 ± 58.18 363.35 ± 61.97 433.17 ± 65.30 364.43 ± 58.42 379.71 ± 56.85
Age 14
Male (N=46) 403.48 ± 58.24 426.83 ± 76.63 371.15 ± 64.68 378.04 ± 80.91 415.15 ± 64.36 374.67 ± 69.30 383.43 ± 65.82
Female (N=36) 424.97 ± 69.54 442.58 ± 72.56 371.42 ± 67.33 366.94 ± 62.95 433.58 ± 69.89 369.28 ± 63.24 383.36 ± 62.93
Age 15

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Male (N=61) 390.61 ± 56.57 414.74 ± 70.48 345.66 ± 53.17 353.41 ± 64.31 402.36 ± 60.35 349.51 ± 56.41 361.15 ± 53.54
Female (N-58) 412.38 ± 56.93 423.31 ± 61.71 363.34 ± 66.87 360.84 ± 66.66 417.91 ± 57.80 362.09 ± 65.38 374.41 ± 61.85
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 Table 66: Visual Norms - Response Times (ms), continued

Age 16
Male (N=22) 391.64 ± 48.46 406.18 ± 59.30 346.32 ± 56.84 338.86 ± 58.50 398.82 ± 51.18 342.45 ± 55.47 354.82 ± 51.97
Female (N=29) 410.17 ± 51.56 430.69 ± 53.35 364.79 ± 68.77 371.69 ± 71.75 420.10 ± 50.90 368.28 ± 68.50 379.62 ± 60.33
Age 17
Male (N=18) 426.44 ± 45.92 434.61 ± 48.61 364.78 ± 54.52 360.83 ± 52.52 430.50 ± 46.46 362.94 ± 51.90 377.89 ± 45.92

The TOVA Company

Female (N=18) 411.89 ± 44.03 418.56 ± 45.98 366.94 ± 52.43 365.00 ± 56.89 415.06 ± 43.63 365.83 ± 52.75 376.72 ± 48.55
Age 18
Male (N=32) 406.91 ± 68.20 423.16 ± 73.43 363.50 ± 65.88 361.81 ± 72.04 415.31 ± 69.38 362.91 ± 66.95 373.94 ± 64.20
Female (N=66) 431.68 ± 53.86 445.55 ± 66.97 392.74 ± 65.02 393.11 ± 66.39 438.06 ± 59.57 392.53 ± 63.94 402.44 ± 60.60
T.O.V.A. 8.0 Professional Manual

Age 19
Male (N=25) 438.04 ± 55.96 441.12 ± 50.34 394.96 ± 59.55 391.88 ± 66.82 439.12 ± 50.06 393.36 ± 60.80 404.04 ± 56.86
Female (N=54) 422.54 ± 41.50 444.63 ± 60.57 393.13 ± 47.43 397.33 ± 62.98 433.22 ± 49.89 394.69 ± 54.13 403.52 ± 49.63
Age 20 - 29
Male (N=19) 414.68 ± 47.36 428.37 ± 62.11 377.21 ± 51.14 370.63 ± 59.22 420.58 ± 55.47 372.79 ± 54.80 383.58 ± 52.36
Female (N=30) 445.50 ± 59.80 470.63 ± 77.15 409.90 ± 74.12 411.07 ± 81.33 457.80 ± 65.80 410.50 ± 74.80 421.07 ± 71.26
Age 30 - 39
Male (N=4) 386.00 ± 62.90 388.00 ± 69.02 341.50 ± 77.52 351.00 ± 77.19 386.75 ± 65.76 346.00 ± 76.62 355.25 ± 72.94
Female (N=22) 401.59 ± 52.29 413.36 ± 64.35 364.64 ± 57.13 357.55 ± 65.78 405.91 ± 57.01 365.09 ± 66.59 369.77 ± 53.53
Age 40 - 49
Male (N=14) 360.71 ± 37.63 367.43 ± 41.36 327.79 ± 34.25 318.57 ± 32.18 364.00 ± 38.72 323.29 ± 32.20 331.93 ± 31.25
Female (N=19) 443.89 ± 85.19 452.32 ± 78.17 401.16 ± 68.60 385.26 ± 64.33 448.16 ± 80.71 393.11 ± 65.32 405.32 ± 66.85
Age 50 - 59
Male (N=8) 452.75 ± 49.90 477.38 ± 65.23 432.50 ± 48.77 439.88 ± 45.03 465.25 ± 57.18 436.13 ± 45.45 442.88 ± 46.85
Female (N=16) 472.88 ± 46.75 480.81 ± 60.94 428.00 ± 49.93 410.19 ± 39.62 476.81 ± 52.21 419.06 ± 42.10 432.06 ± 41.57

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Age 60 - 69
Male (N=12) 450.67 ± 44.15 474.75 ± 33.90 432.25 ± 36.86 452.17 ± 59.43 471.08 ± 51.46 442.83 ± 40.29 447.17 ± 35.92
Female (N=24) 466.17 ± 47.06 478.83 ± 48.21 438.50 ± 66.75 430.08 ± 62.23 472.54 ± 45.39 434.33 ± 62.87 442.75 ± 57.71
Age 70 - 79
Male (N=12) 493.00 ± 54.26 501.08 ± 53.03 456.83 ± 52.80 485.25 ± 72.08 496.92 ± 52.95 470.75 ± 59.38 476.75 ± 55.65
9

Female (N=39) 500.10 ± 56.73 519.28 ± 69.56 475.05 ± 57.90 468.56 ± 54.06 510.03 ± 61.43 471.72 ± 51.73 480.23 ± 50.35
Age 80 and up
Male (N=8) 541.25 ± 31.30 540.13 ± 37.49 487.75 ± 75.53 495.00 ± 88.28 540.13 ± 31.76 491.38 ± 80.46 502.25 ± 68.44
Female (N=23) 522.17 ± 51.18 532.30 ± 61.40 494.74 ± 70.13 515.22 ± 77.57 527.26 ± 55.54 504.87 ± 70.71 509.57 ± 63.09

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 Table 67: Visual Norms - Variability (ms)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 4
Male (N=24) 280.88 ± 69.79 334.29 ± 73.84 330.08 ± 65.98
Female (N=26) 254.42 ± 88.97 331.81 ± 100.49 325.46 ± 91.67
Age 5

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Male (N=66) 228.68 ± 63.68 263.20 ± 74.57 262.94 ± 63.33
Female (N=80) 217.40 ± 69.44 264.23 ± 62.44 260.4 ± 55.69
Age 6
Male (N=19) 170.58 ± 48.78 212.37 ± 79.58 221.26 ± 53.09 261.05 ± 71.52 198.84 ± 60.20 242.32 ± 58.90 236.95 ± 54.41
Female (N=23) 192.74 ± 64.03 212.09 ± 66.69 239.13 ± 48.97 258.52 ± 46.37 210.74 ± 56.80 250.70 ± 40.60 248.04 ± 38.79
Age 7
Male (N=61) 168.75 ± 52.74 184.26 ± 67.28 212.59 ± 61.39 236.33 ± 69.74 181.72 ± 54.83 227.54 ± 59.96 223.15 ± 54.93
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Female (N=61) 166.95 ± 46.95 175.38 ± 50.43 203.90 ± 56.53 230.02 ± 66.30 176.69 ± 40.63 218.79 ± 55.08 215.87 ± 47.89
Age 8
Male (N=36) 145.75 ± 55.27 151.61 ± 47.17 162.11 ± 53.94 185.17 ± 55.85 154.28 ± 43.82 176.47 ± 52.58 176.92 ± 47.66
Female (N=38) 149.21 ± 47.83 156.08 ± 46.52 173.76 ± 45.25 207.53 ± 52.04 160.18 ± 34.54 193.92 ± 43.81 192.79 ± 37.89
Age 9
Male (N=57) 127.07 ± 48.50 135.88 ± 44.90 146.65 ± 48.46 164.93 ± 54.82 135.70 ± 40.64 158.58 ± 48.76 161.74 ± 43.81
Female (N=55) 126.65 ± 41.17 133.40 ± 45.24 149.27 ± 41.65 172.22 ± 52.65 135.22 ± 37.11 163.60 ± 43.55 164.82 ± 38.17
Age 10
Male (N=33) 107.09 ± 34.15 116.06 ± 36.90 122.33 ± 39.41 142.85 ± 57.76 116.27 ± 30.08 135.61 ± 46.21 137.39 ± 39.30
Female (N=34) 122.00 ± 40.99 114.26 ± 38.44 127.09 ± 41.47 135.59 ± 50.41 122.79 ± 31.66 134.38 ± 44.50 138.32 ± 38.78
Age 11
Male (N=55) 101.89 ± 34.33 105.98 ± 40.43 110.96 ± 34.47 124.36 ± 47.27 107.33 ± 34.19 119.35 ± 38.34 123.82 ± 33.70
Female (N=60) 108.77 ± 32.18 114.98 ± 38.61 118.47 ± 37.96 131.40 ± 45.66 114.83 ± 32.65 127.37 ± 38.73 130.95 ± 34.36
Age 12
Male (N=37) 103.92 ± 39.45 110.97 ± 50.52 114.22 ± 40.87 124.35 ± 45.16 110.57 ± 43.21 121.84 ± 40.93 125.05 ± 37.09
Female (N=49) 111.14 ± 52.75 100.39 ± 39.25 110.14 ± 43.82 120.76 ± 45.96 109.10 ± 42.76 117.73 ± 44.21 122.33 ± 40.89
Age 13
Male (N=66) 89.41 ± 31.40 93.86 ± 38.91 100.21 ± 35.21 107.61 ± 40.91 95.39 ± 34.64 106.33 ± 36.42 108.35 ± 33.71
Female (N=69) 79.70 ± 29.14 92.32 ± 36.08 94.19 ± 32.66 100.22 ± 32.75 89.67 ± 30.47 98.83 ± 31.10 103.09 ± 29.61
Age 14
Male (N=46) 79.89 ± 23.84 81.41 ± 27.27 99.28 ± 37.30 105.70 ± 41.70 84.39 ± 25.94 105.39 ± 39.15 104.70 ± 35.07
Female (N=36) 79.89 ± 32.68 78.92 ± 22.62 94.81 ± 39.52 97.97 ± 42.41 81.72 ± 25.34 98.39 ± 39.25 100.39 ± 34.64
Age 15

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Male (N=61) 74.41 ± 26.99 82.16 ± 35.97 88.75 ± 27.82 94.89 ± 31.94 82.31 ± 30.53 93.89 ± 28.53 96.59 ± 27.34
Female (N-58) 70.71 ± 19.69 72.95 ± 21.10 86.43 ± 28.68 88.88 ± 28.50 73.79 ± 18.56 89.28 ± 26.59 90.93 ± 22.71
9

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 Table 68: Visual Norms - Variability (ms), continued

Age 16
Male (N=22) 70.00 ± 21.72 81.77 ± 38.97 82.55 ± 24.27 89.18 ± 37.82 79.27 ± 27.89 88.23 ± 28.70 91.59 ± 25.77
Female (N=29) 81.28 ± 26.84 76.10 ± 22.98 90.72 ± 33.58 101.38 ± 45.17 81.14 ± 22.41 98.41 ± 37.46 100.83 ± 32.13
Age 17
Male (N=18) 87.17 ± 47.37 83.33 ± 47.36 84.78 ± 22.72 91.56 ± 25.83 86.78 ± 45.63 89.50 ± 22.28 95.94 ± 27.72

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Female (N=18) 74.72 ± 28.62 63.78 ± 17.93 83.33 ± 22.85 89.44 ± 32.48 71.11 ± 21.48 88.61 ± 24.59 89.56 ± 20.04
Age 18
Male (N=32) 77.28 ± 36.32 74.09 ± 39.22 80.09 ± 29.40 86.75 ± 34.28 78.13 ± 35.75 86.16 ± 30.31 89.84 ± 29.15
Female (N=66) 64.74 ± 18.93 69.11 ± 19.52 81.03 ± 28.34 84.92 ± 27.06 70.08 ± 17.14 85.24 ± 26.68 86.58 ± 23.18
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Age 19
Male (N=25) 68.68 ± 16.74 69.48 ± 34.41 74.64 ± 20.52 79.36 ± 28.48 72.52 ± 25.00 79.88 ± 23.27 82.92 ± 20.07
Female (N=54) 62.50 ± 15.59 66.37 ± 27.91 80.56 ± 20.11 87.74 ± 33.39 67.70 ± 21.42 85.93 ± 26.30 86.06 ± 23.46
Age 20 - 29
Male (N=19) 64.79 ± 26.78 70.58 ± 20.78 78.79 ± 17.20 80.84 ± 29.13 69.84 ± 22.77 81.11 ± 22.02 83.53 ± 20.86
Female (N=30) 64.60 ± 20.77 74.10 ± 33.94 81.20 ± 28.39 87.73 ± 39.15 74.13 ± 28.14 86.93 ± 33.09 88.63 ± 29.06
Age 30 - 39
Male (N=4) 48.75 ± 9.00 50.00 ± 14.09 63.00 ± 15.64 61.25 ± 11.76 49.50 ± 11.09 63.00 ± 12.96 64.00 ± 12.83
Female (N=22) 67.32 ± 30.38 63.27 ± 25.75 76.68 ± 24.25 75.45 ± 24.15 69.41 ± 25.96 80.32 ± 26.37 81.36 ± 24.57
Age 40 - 49
Male (N=14) 52.86 ± 12.46 52.50 ± 10.76 64.07 ± 14.37 64.14 ± 15.40 54.14 ± 7.59 65.21 ± 11.97 66.14 ± 11.60
Female (N=19) 69.21 ± 27.82 63.95 ± 19.45 79.37 ± 20.50 75.74 ± 22.28 69.11 ± 20.59 79.37 ± 19.83 81.89 ± 21.06
Age 50 - 59
Male (N=8) 62.00 ± 19.68 60.50 ± 24.73 70.13 ± 8.89 79.00 ± 15.66 63.38 ± 21.31 75.88 ± 10.48 75.38 ± 11.55
Female (N=16) 68.06 ± 26.07 67.88 ± 27.30 76.75 ± 20.55 67.56 ± 17.13 70.81 ± 23.40 74.69 ± 17.88 79.56 ± 17.37

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Age 60 - 69
Male (N=12) 83.17 ± 36.61 75.00 ± 28.87 77.08 ± 19.77 82.00 ± 21.80 82.50 ± 29.77 84.42 ± 25.19 86.50 ± 22.93
Female (N=24) 66.13 ± 20.95 69.88 ± 21.84 76.29 ± 15.59 80.08 ± 26.82 70.54 ± 18.55 80.00 ± 20.06 81.67 ± 16.73
Age 70 - 79
Male (N=12) 86.92 ± 31.18 77.08 ± 26.62 94.33 ± 31.02 117.92 ± 48.92 83.50 ± 26.79 110.33 ± 38.62 107.08 ± 33.85
9

Female (N=39) 83.64 ± 34.23 77.69 ± 28.94 99.26 ± 34.41 91.54 ± 27.30 84.46 ± 27.45 97.15 ± 26.78 97.87 ± 26.33
Age 80 and up
Male (N=8) 114.38 ± 32.15 102.13 ± 16.56 124.75 ± 35.62 128.75 ± 29.24 110.75 ± 17.52 128.38 ± 29.51 128.88 ± 21.68
Female (N=23) 84.83 ± 27.75 78.57 ± 25.77 108.52 ± 50.81 123.52 ± 63.45 83.30 ± 24.68 118.78 ± 55.67 115.00 ± 48.39

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Table 69: Visual Norms - D Prime (Perceptual Sensitivity)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 4
Male (N=24) 1.99 + 1.07 1.18 + 0.63 1.68 + 0.69
Female (N=26) 2.25 + 1.64 1.38 + 0.86 1.86 + 0.84
Age 5
Male (N=66) 3.18 + 1.15 1.99 + 0.86 2.59 + 0.65
Female (N=80) 3.78 + 1.67 2.40 + 1.05 2.93 + 0.98
Age 6
Male (N=19) 5.05 ± 1.68 4.70 ± 2.24 2.37 ± 0.96 1.74 ± 1.03 4.45 ± 1.79 2.02 ± 0.97 2.96 ± 0.94
Female (N=23) 4.31 ± 1.39 4.85 ± 1.90 2.91 ± 1.34 2.22 ± 0.95 4.62 ± 1.56 2.40 ± 0.91 3.10 ± 0.70
Age 7
Male (N=61) 4.77 ± 1.59 4.59 ± 1.89 2.77 ± 1.43 2.18 ± 1.44 4.44 ± 1.62 2.37 ± 1.20 3.19 ± 1.04
Female (N=61) 5.40 ± 1.74 5.77 ± 1.95 3.53 ± 1.40 2.84 ± 1.34 5.31 ± 1.82 3.06 ± 1.31 3.84 ± 1.20
Age 8
Male (N=36) 5.47 ± 1.66 5.94 ± 1.99 3.78 ± 1.28 3.43 ± 1.44 5.41 ± 1.79 3.64 ± 1.36 4.22 ± 1.24
Female (N=38) 5.98 ± 1.55 6.41 ± 1.85 4.14 ± 1.30 3.65 ± 1.33 5.64 ± 1.66 3.74 ± 1.29 4.31 ± 1.19
Age 9
Male (N=57) 5.52 ± 1.86 6.06 ± 1.85 3.79 ± 1.48 3.27 ± 1.58 5.49 ± 1.75 3.54 ± 1.46 4.25 ± 1.44
Female (N=55) 6.36 ± 1.67 6.43 ± 1.50 4.35 ± 1.31 3.84 ± 1.45 6.05 ± 1.64 4.01 ± 1.33 4.71 ± 1.23
Age 10
Male (N=33) 5.66 ± 1.59 6.70 ± 1.72 4.07 ± 1.21 3.74 ± 1.30 5.86 ± 1.65 3.83 ± 1.31 4.60 ± 1.29
Female (N=34) 6.63 ± 1.21 7.21 ± 1.72 4.88 ± 1.35 4.34 ± 1.43 6.73 ± 1.51 4.65 ± 1.32 5.39 ± 1.41
Age 11
Male (N=55) 6.21 ± 1.56 6.30 ± 2.04 4.15 ± 1.48 3.67 ± 1.62 6.01 ± 1.88 3.84 ± 1.57 4.69 ± 1.48
Female (N=60) 6.34 ± 1.42 6.79 ± 1.72 4.61 ± 1.20 4.09 ± 1.30 6.43 ± 1.49 4.43 ± 1.17 5.06 ± 1.17
Age 12
Male (N=37) 7.04 + 1.46 6.96 ± 1.71 4.35 ± 1.44 4.26 ± 1.49 6.62 ± 1.47 4.22 ± 1.41 4.97 ± 1.15
Female (N=49) 7.09 ± 1.50 7.18 ± 1.42 4.93 ± 1.39 4.84 ± 1.50 7.04 ± 1.51 4.64 ± 1.29 5.34 ± 1.26
Age 13
Male (N=66) 6.60 ± 1.53 6.92 ± 1.64 4.82 ± 1.45 4.72 ± 1.66 6.31 ± 1.53 4.61 ± 1.43 5.16 ± 1.22
Female (N=69) 7.30 ± 1.38 7.39 ± 1.35 4.80 ± 1.58 4.89 ± 1.45 6.98 ± 1.40 4.53 ± 1.33 5.14 ± 1.14
Age 14
Male (N=46) 7.24 ± 1.06 7.19 ± 1.37 5.08 ± 1.17 5.17 ± 1.39 6.77 ± 1.20 4.83 ± 1.14 5.32 ± 1.05
Female (N=36) 7.72 ± 1.04 7.75 ± 1.13 5.29 ± 1.48 5.47 ± 1.64 7.45 ± 1.07 5.06 ± 1.26 5.71 ± 1.12
Age 15
Male (N=61) 7.41 ± 1.47 7.34 ± 1.53 4.84 ± 1.64 5.08 ± 1.38 6.92 ± 1.55 4.68 ± 1.32 5.25 ± 1.19
Female (N-58) 7.31 ± 1.36 7.66 ± 1.36 5.20 ± 1.58 5.23 ± 1.88 7.10 ± 1.44 5.10 ± 1.58 5.63 ± 1.42

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Table 70: Visual Norms - D Prime (Perceptual Sensitivity), continued

Age 16
Male (N=22) 6.82 ± 1.87 7.27 ± 1.47 4.85 ± 1.88 5.04 ± 1.81 6.59 ± 1.80 4.58 ± 1.53 5.16 ± 1.36
Female (N=29) 7.41 ± 1.48 7.56 ± 1.52 5.28 ± 1.53 5.03 ± 1.62 7.27 ± 1.49 4.88 ± 1.38 5.56 ± 1.31
Age 17
Male (N=18) 7.33 ± 1.51 8.09 ± 0.85 5.47 ± 1.97 5.81 ± 2.09 7.36 ± 1.32 5.00 ± 1.74 5.63 ± 1.51
Female (N=18) 7.23 ± 1.51 7.77 ± 0.99 6.07 ± 1.55 5.46 ± 1.68 7.05 ± 1.27 5.60 ± 1.57 5.88 ± 1.08
Age 18
Male (N=32) 7.46 ± 1.03 7.24 ± 1.16 4.76 ± 1.36 4.98 ± 1.79 6.93 ± 0.98 4.48 ± 1.17 5.18 ± 1.04
Female (N=66) 7.55 ± 1.22 7.60 ± 1.23 5.14 ± 1.37 5.26 ± 1.33 7.20 ± 1.26 4.92 ± 1.20 5.49 ± 1.08
Age 19
Male (N=25) 7.82 ± 0.97 8.07 ± 1.04 5.77 ± 1.08 5.90 ± 1.19 7.56 ± 1.03 5.64 ± 1.17 6.24 ± 1.00
Female (N=54) 7.29 ± 1.16 7.45 ± 1.37 5.22 ± 1.52 5.13 ± 1.52 6.98 ± 1.28 4.88 ± 1.36 5.44 ± 1.14
Age 20 - 29
Male (N=19) 7.03 ± 1.42 7.21 ± 1.28 4.94 ± 1.14 4.88 ± 1.28 6.77 ± 1.36 4.75 ± 1.15 5.30 ± 1.08
Female (N=30) 7.78 ± 1.29 7.63 ± 1.44 5.85 ± 1.50 5.75 ± 1.82 7.30 ± 1.35 5.50 ± 1.51 5.89 ± 1.25
Age 30 - 39
Male (N=4) 8.53 ± 0.01 8.07 ± 0.93 5.81 ± 0.34 6.35 ± 1.47 8.13 ± 0.81 5.84 ± 0.44 6.49 ± 0.36
Female (N=22) 7.98 ± 1.13 7.92 ± 1.30 6.30 ± 1.42 5.66 ± 1.25 7.58 ± 1.47 5.55 ± 0.94 6.05 ± 0.96
Age 40 - 49
Male (N=14) 7.57 ± 1.00 7.87 ± 0.92 6.01 ± 1.47 5.67 ± 0.92 7.32 ± 0.81 5.64 ± 1.04 6.29 ± 0.84
Female (N=19) 7.58 ± 1.06 7.67 + 1.27 5.82 ± 0.92 6.37 ± 1.17 7.29 ± 1.10 5.77 ± 0.87 6.21 ± 0.85
Age 50 - 59
Male (N=8) 7.45 ± 1.70 7.54 ± 1.07 6.19 ± 1.05 5.38 ± 1.03 6.73 ± 1.52 5.32 ± 0.94 5.71 ± 1.02
Female (N=16) 7.71 ± 1.11 8.27 ± 0.72 6.10 ± 1.76 6.25 ± 1.53 7.79 ± 1.01 5.61 ± 1.38 6.20 ± 1.22
Age 60 - 69
Male (N=12) 7.69 ± 1.05 8.04 ± 0.88 6.09 ± 1.76 5.89 ± 1.18 7.62 ± 0.97 5.75 ± 1.30 6.19 ± 0.91
Female (N=24) 7.25 ± 1.35 7.76 ± 1.36 5.54 ± 1.44 5.71 ± 1.17 7.13 ± 1.42 5.40 ± 1.27 5.76 ± 1.23
Age 70 - 79
Male (N=12) 7.19 ± 1.57 6.64 ± 1.89 4.54 ± 1.79 4.53 ± 1.58 6.43 ± 1.85 4.17 ± 1.46 4.77 ± 1.35
Female (N=39) 7.17 ± 1.29 7.03 ± 1.54 4.92 ± 1.35 5.64 ± 1.46 6.55 ± 1.42 4.78 ± 1.13 5.21 ± 1.01
Age 80 and up
Male (N=8) 5.62 ± 2.06 5.56 ± 1.64 2.94 ± 0.62 4.02 ± 2.07 5.13 ± 1.66 3.04 ± 0.71 3.80 ± 0.58
Female (N=23) 6.51 ± 1.51 7.04 ± 1.92 4.75 ± 1.68 4.22 ± 1.74 6.32 ± 1.72 4.05 ± 1.35 4.63 ± 1.21

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Table 71: REFERENCE KEY

Ref. # Type Description

1 Q1/Q2 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.794% (1 error / 126 stimuli).*
2 Q3/Q4 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.794% (1 error / 126 stimuli).*
3 Q3/Q4 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 2.778% (1 error / 36 stimuli).*
4 Q1/Q2 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 2.778% (1 error / 36 stimuli).*
5 H1 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 1.389% 1 error / 72 stimuli).*
6 H2 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 1.389% 1 error / 72 stimuli).*
7 H2 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.397% (1 error / 252 stimuli).*
8 H1 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.397% (1 error / 252 stimuli).*
9 T commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.309% (1 error / 324 stimuli).*
10 T omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.309% (1 error / 324 stimuli).*
* Omission and commission errors are not normally distributed. This makes a
comparison to a norming group difficult, especially when some norming groups
(e.g. adults) made no omission/commission errors. Norming groups with no
errors (which implies a zero in the norming standard deviation) causes a single
error to distort distribution values such as z scores. Because one omission or
one commission error is not clinically relevant, the norming standard deviations
have been bounded at a minimum of one error.

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9.7 Appendix G: Auditory Norms

Table 72: Auditory Norms - Summary

Omission Commission Response Time Variability D PRIME: Hit

Errors (%): Errors (%): (ms) (SD & ms) Rate/False
Inattention Impulsivity Alarm Rate
Years of Age M ean ± SD M ean ± SD M ean ± SD M ean ± SD M ean ± SD
Age 6
Male (N=85) 18.96 + 20.82 10.43 + 14.64 775.63 + 127.05 309.01. + 73.42 2.69 ± 1.48
Female (N=90) 19.05 + 20.51 8.38 + 13.27 806.51 + 117.35 309.98 + 61.16 2.82 ± 1.32
Age 7
Male (N=92) 12.20 + 18.97 6.58 + 8.13 701.82 + 127.34 266.41 + 70.79 3.35 ± 1.42
Female (N=82) 15.03 + 21.43 5.41 + 7.95 752.50 + 137.70 272.92 + 67.98 3.56 ± 1.69
Age 8
Male (N=97) 6.50 + 13.15 4.15 + 4.34 663.21 + 109.48 240.06 + 65.38 4.02 ± 1.39
Female (N=108) 6.46 + 13.53 3.10 + 3.54 681.88 + 119.08 225.43 + 64.57 4.28 ± 1.49
Age 9-
Male (N=104) 4.49 + 11.32 3.07 + 3.89 640.90 + 107.58 215.02 + 66.30 4.41 ± 1.30
Female (N=100) 4.19 + 9.42 2.64 + 2.29 636.17 + 111.07 205.02 + 63.36 4.51 ± 1.33
Age 10
Male (N=106) 2.35 + 8.38 2.32 + 2.83 588.63 + 93.15 180.28 + 54.41 5.06 ± 1.48
Female (N=107) 1.50 + 3.12 1.51 + 1.44 585.33 + 98.77 171.90 + 59.36 5.42 ± 1.37
Age 11
Male (N=96) .88 + 1.69 1.54 + 1.27 562.04 + 92.64 162.40 + 55.80 5.54 ± 1.30
Female (N=104) 1.49 + 3.42 1.44 + 1.39 573.87 + 113.87 164.03 + 61.52 5.45 ± 1.48
Age 12
Male (N=87) 1.50 + 7.81 1.40 + 1.53 569.63 + 104.86 167.43 + 58.33 5.74 ± 1.57
Female (N=94) .74 + 1.36 1.08 + 1.04 574.14 + 108.32 161.31 + 60.52 5.78 ± 1.38
Age 13
Male (N=98) 1.03 + 2.21 1.17 + 1.36 559.24 + 96.89 164.35 + 58.13 5.79 ± 1.50
Female (N=91) 2.17 + 5.99 1.33 + 1.68 548.52 + 93.68 163.11 + 64.67 5.60 ± 1.55
Age 14
Male (N=100) 1.45 + 6.17 1.20 + 1.69 523.00 + 95.95 159.70 + 62.84 5.95 ± 1.46
Female (N=101) .69 + 1.18 .85 + .97 521.12 + 93.05 146.99 + 56.91 6.03 ± 1.49
Age 15
Male (N=98) .51 + 1.28 .88 + .93 510.76 + 111.05 148.95 + 62.30 6.15 ± 1.32
Female (N=90) 1.47 + 7.16 1.13 + 2.35 517.72 + 106.38 150.68 + 64.76 5.88 ± 1.55
Age 16
Male (N=94) .72 + 1.40 .71 + .79 511.30 + 109.41 144.78 + 53.66 6.14 ± 1.44
Female (N=87) .78 + 1.90 .68 + 1.16 499.97 + 109.84 135.79 + 57.39 6.54 ± 1.59
Age 17
Male (N=99) .49 + .98 .67 + 1.29 480.81 + 84.41 132.75 + 49.76 6.47 ± 1.56
Female (N=107) .84 + 2.58 .97 + 3.56 492.13 + 109.23 126.53 + 57.96 6.58 ± 1.62
Age 18
Male (N=101) .43 + 1.78 .52 + .71 477.90 + 88.76 127.39 + 47.52 6.65 ± 1.39
Female (N=101) .55 + 1.38 .38 + .53 492.42 + 98.42 125.11 + 50.23 6.81 ± 1.44
Age 19
Male (N=22) .44 + 1.03 .49 + .90 476.40 + 94.67 127.09 + 47.34 6.89 ± 1.60
Female (N=10) .34 + .71 .56 + .76 450.59 + 90.54 128.72 + 60.26 7.00 ± 1.62
Age 20 - 29
Male (N=54) 1.22 ± 3.26 1.571 ± 1.59 490.33 ± 127.47 119.28 ± 62.97 5.88 ± 1.31
Female (N=75) .56 ± 1.20 1.11 ± 1.40 511.97 ± 120.63 115.59 ± 49.73 6.34 ± 1.38

The TOVA Company 800.729.2886 562.594.7700 info@tovatest.com 106

 Table 73: Auditory Norms - Omissions (%)(See end of this section for reference key.)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 6
Male (N=85) 11.61 ± 14.91 13.43 ± 17.45 19.60 ± 22.66 21.99 ± 25.09 12.52 ± 15.58 20.87 ± 23.59 18.96 ± 20.82
Female (N=90) 11.26 ± 13.40 16.37 ± 17.54 20.54 ± 23.90 20.66 ± 23.56 13.80 ± 14.69 20.59 ± 23.36 19.05 ± 20.51
Age 7

The TOVA Company

Male (N=92) 6.15 ± 12.04 8.42 ± 13.84 13.30 ± 21.49 13.90 ± 22.65 7.28 ± 11.95 13.61 ± 21.65 12.20 ± 18.97
Female (N=82) 8.81 ± 14.45 10.37 ± 16.56 16.94 ± 24.82 16.26 ± 25.15 9.59 ± 14.84 16.62 ± 24.43 15.03 ± 21.43
Age 8
Male (N=97) 2.014 ± 4.39 3.59 ± 7.88 7.13 ± 15.36 8.08 ± 17.12 2.80 ± 5.52 7.59 ± 15.91 6.50 ± 13.15
Female (N=108) 4.12 ± 11.28 4.16 ± 9.01 7.40 ± 16.47 6.89 ± 14.96 4.14 ± 9.57 7.14 ± 15.48 6.46 ± 13.53
Age 9
Male (N=104) 1.994 ± 5.22 2.174 ± 5.59 5.35 ± 14.36 5.04 ± 13.34 2.08 ± 5.13 5.19 ± 13.67 4.49 ± 11.32
T.O.V.A. 8.0 Professional Manual

Female (N=100) 1.724 ± 4.18 2.264 ± 4.61 4.87 ± 12.15 4.79 ± 10.88 1.98 ± 3.92 4.84 ± 11.27 4.19 ± 9.42
Age 10
Male (N=106) .85 ± 2.254 1.244 ± 3.41 3.01 ± 10.72 2.46 ± 10.25 1.05 ± 2.54 2.73 ± 10.42 2.35 ± 8.38
Female (N=107) 1.174 ± 5.85 1.07 ± 2.404 1.72 ± 4.42 1.50 ± 2.60 1.12 ± 3.90 1.61 ± 3.29 1.50 ± 3.12
Age 11
Male (N=96) .29 ± 1.184 .46 ± 1.554 1.18 ± 2.54 .88 ± 1.76 .388 ± 1.18 1.036 ± 1.99 .88 ± 1.69
Female (N=104) .73 ± 2.434 .89 ± 2.184 1.79 ± 4.89 1.58 ± 3.59 .81 ± 2.05 1.69 ± 4.11 1.49 ± 3.42
Age 12
Male (N=87) .534 ± 3.09 1.624 ± 7.78 1.57 ± 8.14 1.66 ± 9.03 1.08 ± 5.42 1.61 ± 8.56 1.50 ± 7.81
Female (N=94) .36 ± 1.804 .77 ± 2.174 .692 ± 1.38 .87 ± 1.62 .56 ± 1.76 .79 ± 1.366 .74 ± 1.36
Age 13
Male (N=98) .65 ± 2.214 .79 ± 2.714 .99 ± 2.38 1.26 ± 2.86 .72 ± 2.24 1.126 ± 2.54 1.03 ± 2.21
Female (N=91) .74 ± 2.164 1.514 ± 3.80 2.24 ± 6.28 2.70 ± 8.08 1.12 ± 2.85 2.47 ± 7.09 2.17 ± 5.99
Age 14
Male (N=100) .34 ± 1.174 1.044 ± 4.51 1.64 ± 6.61 1.75 ± 8.59 .69 ± 2.77 1.69 ± 7.53 1.45 ± 6.17
Female (N=101) .50 ± 2.284 .63 ± 1.614 .772 ± 1.54 .662 ± 1.37 .57 ± 1.68 .72 ± 1.286 .69 ± 1.18
Age 15
Male (N=98) .31 ± 1.594 .31 ± 1.384 .502 ± 1.26 .632 ± 2.06 .318 ± 1.14 .576 ± 1.56 .51 ± 1.28
Female (N=90) .37 ± 1.684 .714 ± 2.81 1.49 ± 7.81 1.98 ± 10.50 .54 ± 2.14 1.73 ± .9.11 1.47 ± 7.16
Age 16
Male (N=94) .24 ± .894 .83 ± 2.114 .582 ± 1.15 .96 ± 2.39 .53 ± 1.21 .776 ± 1.64 .72 ± 1.40

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Female (N=87) .35 ± 1.194 .894 ± 3.75 .582 ± 1.35 1.07 ± 3.27 .62 ± 2.17 .826 ± 2.01 .78 ± 1.90
Age 17
Male (N=99) .22 ± 1.034 .45 ± 1.304 .462 ± .88 .612 ± 2.14 .348 ± .85 .54 ± 1.216 .49 ± .98
Female (N=107) .31 ± 1.174 .60 ± 1.754 1.09 ± 3.59 .81 ± 2.91 .46 ± 1.37 .956 ± .3.16 .84 ± 2.58
Age 18
Male (N=101) .25 ± .804 .36 ± 2.074 .442 ± 1.52 .492 ± 2.58 .308 ± 1.22 .476 ± 1.98 .43 ± 1.78
Female (N=101) .17 ± .954 .30 ± 1.364 .492 ± 1.17 .80 ± 2.45 .238 ± .96 .646 ± 1.65 .55 ± 1.38
9

Age 19
Male (N=22) .00 ± .014 .13 ± .594 .762 ± 2.20 .33 ± .642 .06 ± .308 .55 ± 1.336 .44 ± 1.03
Female (N=10) .00 ± .014 .00 ± .014 .642 ± 1.19 .24 ± .752 .00 ± .018 .44 ± .916 .34 ± .71
Age 20-29
Male (N=54) .51 ± 2.024 .41 ± .1.134 .762 ± 1.88 2.10 ± 6.66 .46 ± 1.40 1.43 ± 1.106 1.22 ± 3.26
Female (N=75) 1.26 ± 1.134 .784 ± 3.75 .492 ± 1.06 .662 ± 1.59 .52 ± 2.17 .57 ± 1.216 .56 ± 1.20

107
APPENDICES
 Table 74: Auditory Norms - Commissions (%)(See end of this section for reference key.)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 6
Male (N=85) 6.29 ± 16.52 5.98 ± 15.93 24.96 ± 18.98 28.32 ± 21.79 6.12 ± 15.90 26.54 ± 19.13 10.43 ± 14.64
Female (N=90) 4.40 ± 12.39 5.72 ± 15.84 17.13 ± 18.34 24.53 ± 20.71 5.05 ± 13.88 20.77 ± 18.58 8.38 ± 13.27
Age 7

The TOVA Company

Male (N=92) 2.88 ± 9.04 2.44 ± 7.59 17.96 ± 16.75 23.79 ± 19.66 2.63 ± 7.40 20.87 ± 17.36 6.58 ± 8.13
Female (N=82) 2.89 ± 8.40 2.12 ± 7.97 13.44 ± 14.53 18.65 ± 17.27 2.50 ± 7.91 15.97 ± 14.56 5.41 ± 7.95
Age 8
Male (N=97) 1.18 ± 3.41 .81 ± 3.46 13.96 ± 12.61 17.31 ± 16.05 .995 ± 3.38 15.63 ± 13.43 4.15 ± 4.34
Female (N=108) 1.08 ± 2.45 .751 ± 2.46 9.20 ± 11.36 12.69 ± 13.50 .915 ± 1.92 10.94 ± 11.82 3.10 ± 3.54
Age 9
Male (N=104) .92 ± 2.10 .621 ± 2.09 9.30 ± 12.70 13.34 ± 16.07 .775 ± 1.96 11.30 ± 13.68 3.07 ± 3.89
T.O.V.A. 8.0 Professional Manual

Female (N=100) .701 ± 1.56 .21 ± .421 8.00 ± 8.09 12.99 ± 12.30 .46 ± .825 10.47 ± 9.29 2.64 ± 2.29
Age 10
Male (N=106) .541 ± 1.41 .331 ± .83 8.04 ± 11.34 10.30 ± 14.27 .43 ± .925 9.16 ± 12.43 2.32 ± 2.83
Female (N=107) .421 ± 1.14 .10 ± .291 4.76 ± 6.46 7.16 ± 6.68 .26 ± .595 5.95 ± 5.92 1.51 ± 1.44
Age 11
Male (N=96) .45 ± .681 .15 ± .331 4.93 ± 4.95 7.03 ± 7.44 .30 ± .405 5.96 ± 5.14 1.54 ± 1.27
Female (N=104) .21 ± .461 .15 ± .371 4.35 ± 4.74 7.52 ± 8.55 .18 ± .345 5.93 ± 6.13 1.44 ± 1.39
Age 12
Male (N=87) .40 ± .701 .24 ± .741 4.91 ± 6.45 5.64 ± 7.80 .32 ± .665 5.28 ± 6.65 1.40 ± 1.53
Female (N=94) .29 ± .671 .11 ± .301 3.08 ± 3.54 5.28 ± 5.59 .20 ± .385 4.18 ± 3.96 1.08 ± 1.04
Age 13
Male (N=98) .31 ± .701 .11 ± .331 3.67 ± 4.53 5.49 ± 7.40 .215 ± .37 4.57 ± 5.45 1.17 ± 1.36
Female (N=91) .30 ± .551 .12 ± .371 4.57 ± 7.27 6.09 ± 7.92 .215 ± .39 5.32 ± 6.97 1.33 ± 1.68
Age 14
Male (N=100) .25 ± .591 .281 ± .82 4.22 ± 7.29 4.99 ± 8.05 .27 ± .585 4.60 ± 7.34 1.20 ± 1.69
Female (N=101) .18 ± .401 .13 ± .331 2.83 ± 4.34 3.76 ± 4.83 .15 ± .275 3.30 ± 3.98 .85 ± .97
Age 15
Male (N=98) .22 ± .461 .13 ± .341 3.22 ± 4.18 3.54 ± 4.31 .17 ± .295 3.38 ± 3.67 .88 ± .93
Female (N=90) .14 ± .491 .10 ± .331 3.98 ± 9.18 5.36 ± 11.70 .12 ± .335 4.67 ± 10.23 1.13 ± 2.35
Age 16
Male (N=94) .17 ± .401 .13 ± .311 2.653 ± 3.81 2.83 ± 3.90 .15 ± .255 2.73 ± 3.36 .71 ± .79

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Female (N=87) .201 ± .81 .07 ± .291 2.113 ± 3.94 3.08 ± 5.83 .14 ± .445 2.61 ± 4.54 .68 ± 1.16
Age 17
Male (N=99) .15 ± .391 .09 ± .251 2.523 ± 6.93 2.99 ± 6.85 .12 ± .255 2.76 ± 6.74 .67 ± 1.29
Female (N=107) .211 ± .91 .491 ± 4.47 2.86 ± 8.05 3.59 ± 8.38 .355 ± 2.63 3.22 ± 8.01 .97 ± 3.56
Age 18
Male (N=101) .12 ± .321 .05 ± .201 1.883 ± 3.19 2.253 ± 3.84 .09 ± .195 2.06 ± 3.16 .52 ± .71
Female (N=101) .07 ± .301 .03 ± .151 1.16 ± 2.533 1.943 ± 2.89 .05 ± .175 1.55 ± 2.29 .38 ± .53
9

Age 19
Male (N=22) .07 ± .241 .07 ± .231 2.083 ± 5.15 1.993 ± 3.78 .07 ± .165 2.03 ± 4.17 .49 ± .90
Female (N=10) .16 ± .331 .08 ± .251 2.323 ± 3.78 1.943 ± 2.94 .12 ± .195 2.12 ± 3.27 .56 ± .76
Age 20-29
Male (N=54) .34 ± .611 .18 ± .321 6.26 ± 7.34 6.39 ± 7.35 .23 ± .335 6.63 ± 6.74 1.57 ± 1.59
Female (N=75) .23 ± 1.141 .78v ± 3.75 4.40 ± 3.10 4.33 ± 5.95 .18 ± .595 4.37 ± 5.70 1.11 ± 1.40

108
APPENDICES
 Table 75: Auditory Norms - Response Time (ms)
Years of Age Quarter Half Total

1 2 3 4 1 2
Age 6
Male (N=85) 755.55 ± 148.49 805.03 ± 154.90 765.92 ± 150.78 782.39 ± 163.65 779.88 ± 145.27 779.04 ± 136.72 775.63 ± 127.05
Female (N=90) 772.06 ± 131.58 857.25 ± 149.63 810.08 ± 149.67 818.02 ± 151.79 812.84 ± 130.67 809.13 ± 130.53 806.51 ± 117.35
Age 7

The TOVA Company

Male (N=92) 634.11 ± 135.10 700.45 ± 160.09 698.72 ± 129.88 712.68 ± 156.54 666.22 ± 140.93 711.05 ± 129.74 701.82 ± 127.34
Female (N=82) 702.74 ± 155.52 751.57 ± 165.76 755.44 ± 157.94 773.46 ± 147.82 726.89 ± 155.16 765.92 ± 148.99 752.50 ± 137.70
Age 8
Male (N=97) 605.18 ± 110.17 672.24 ± 130.49 655.92 ± 122.84 693.91 ± 132.78 638.12 ± 115.27 674.55 ± 123.40 663.21 ± 109.48
Female (N=108) 641.04 ± 127.83 685.73 ± 121.89 682.38 ± 141.07 698.25 ± 139.17 661.87 ± 112.03 690.00 ± 135.62 681.88 ± 119.08
Age 9
Male (N=104) 574.69 ± 94.04 627.57 ± 108.36 640.99 ± 117.55 661.60 ± 144.47 601.03 ± 97.43 654.89 ± 118.73 640.90 ± 107.58
T.O.V.A. 8.0 Professional Manual

Female (N=100) 585.32 ± 92.93 634.21 ± 106.55 632.77 ± 121.62 654.71 ± 131.57 609.73 ± 96.28 643.63 ± 122.55 636.17 ± 111.07
Age 10
Male (N=106) 531.05 ± 80.41 584.58 ± 99.00 590.99 ± 100.26 610.84 ± 127.00 557.68 ± 86.77 600.37 ± 105.54 588.63 ± 93.15
Female (N=107) 539.26 ± 93.24 579.55 ± 101.03 585.40 ± 106.26 600.64 ± 116.12 559.44 ± 94.77 592.97 ± 107.09 585.33 ± 98.77
Age 11
Male (N=96) 508.87 ± 86.73 554.75 ± 99.35 559.01 ± 95.77 582.67 ± 109.43 531.81 ± 90.36 570.84 ± 99.01 562.04 ± 92.64
Female (N=104) 532.50 ± 94.77 567.31 ± 111.43 574.22 ± 122.03 587.88 ± 132.19 549.92 ± 99.64 580.91 ± 123.48 573.87 ± 113.87
Age 12
Male (N=87) 506.63 ± 85.36 557.93 ± 109.87 572.60 ± 115.18 588.66 ± 123.59 531.39 ± 93.05 580.68 ± 115.54 569.63 ± 104.86
Female (N=94) 531.11 ± 85.81 580.81 ± 102.53 575.54 ± 121.37 583.43 ± 128.14 555.87 ± 90.77 579.48 ± 120.99 574.14 ± 108.32
Age 13
Male (N=98) 519.10 ± 90.88 574.62 ± 122.11 554.73 ± 99.81 570.81 ± 114.32 546.88 ± 103.29 562.74 ± 102.09 559.24 ± 96.89
Female (N=91) 512.87 ± 89.07 555.82 ± 107.46 541.39 ± 102.03 563.93 ± 106.35 534.27 ± 95.47 552.62 ± 100.98 548.52 ± 93.68
Age 14
Male (N=100) 478.43 ± 86.90 516.93 ± 112.84 517.19 ± 102.98 543.11 ± 111.06 497.50 ± 96.05 530.16 ± 102.35 523.00 ± 95.95
Female (N=101) 489.02 ± 86.32 530.85 ± 109.31 521.91 ± 97.64 526.65 ± 107.54 509.87 ± 95.75 524.30 ± 98.26 521.12 ± 93.05
Age 15
Male (N=98) 470.84 ± 103.44 502.43 ± 120.13 509.66 ± 110.62 525.84 ± 131.25 486.58 ± 108.36 517.81 ± 117.42 510.76 ± 111.05
Female (N=90) 501.21 ± 106.36 532.54 ± 126.98 517.92 ± 119.14 519.97 ± 113.61 516.90 ± 113.52 519.06 ± 112.34 517.72 ± 106.38
Age 16
Male (N=94) 487.77 ± 102.33 528.74 ± 125.06 502.89 ± 122.29 521.46 ± 117.90 508.10 ± 109.96 512.26 ± 117.12 511.30 ± 109.41
Female (N=87) 497.81 ± 105.88 536.73 ± 128.70 496.64 ± 116.45 493.66 ± 118.03 517.09 ± 114.25 495.12 ± 113.93 499.97 ± 109.84
Age 17

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Male (N=99) 471.04 ± 81.82 498.56 ± 98.21 475.08 ± 93.49 483.78 ± 96.92 484.76 ± 87.76 479.49 ± 90.44 480.81 ± 84.41
Female (N=107) 484.82 ± 95.11 515.31 ± 109.75 491.23 ± 117.83 488.82 ± 123.28 500.02 ± 99.83 490.03 ± 117.19 492.13 ± 109.23
Age 18
Male (N=101) 468.38 ± 94.34 489.55 ± 109.41 469.63 ± 91.95 485.48 ± 101.25 478.91 ± 99.53 477.60 ± 91.87 477.90 ± 88.76
Female (N=101) 487.80 ± 90.53 518.55 ± 107.60 488.75 ± 108.55 489.82 ± 107.15 503.19 ± 96.45 489.36 ± 104.94 492.42 ± 98.42
Age 19
Male (N=22) 465.19 ± 76.92 500.17 ± 103.66 466.88 ± 104.39 482.00 ± 111.98 482.73 ± 85.79 474.55 ± 103.77 476.40 ± 94.67
9

Female (N=10) 464.87 ± 92.09 464.70 ± 110.54 439.82 ± 92.73 452.87 ± 107.66 464.81 ± 99.41 446.54 ± 90.72 450.59 ± 90.54
Age 20-29
Male (N=54) 488.28 ± 132.77 509.09 ± 144.16 479.50 ± 128.39 496.96 ± 136.66 498.67 ± 136.22 488.05 ± 130.05 490.33 ± 127.47
Female (N=75) 499.95 ± 108.35 522.39 ± 127.94 504.39 ± 124.75 520.59 ± 130.93 510.88 ± 115.62 512.47 ± 125.56 511.97 ± 120.63

109
APPENDICES
 Table 76: Auditory Norms - Variability (ms)
Years of Age Quarter Half Total

1 2 3 4 1 2
Age 6
Male (N=85) 244.75 ± 80.21 263.95 ± 84.24 307.98 ± 84.47 321.13 ± 89.94 261.24 ± 76.15 321.99 ± 81.79 309.01 ± 73.42
Female (N=90) 247.01 ± 80.30 272.10 ± 78.37 306.12 ± 75.47 316.06 ± 72.03 270.78 ± 70.35 317.79 ± 65.56 309.98 ± 61.16
Age 7

The TOVA Company

Male (N=92) 196.89 ± 78.55 212.53 ± 77.79 260.68 ± 80.61 280.16 ± 86.72 211.74 ± 71.85 274.90 ± 74.79 266.41 ± 70.79
Female (N=82) 208.12 ± 81.63 223.67 ± 85.30 265.60 ± 80.28 283.00 ± 86.80 223.50 ± 77.10 281.18 ± 78.06 272.92 ± 67.98
Age 8
Male (N=97) 160.48 ± 59.21 193.29 ± 77.20 234.58 ± 70.20 259.66 ± 82.67 184.56 ± 63.71 250.94 ± 72.79 240.06 ± 65.38
Female (N=108) 174.79 ± 68.30 187.11 ± 63.51 217.32 ± 70.00 234.37 ± 77.88 188.58 ± 61.04 229.32 ± 70.74 225.43 ± 64.57
Age 9
Male (N=104) 150.98 ± 64.09 170.77 ± 71.30 205.41 ± 70.95 228.86 ± 79.00 167.75 ± 61.78 221.76 ± 71.32 215.02 ± 66.30
T.O.V.A. 8.0 Professional Manual

Female (N=100) 151.77 ± 65.35 161.70 ± 64.06 200.30 ± 70.58 213.92 ± 72.30 162.90 ± 59.23 210.56 ± 68.03 205.02 ± 63.36
Age 10
Male (N=106) 124.76 ± 50.75 137.80 ± 53.89 176.73 ± 61.87 190.18 ± 67.44 137.17 ± 49.37 188.47 ± 61.79 180.28 ± 54.41
Female (N=107) 125.04 ± 58.26 140.25 ± 59.99 165.25 ± 67.24 177.35 ± 64.95 137.71 ± 55.55 175.00 ± 63.55 171.90 ± 59.36
Age 11
Male (N=96) 109.41 ± 39.59 128.62 ± 50.86 157.25 ± 58.06 171.09 ± 65.18 124.62 ± 42.76 167.50 ± 59.92 162.40 ± 55.80
Female (N=104) 127.97 ± 59.00 128.44 ± 58.70 155.78 ± 69.02 169.62 ± 67.32 134.84 ± 53.01 166.12 ± 66.68 164.03 ± 61.52
Age 12
Male (N=87) 113.31 ± 44.06 133.99 ± 59.54 160.42 ± 61.90 171.92 ± 67.75 129.70 ± 50.71 169.93 ± 62.44 167.43 ± 58.33
Female (N=94) 111.81 ± 48.53 133.73 ± 57.65 153.24 ± 64.80 164.18 ± 70.52 129.22 ± 50.91 162.58 ± 65.47 161.31 ± 60.52
Age 13
Male (N=98) 119.37 ± 46.68 135.66 ± 59.40 154.30 ± 61.96 171.03 ± 66.33 134.76 ± 51.91 166.64 ± 62.94 164.35 ± 58.13
Female (N=91) 112.59 ± 57.07 124.66 ± 56.53 156.24 ± 70.75 172.04 ± 71.96 124.01 ± 55.04 167.54 ± 69.06 163.11 ± 64.67
Age 14
Male (N=100) 109.84 ± 52.85 123.25 ± 55.88 153.19 ± 65.55 166.92 ± 73.63 122.37 ± 52.89 164.19 ± 67.35 159.70 ± 62.84
Female (N=101) 101.26 ± 47.05 119.51 ± 56.47 139.41 ± 56.32 152.73 ± 69.26 115.92 ± 49.68 149.77 ± 61.69 146.99 ± 56.91
Age 15
Male (N=98) 98.05 ± 44.31 109.61 ± 49.97 144.67 ± 65.62 155.16 ± 70.64 109.04 ± 46.78 153.77 ± 66.80 148.95 ± 62.30
Female (N=90) 99.93 ± 41.13 119.49 ± 66.03 145.18 ± 67.38 152.78 ± 73.32 115.86 ± 52.83 154.26 ± 66.96 150.68 ± 64.76
Age 16
Male (N=94) 105.83 ± 43.43 116.50 ± 49.55 136.53 ± 54.80 147.11 ± 63.74 118.39 ± 42.98 145.47 ± 57.85 144.78 ± 53.66
Female (N=87) 101.42 ± 52.40 111.62 ± 64.03 127.11 ± 58.97 136.48 ± 68.37 113.17 ± 55.25 135.79 ± 61.17 135.79 ± 57.39
Age 17

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Male (N=99) 97.44 ± 37.82 106.68 ± 51.71 123.79 ± 55.12 135.01 ± 58.64 106.40 ± 42.31 134.18 ± 53.83 132.75 ± 49.76
Female (N=107) 88.54 ± 39.10 99.68 ± 49.63 119.83 ± 63.49 130.00 ± 64.47 99.51 ± 41.91 128.63 ± 63.03 126.53 ± 57.96
Age 18
Male (N=101) 102.05 ± 46.07 102.98 ± 48.10 114.80 ± 45.24 129.97 ± 62.11 107.37 ± 42.25 126.98 ± 52.53 127.39 ± 47.52
Female (N=101) 85.47 ± 36.59 96.83 ± 41.52 119.59 ± 53.39 127.64 ± 60.03 96.72 ± 36.74 126.53 ± 55.78 125.11 ± 50.23
Age 19
Male (N=22) 98.08 ± 39.02 106.35 ± 56.34 119.32 ± 52.92 124.22 ± 51.05 109.02 ± 46.47 125.53 ± 51.58 127.09 ± 47.34
9

Female (N=10) 81.77 ± 32.06 77.45 ± 40.26 119.12 ± 54.21 140.75 ± 77.14 82.71 ± 35.11 136.44 ± 67.78 128.72 ± 60.26
Age 20-29
Male (N=54) 78.14 ± 35.72 91.34 ± 57.55 110.26 ± 57.58 128.83 ± 73.65 89.79 ± 46.87 122.13 ± 64.31 119.28 ± 62.97
Female (N=75) 80.65 ± 40.29 86.84 ± 48.99 109.98 ± 46.94 121.45 ± 57.97 88.08 ± 44.12 118.66 ± 52.17 115.59 ± 49.73

110
APPENDICES
T.O.V.A. 8.0 Professional Manual 9 APPENDICES

Table 77: Auditory Norms - D Prime (Perceptual Sensitivity)

Years of Age Quarter Half Total

1 2 3 4 1 2
Age 6
Male (N=85) 4.38 ± 2.24 4.58 ± 2.43 2.08 ± 1.66 1.89 ± 1.76 4.05 ± 2.05 1.90 ± 1.58 2.69 ± 1.48
Female (N=90) 4.87 ± 2.42 4.50 ± 2.21 2.59 ± 1.94 2.21 ± 1.69 4.06 ± 1.88 2.22 ± 1.56 2.82 ± 1.32
Age 7
Male (N=92) 5.79 ± 2.29 5.50 ± 2.33 2.98 ± 2.04 2.63 ± 2.09 5.08 ± 2.12 2.57 ± 1.67 3.35 ± 1.42
Female (N=82) 5.60 ± 2.39 5.86 ± 2.41 3.34 ± 2.24 2.96 ± 2.12 5.23 ± 2.26 2.90 ± 1.87 3.56 ± 1.69
Age 8
Male (N=97) 6.58 ± 1.79 6.72 ± 2.07 3.77 ± 1.99 3.48 ± 1.98 5.97 ± 1.89 3.26 ± 1.59 4.02 ± 1.39
Female (N=108) 6.34 ± 2.00 6.74 ± 2.02 4.38 ± 2.23 4.01 ± 2.06 5.98 ± 1.98 3.79 ± 1.78 4.28 ± 1.49
Age 9
Male (N=104) 6.93 ± 1.76 7.15 ± 1.80 4.38 ± 1.88 4.03 ± 2.27 6.49 ± 1.75 3.76 ± 1.57 4.41 ± 1.30
Female (N=100) 7.03 ± 1.89 7.19 ± 1.62 4.52 ± 1.94 4.05 ± 1.76 6.50 ± 1.72 3.92 ± 1.55 4.51 ± 1.33
Age 10
Male (N=106) 7.41 ± 1.52 7.47 ± 1.61 4.99 ± 2.10 4.89 ± 2.06 6.94 ± 1.64 4.47 ± 1.74 5.06 ± 1.48
Female (N=107) 7.54 ± 1.37 7.71 ± 1.24 5.80 ± 1.95 5.09 ± 1.81 7.22 ± 1.42 4.93 ± 1.59 5.42 ± 1.37
Age 11
Male (N=96) 7.58 ± 1.27 7.92 ± 1.08 5.74 ± 1.94 5.37 ± 1.71 7.36 ± 1.34 5.04 ± 1.51 5.54 ± 1.30
Female (N=104) 7.80 ± 1.35 7.69 ± 1.38 5.80 ± 2.02 5.26 ± 1.81 7.41 ± 1.43 5.07 ± 1.72 5.45 ± 1.48
Age 12
Male (N=87) 7.64 ± 1.30 7.68 ± 1.54 6.04 ± 1.99 5.88 ± 2.11 7.26 ± 1.52 5.52 ± 1.95 5.74 ± 1.57
Female (N=94) 7.89 ± 1.11 7.84 ± 1.34 6.34 ± 1.91 5.69 ± 1.96 7.47 ± 1.35 5.41 ± 1.60 5.78 ± 1.38
Age 13
Male (N=98) 7.69 ± 1.36 7.94 ± 1.16 6.16 ± 1.88 5.88 ± 2.10 7.40 ± 1.40 5.46 ± 1.77 5.79 ± 1.50
Female (N=91) 7.61 ± 1.45 7.75 ± 1.39 5.91 ± 2.01 5.47 ± 2.09 7.36 ± 1.59 5.14 ± 1.74 5.60 ± 1.55
Age 14
Male (N=100) 7.80 ± 1.29 7.75 ± 1.41 6.19 ± 2.05 6.14 ± 1.91 7.43 ± 1.48 5.64 ± 1.78 5.95 ± 1.46
Female (N=101) 7.95 ± 1.13 7.84 ± 1.20 6.47 ± 1.89 6.20 ± 1.86 7.54 ± 1.34 5.73 ± 1.76 6.03 ± 1.49
Age 15
Male (N=98) 7.95 ± 1.10 8.08 ± 1.02 6.51 ± 1.79 6.25 ± 1.80 7.74 ± 1.14 5.81 ± 1.57 6.15 ± 1.32
Female (N=90) 8.11 ± 1.03 7.96 ± 1.18 6.36 ± 2.01 5.81 ± 2.33 7.78 ± 1.26 5.57 ± 1.91 5.88 ± 1.55
Age 16
Male (N=94) 8.01 ± .95 7.77 ± 1.22 6.51 ± 1.84 6.39 ± 1.94 7.52 ± 1.26 5.96 ± 1.75 6.14 ± 1.44
Female (N=87) 7.99 ± 1.17 8.09 ± 1.08 6.94 ± 1.73 6.58 ± 1.97 7.75 ± 1.30 6.29 ± 1.82 6.54 ± 1.59
Age 17
Male (N=99) 8.09 ± .96 8.01 ± 1.07 6.80 ± 1.91 6.73 ± 1.87 7.75 ± 1.20 6.22 ± 1.85 6.47 ± 1.56
Female (N=107) 8.05 ± 1.09 7.96 ± 1.21 6.99 ± 1.82 6.72 ± 1.90 7.76 ± 1.30 6.41 ± 1.82 6.58 ± 1.62
Age 18
Male (N=101) 8.08 ± 1.10 8.25 ± 0.75 7.04 ± 1.72 6.99 ± 1.74 7.94 ± 1.10 6.53 ± 1.70 6.65 ± 1.39
Female (N=101) 8.30 ± 0.67 8.28 ± 0.78 7.35 ± 1.44 6.86 ± 1.87 8.15 ± 0.90 6.58 ± 1.70 6.81 ± 1.44
Age 19
Male (N=22) 8.36 ± 0.55 8.25 ± 0.71 7.13 ± 1.88 7.14 ± 1.72 8.14 ± 0.74 6.65 ± 1.79 6.89 ± 1.60
Female (N=10) 8.16 ± 0.78 8.34 ± 0.59 7.02 ± 2.17 7.28 ± 1.77 8.05 ± 0.78 6.90 ± 2.00 7.00 ± 1.62
Age 20-29
Male (N=54) 7.72 ± 1.31 7.97 ± 1.23 5.60 ± 1.72 5.65 ± 1.83 7.46 ± 1.35 5.36 ± 1.51 5.88 ± 1.31
Female (N=75) 8.12 ± 1.11 7.97 ± 1.15 6.23 ± 1.67 6.32 ± 1.77 7.80 ± 1.23 5.93 ± 1.54 6.34 ± 1.38

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T.O.V.A. 8.0 Professional Manual 9 APPENDICES

Table 78: REFERENCE KEY

Ref. # Type Description

1 Q1/Q2 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.794% (1 error / 126 stimuli).*
2 Q3/Q4 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.794% (1 error / 126 stimuli).*
3 Q3/Q4 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 2.778% (1 error / 36 stimuli).*
4 Q1/Q2 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 2.778% (1 error / 36 stimuli).*
5 H1 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 1.389% 1 error / 72 stimuli).*
6 H2 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 1.389% 1 error / 72 stimuli).*
7 H2 commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.397% (1 error / 252 stimuli).*
8 H1 omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.397% (1 error / 252 stimuli).*
9 T commissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.309% (1 error / 324 stimuli).*
10 T omissions Norming group standard deviation values in this norming group were
bounded at a minimum value of 0.309% (1 error / 324 stimuli).*
* Omission and commission errors are not normally distributed. This makes a
comparison to a norming group difficult, especially when some norming groups
(e.g. adults) made no omission/commission errors. Norming groups with no
errors (which implies a zero in the norming standard deviation) causes a single
error to distort distribution values such as z scores. Because one omission or
one commission error is not clinically relevant, the norming standard deviations
have been bounded at a minimum of one error.

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T.O.V.A. 8.0 Professional Manual 9 APPENDICES

9.8 Appendix H: T.O.V.A. Observer Behavior Rating Form

Figure 36: T.O.V.A. Observer’s Behavior Rating Form

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T.O.V.A. 8.0 Professional Manual 9 APPENDICES

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 9.9
Table 79: Pearson Product Coefficients - Visual - All Variables
O O O O O O O C C C C C C C R R R
M M M M M M M O O O O O O O T T T
1Q 2Q 3Q 4Q 1H 2H T 1Q 2Q 3Q 4Q 1H 2H T 1Q 2Q 3Q
O F F O T T T
T T T T F F T T T T T T

OM1QT .1
OM2QT .6724 .1
OM3QT .5863 .6668 .1
OM4QT .5934 .6075 .6187 .1
OM1HF .9092 .9179 .6889 .6551 .1
OM2HF .6566 .7076 .9027 .8947 .7472 .1

The TOVA Company

OMOT .7516 .7952 .8927 .8792 .8466 .9847 .1
CO1QT .1355 .1469 .1186 .208 .1505 .1796 .1802 .1
CO2QT .1429 .2137 .2002 .2441 .1939 .2421 .2433 .554 .1
CO3QT .1063 .1436 .0664 .1736 .1347 .1299 .1391 .358 .4325 .1
CO4QT .1687 .2323 .1403 .2511 .2164 .211 .2267 .5265 .4495 .7701 .1
CO1HF .1554 .1981 .1735 .2558 .1911 .2359 .2359 .9047 .8258 .5422 .5341 .1
CO2HF .149 .2048 .1128 .2301 .1908 .1851 .1987 .5632 .4694 .926 .9527 .5701 .1
COTOT .1587 .2111 .1331 .2446 .1993 .2051 .2159 .71 .6064 .9069 .9234 .7334 .9729 .1
RT1QT .3188 .3324 .2615 .4102 .3518 .3684 .384 .0828 .0376 .0892 .2158 .0507 .1697 .1433 .1
T.O.V.A. 8.0 Professional Manual

RT2QT .3375 .383 .3013 .453 .3895 .4153 .4316 .1159 .0691 .097 .2369 .0874 .1855 .1654 .9294 .1
RT3QT .2211 .2739 .2546 .3752 .266 .3458 .3458 .0398 .0343 -.0806 .0523 .0232 -.0071 -.0094 .8554 .8697 .1
RT4QT .2125 .2523 .2461 .3877 .2495 .3486 .3415 .0207 .0289 -.0853 -.0034 .0112 -.0419 -.0404 .8144 .839 .9262
RT1HF .334 .3621 .2848 .4384 .3761 .3974 .4137 .1016 .0527 .0958 .2319 .0697 .1822 .158 .9794 .9839 .8778
RT2HF .2217 .2679 .2549 .3879 .263 .3532 .3498 .0303 .0313 -.0847 .0236 .0167 -.0259 -.0263 .8506 .87 .9795
RTTOT .2461 .2892 .268 .4079 .288 .3714 .3707 .049 .0376 -.0428 .0744 .0307 .0239 .0179 .9002 .9163 .9787
V1QT .3371 .3288 .2484 .3931 .3595 .3518 .3717 .2943 .1576 .2638 .3679 .2442 .3416 .3433 .7396 .6788 .5952
V2QT .3079 .373 .2988 .4218 .3671 .3982 .4116 .2913 .2301 .2815 .402 .2783 .3706 .3726 .6484 .7509 .5995
V3QT .2993 .36 .3252 .471 .3539 .4353 .4404 .2373 .2 .2614 .3683 .2208 .3413 .3328 .7511 .7867 .789
V4QT .2939 .3559 .3053 .5012 .3494 .4417 .4424 .2641 .2232 .2775 .4022 .2568 .3684 .3637 .7296 .7724 .7266
V1HF .3419 .3878 .3008 .444 .3937 .4106 .4278 .3103 .2159 .2849 .4069 .282 .3749 .3782 .7343 .7816 .6471
V2HF .3025 .3648 .3187 .4974 .3584 .4466 .4496 .2567 .2185 .2734 .393 .2454 .3613 .3552 .7625 .803 .7796
VTOT .3306 .3839 .3245 .5054 .3843 .4549 .4624 .2782 .2209 .3044 .4304 .2601 .398 .3894 .7934 .8328 .7598
D1QT -.4924 -.3884 -.3181 -.406 -.4697 -.3922 -.4262 -.5413 -.3247 -.4614 -.5182 -.4594 -.5148 -.5572 -.336 -.3608 -.2457
D2QT -.3063 -.5304 -.3267 -.4266 -.449 -.4052 -.4329 -.4522 -.5114 -.4521 -.5087 -.5028 -.5066 -.565 -.3086 -.3481 -.2474
D3QT -.2785 -.3358 -.3535 -.4031 -.3296 -.4068 -.4043 -.4 -.3116 -.6491 -.6 -.3763 -.6513 -.6193 -.2981 -.3204 -.1692
D4QT -.3169 -.3806 -.3369 -.5111 -.3729 -.4567 -.4553 -.4133 -.3308 -.5796 -.7114 -.3925 -.6811 -.6468 -.3367 -.3718 -.2098
D1HF -.4031 -.4738 -.3195 -.4232 -.4684 -.4024 -.4339 -.523 -.4337 -.4787 -.5299 -.5161 -.5302 -.5867 -.3139 -.3563 -.241
D2HF -.3271 -.3896 -.3938 -.5108 -.3838 -.4919 -.484 -.4204 -.3292 -.6093 -.6582 -.3987 -.6659 -.6385 -.3394 -.3771 -.2165
DTOT -.3673 -.4506 -.3984 -.5102 -.4381 -.492 -.5023 -.427 -.3489 -.5415 -.6016 -.412 -.6012 -.599 -.3703 -.4132 -.2653
Appendix I: Pearson Product Coefficients, Visual

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 Table 80: Pearson Product Coefficients - Visual - All Variables, continued
C C C C C C C C C C C D D D D D D D
R R R R R R R R R R R 1Q 2Q 3Q 4Q 1H 2H T
M M M M V V V V V V V O
Q H H T Q Q Q Q H H T T T T T F F T
4 1 2 O 1 2 3 4 1 2 O
T T

CRMQ4 0.1
CRMH1 0.7508 0.1
CRMH2 0.9509 0.8093 0.1
CRMTOT 0.9372 0.8845 0.9857 0.1
CRVQ1 0.5988 0.7369 0.6431 0.6884 0.1

The TOVA Company

CRVQ2 0.6158 0.7458 0.6509 0.694 0.7488 0.1
CRVQ3 0.7146 0.6866 0.7587 0.7619 0.746 0.7683 0.1
CRVQ4 0.7537 0.6521 0.7317 0.7412 0.7051 0.732 0.8654 0.1
CRVH1 0.6551 0.7984 0.697 0.7445 0.9125 0.9462 0.8059 0.768 0.1
CRVH2 0.7661 0.6914 0.7796 0.7804 0.7522 0.78 0.9632 0.9546 0.8176 0.1
CRVTOT 0.7705 0.7306 0.7927 0.8061 0.8004 0.8275 0.9535 0.9436 0.8702 0.9875 0.1
D1QT -0.4339 -0.5103 -0.4719 -0.4949 -0.6428 -0.5904 -0.6015 -0.5473 -0.6485 -0.5994 -0.62 0.1
D2QT -0.4481 -0.5493 -0.4948 -0.5204 -0.6349 -0.6502 -0.6386 -0.5842 -0.6815 -0.6383 -0.6573 0.6347 0.1
D3QT -0.4537 -0.4589 -0.4845 -0.4868 -0.602 -0.603 -0.7088 -0.6601 -0.6358 -0.7115 -0.7062 0.5844 0.6018 0.1
T.O.V.A. 8.0 Professional Manual

D4QT -0.4684 -0.4804 -0.501 -0.5035 -0.6076 -0.6171 -0.6975 -0.6932 -0.6465 -0.7252 -0.7205 0.567 0.5893 0.7388 0.1
D1HF -0.4678 -0.5474 -0.5098 -0.5331 -0.6671 -0.662 -0.6689 -0.6161 -0.703 -0.6682 -0.6873 0.8727 0.8718 0.6413 0.6345 0.1
D2HF -0.4837 -0.485 -0.5121 -0.5145 -0.6263 -0.6369 -0.7366 -0.7104 -0.667 -0.7528 -0.7467 0.5845 0.6044 0.8869 0.9223 0.6504 0.1
DTOT -0.5115 -0.5218 -0.5432 -0.5498 -0.6607 -0.671 -0.7591 -0.7241 -0.7052 -0.7728 -0.7728 0.668 0.6801 0.8664 0.8926 0.7525 0.9655 0.1

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 Table 81: Pearson Product Coefficients Visual Condition 1

OM1QT OM2QT OM1HF OMTOT CO1QT CO2QT CO1HF COTOT RT1QT RT2QT RT1HF RTTOT V1QT V2QT V1HF VTOT
OM1QT 1
OM2QT 0.6724 1
OM1HF 0.9092 0.9179 1
OMTOT 0.7516 0.7952 0.8466 1
CO1QT 0.1355 0.1469 0.1505 0.1802 1

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CO2QT 0.1429 0.2137 0.1939 0.2433 0.554 1
CO1HF 0.1554 0.1981 0.1911 0.2359 0.9047 0.8258 1
COTOT 0.1587 0.2111 0.1993 0.2159 0.71 0.6064 0.7334 1
RT1QT 0.3188 0.3324 0.3518 0.384 0.0828 0.0376 0.0507 0.1433 1
RT2QT 0.3375 0.383 0.3895 0.4316 0.1159 0.0691 0.0874 0.1654 0.9294 1
RT1HF 0.334 0.3621 0.3761 0.4137 0.1016 0.0527 0.0697 0.158 0.9794 0.9839 1
RTTOT 0.2461 0.2892 0.288 0.3707 0.049 0.0376 0.0307 0.0179 0.9002 0.9163 0.9249 1
T.O.V.A. 8.0 Professional Manual

V1QT 0.3371 0.3288 0.3595 0.3717 0.2943 0.1576 0.2442 0.3433 0.7396 0.6788 0.7197 0.6368 1
V2QT 0.3079 0.373 0.3671 0.4116 0.2913 0.2301 0.2783 0.3726 0.6484 0.7509 0.7142 0.6388 0.6994 1
V1HF 0.3419 0.3878 0.3937 0.4278 0.3103 0.2159 0.282 0.3782 0.7343 0.7816 0.772 0.6904 0.8935 0.9385 1
VTOT 0.3306 0.3839 0.3843 0.4624 0.2782 0.2209 0.2601 0.3894 0.7934 0.8328 0.8282 0.8011 0.8088 0.8397 0.8928 1

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 Table 82: Pearson Product Coefficients Visual Condition 2

OM3QT OM4QT OM2HF OMTOT CO3QT CO4QT CO2HF COTOT RT3QT RT4QT RT2HF RTTOT V3QT V4QT V2HF VTOT
OM3QT 1
OM4QT 0.6187 1
OM2HF 0.9027 0.8947 1
OMTOT 0.8927 0.8792 0.9847 1
CO3QT 0.0664 0.1736 0.1299 0.1391 1

The TOVA Company

CO4QT 0.1403 0.2511 0.211 0.2267 0.7701 1
CO2HF 0.1128 0.2301 0.1851 0.1987 0.926 0.9527 1
COTOT 0.1331 0.2446 0.2051 0.2159 0.9069 0.9234 0.9729 1
RT3QT 0.2546 0.3752 0.3458 0.3458 -0.0806 0.0523 -0.0071 -0.0094 1
RT4QT 0.2461 0.3877 0.3486 0.3415 -0.0853 -0.0034 -0.0419 -0.0404 0.9262 1
RT2HF 0.2549 0.3879 0.3532 0.3498 -0.0847 0.0236 -0.0259 -0.0263 0.9795 0.9823 1
RTTOT 0.268 0.4079 0.3714 0.3707 -0.0428 0.0744 0.0239 0.0179 0.9787 0.9712 0.9931 1
T.O.V.A. 8.0 Professional Manual

V3QT 0.3252 0.471 0.4353 0.4404 0.2614 0.3683 0.3413 0.3328 0.789 0.7285 0.7717 0.7927 1
V4QT 0.3053 0.5012 0.4417 0.4424 0.2775 0.4022 0.3684 0.3637 0.7266 0.7692 0.7615 0.7802 0.8676 1
V2HF 0.3187 0.4974 0.4466 0.4496 0.2734 0.393 0.3613 0.3552 0.7796 0.7811 0.7947 0.8136 0.9545 0.9728 1
VT 0.3245 0.5054 0.4549 0.4624 0.3044 0.4304 0.398 0.3894 0.7598 0.7518 0.7697 0.8011 0.9463 0.9592 0.9874 1

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T.O.V.A. 8.0 Professional Manual 9 APPENDICES

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 Table 83: Pearson Product Coefficients - Auditory All Variables
9.10

O O O O O O O C C C C C C C C C C
M M M M M M M O O O O O O O R R R
P P P P P P P P P P P P P P M M M
Q Q Q Q H H T Q Q Q Q H H T Q Q Q
1 2 3 4 1 2 O 1 2 3 4 1 2 O 1 2 3
T T

OMPQ1 .1
OMPQ2 .8082 .1
OMPQ3 .6756 .7336 .1
OMPQ4 .6405 .7055 .9358 .1
OMPH1 .9416 .9593 .7432 .7102 .1

The TOVA Company

OMPH2 .669 .731 .9834 .9842 .7385 .1
OMPTOT .7325 .7896 .9806 .9769 .8024 .9949 .1
COPQ1 .4108 .3769 .3736 .3996 .4117 .3948 .4143 .1
COPQ2 .46 .4135 .3768 .3971 .4562 .3947 .4203 .8664 .1
COPQ3 .4829 .458 .542 .5592 .4932 .5597 .5685 .4269 .4779 .1
COPQ4 .4518 .4305 .4952 .489 .4628 .4996 .5104 .3268 .3563 .8299 .1
COPH1 .4514 .4099 .3884 .4121 .45 .4085 .4319 .9635 .9683 .4697 .3544 .1
COPH2 .486 .4621 .5391 .5433 .4972 .5498 .56 .3867 .4284 .9476 .9645 .4231 .1
COPTOT .5481 .5075 .5302 .5476 .5523 .5487 .57 .8599 .8841 .7778 .7051 .9033 .7701 .1
T.O.V.A. 8.0 Professional Manual

CRMQ1 .5544 .5661 .4986 .4847 .5894 .4993 .5289 .2073 .2258 .3582 .39 .2247 .392 .344 .1
CRMQ2 .4962 .5449 .4803 .4822 .5494 .4889 .5137 .2031 .2198 .339 .3736 .2194 .3736 .3313 .9149 .1
CRMQ3 .4469 .4748 .5259 .5094 .4855 .5257 .5366 .2008 .2121 .3115 .3439 .214 .3438 .3149 .7822 .8106 .1
CRMQ4 .3718 .4044 .4417 .4377 .4096 .4462 .4549 .1689 .1591 .2869 .314 .1703 .3156 .2704 .7131 .7512 .879
CRMH1 .5322 .5604 .4956 .4891 .5755 .5001 .5275 .2084 .2227 .3533 .3885 .2236 .3889 .3416 .9751 .9808 .8149
CRMH2 .4309 .4656 .5151 .5083 .4727 .5197 .5295 .1986 .2065 .3233 .3506 .2099 .3532 .3167 .7737 .8082 .975
CRMTOT .4675 .5009 .504 .4968 .5104 .5083 .525 .2106 .2181 .3285 .3577 .2222 .3596 .3279 .85 .8788 .9668
CRVQ1 .5613 .5864 .5493 .5421 .6043 .5545 .5804 .3324 .3027 .4927 .5108 .3284 .5245 .4789 .7472 .6965 .6364
CRVQ2 .5172 .559 .5184 .5286 .5674 .5319 .5548 .3098 .3231 .4983 .5196 .3281 .5327 .4824 .6843 .7718 .6388
CRVQ3 .4977 .5375 .5775 .5661 .5459 .5809 .5945 .2864 .2808 .5437 .5616 .2937 .5781 .4803 .6591 .6823 .7564
CRVQ4 .437 .4746 .4947 .4998 .4811 .5047 .5167 .2184 .2016 .5194 .5651 .2178 .5693 .4239 .6193 .6523 .679
CRVH1 .5767 .6096 .5644 .5678 .6249 .5752 .6017 .3344 .3293 .5184 .541 .3435 .5543 .5035 .7577 .8026 .6892
CRVH2 .4955 .535 .5808 .5823 .5434 .5909 .603 .289 .2783 .5551 .5845 .2938 .5966 .4892 .6592 .6908 .7458
CRVTOT .52 .5607 .57 .5729 .5699 .5806 .598 .3047 .2993 .5509 .5787 .3128 .5913 .4998 .695 .7323 .7625
D1QT -.6866 -.6042 -.5707 -.5536 -.6745 -.5713 -.606 -.4739 -.4011 -.5393 -.5457 -.452 -.5667 -.5864 -.5097 -.4914 -.4733
D2QT -.6038 -.7221 -.6054 -.5936 -.7024 -.6091 -.6434 -.4132 -.459 -.5698 -.5546 -.4523 -.5863 -.5954 -.5378 -.5434 -.4962
D3QT -.4572 -.4903 -.5788 -.5524 -.4995 -.5744 -.5823 -.2898 -.2867 -.7193 -.6516 -.2986 -.7127 -.5489 -.4516 -.4493 -.471
D4QT -.4361 -.4708 -.5443 -.574 -.4782 -.5682 -.5736 -.2662 -.262 -.6307 -.742 -.2735 -.7228 -.5363 -.4706 -.472 -.4792
D1HF -.6214 -.6523 -.5746 -.5601 -.6709 -.5765 -.6098 -.4244 -.4007 -.5698 -.5801 -.427 -.6009 -.5847 -.5358 -.5395 -.5092
D2HF -.4522 -.4864 -.5679 -.5708 -.4949 -.5784 -.5851 -.2828 -.2759 -.6725 -.7061 -.2892 -.7219 -.5468 -.475 -.4764 -.4928
DTOT -.5041 -.5388 -.5896 -.5903 -.5497 -.5994 -.6121 -.3416 -.326 -.6463 -.6724 -.3455 -.6901 -.5711 -.5091 -.5147 -.5269

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Appendix J: Pearson Product Coefficients, Auditory
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 Table 84: Pearson Product Coefficients - Auditory All Variables, continued
C C C C C C C C C C C D D D D D D D
R R R R R R R R R R R 1Q 2Q 3Q 4Q 1H 2H T
M M M M V V V V V V V O
Q H H T Q Q Q Q H H T T T T T F F T
4 1 2 O 1 2 3 4 1 2 O
T T

CRMQ4 0.1
CRMH1 0.7508 0.1
CRMH2 0.9509 0.8093 0.1
CRMTOT 0.9372 0.8845 0.9857 0.1
CRVQ1 0.5988 0.7369 0.6431 0.6884 0.1

The TOVA Company

CRVQ2 0.6158 0.7458 0.6509 0.694 0.7488 0.1
CRVQ3 0.7146 0.6866 0.7587 0.7619 0.746 0.7683 0.1
CRVQ4 0.7537 0.6521 0.7317 0.7412 0.7051 0.732 0.8654 0.1
CRVH1 0.6551 0.7984 0.697 0.7445 0.9125 0.9462 0.8059 0.768 0.1
CRVH2 0.7661 0.6914 0.7796 0.7804 0.7522 0.78 0.9632 0.9546 0.8176 0.1
CRVTOT 0.7705 0.7306 0.7927 0.8061 0.8004 0.8275 0.9535 0.9436 0.8702 0.9875 0.1
D1QT -0.4339 -0.5103 -0.4719 -0.4949 -0.6428 -0.5904 -0.6015 -0.5473 -0.6485 -0.5994 -0.62 0.1
D2QT -0.4481 -0.5493 -0.4948 -0.5204 -0.6349 -0.6502 -0.6386 -0.5842 -0.6815 -0.6383 -0.6573 0.6347 0.1
D3QT -0.4537 -0.4589 -0.4845 -0.4868 -0.602 -0.603 -0.7088 -0.6601 -0.6358 -0.7115 -0.7062 0.5844 0.6018 0.1
T.O.V.A. 8.0 Professional Manual

D4QT -0.4684 -0.4804 -0.501 -0.5035 -0.6076 -0.6171 -0.6975 -0.6932 -0.6465 -0.7252 -0.7205 0.567 0.5893 0.7388 0.1
D1HF -0.4678 -0.5474 -0.5098 -0.5331 -0.6671 -0.662 -0.6689 -0.6161 -0.703 -0.6682 -0.6873 0.8727 0.8718 0.6413 0.6345 0.1
D2HF -0.4837 -0.485 -0.5121 -0.5145 -0.6263 -0.6369 -0.7366 -0.7104 -0.667 -0.7528 -0.7467 0.5845 0.6044 0.8869 0.9223 0.6504 0.1
DTOT -0.5115 -0.5218 -0.5432 -0.5498 -0.6607 -0.671 -0.7591 -0.7241 -0.7052 -0.7728 -0.7728 0.668 0.6801 0.8664 0.8926 0.7525 0.9655 0.1

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 Table 85: Auditory Correlation Coefficients Condition 1
OMQ1 OMQ2 OMH1 OMT CQ1 CQ2 CH1 CT RTQ1 RTQ2 RTH1 RTT VQ1 VQ2 VH1 VT
OMQ1 1
OMQ2 0.8082 1
OMH1 0.9416 0.9593 1
OMT 0.7325 0.7896 0.8024 1
CQ1 0.4108 0.3769 0.4117 0.4143 1
CQ2 0.46 0.4135 0.4562 0.4203 0.8664 1

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CH1 0.4514 0.4099 0.45 0.4319 0.9635 0.9683 1
CT 0.5481 0.5075 0.5523 0.57 0.8599 0.8841 0.9033 1
RTQ1 0.5544 0.5661 0.5894 0.5289 0.2073 0.2258 0.2247 0.344 1
RTQ2 0.4962 0.5449 0.5494 0.5137 0.2031 0.2198 0.2194 0.3313 0.9149 1
RTH1 0.5322 0.5604 0.5755 0.5275 0.2084 0.2227 0.2236 0.3416 0.9751 0.9808 1
RTT 0.4675 0.5009 0.5104 0.525 0.2106 0.2181 0.2222 0.3279 0.85 0.8788 0.8845 1
VQ1 0.5613 0.5864 0.6043 0.5804 0.3324 0.3027 0.3284 0.4789 0.7472 0.6965 0.7369 0.6884 1
T.O.V.A. 8.0 Professional Manual

VQ2 0.5172 0.559 0.5674 0.5548 0.3098 0.3231 0.3281 0.4824 0.6843 0.7718 0.7458 0.694 0.7488 1
VH1 0.5767 0.6096 0.6249 0.6017 0.334 0.3293 0.3435 0.5035 0.7577 0.8026 0.7984 0.7445 0.9125 0.9462 1
VT 0.52 0.5607 0.5699 0.598 0.3047 0.2993 0.3128 0.4998 0.695 0.7323 0.7306 0.8061 0.8004 0.8275 0.8702 1

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 Table 86: Auditory Correlation Coefficients Condition 2
OMQ3 OMQ4 OMH2 OMT COQ3 COQ4 COH2 COT RTQ3 RTQ4 RTH2 RTT VQ3 VQ4 VH2 VT
OMQ3 1
OMQ4 0.9358 1
OMH2 0.9834 0.9842 1
OMT 0.9806 0.9769 0.9949 1
COQ3 0.542 0.5592 0.5597 0.5685 1
COQ4 0.4952 0.489 0.4996 0.5104 0.8299 1

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COH2 0.5391 0.5433 0.5498 0.56 0.9476 0.9645 1
COT 0.5302 0.5476 0.5487 0.57 0.7778 0.7051 0.7701 1
RTQ3 0.5259 0.5094 0.5257 0.5366 0.3115 0.3439 0.3438 0.3149 1
RTQ4 0.4417 0.4377 0.4462 0.4549 0.2869 0.314 0.3156 0.2704 0.879 1
RTH2 0.5151 0.5083 0.5197 0.5295 0.3233 0.3506 0.3532 0.3167 0.975 0.9509 1
RTT 0.504 0.4968 0.5083 0.525 0.3285 0.3577 0.3596 0.3279 0.9668 0.9372 0.9857 1
VQ3 0.5775 0.5661 0.5809 0.5945 0.5437 0.5616 0.5781 0.4803 0.7564 0.7146 0.7587 0.7619 1
T.O.V.A. 8.0 Professional Manual

VQ4 0.4947 0.4998 0.5047 0.5167 0.5194 0.5651 0.5693 0.4239 0.679 0.7537 0.7317 0.7412 0.8654 1
VH2 0.5808 0.5823 0.5909 0.603 0.5551 0.5845 0.5966 0.4892 0.7458 0.7661 0.7796 0.7804 0.9632 0.9546 1
VTOT 0.57 0.5729 0.5806 0.598 0.5509 0.5787 0.5913 0.4998 0.7625 0.7705 0.7927 0.8061 0.9535 0.9436 0.9875 1

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