Clinical NeuroscienceThe effect of environmental distractors incorporation into a CPT on sustained attention and ADHD diagnosis among adolescents

•Adolescents with ADHD are more easily distracted than controls.•Incorporation of environmental distractors improves CPT validity.•Visual distractors are more beneficial in terms of ADHD diagnosis than auditory distractors.

BackgroundDiagnosis of ADHD in adolescents involves specific challenges. Conventional CPT's may fail to consistently distinguish ADHD from non-ADHD due to insufficient cognitive demands. The aim of this study was to explore whether the incorporation of environmental distractors into a CPT would increase its ability to distinguish ADHD from non-ADHD adolescents.New methodUsing the rate of omission errors as a measure of difficulty in sustained attention, this study examined whether ADHD adolescents are more distracted than controls and which type of distractors is more effective in terms of ADHD diagnosis. The study employed the MOXO-CPT version which includes visual and auditory stimuli serving as distractors. Participants were 176 adolescents aged 13-18 years, 133 diagnosed with ADHD and 43 without ADHD.Results and comparison with existing methodsResults showed that ADHD adolescents produced significantly more omission errors in the presence of pure visual distractors and the combination of visual and auditory distractors than in no-distractors conditions. Distracting stimuli had no effect on CPT performance of non-ADHD adolescents. ROC analysis further demonstrated that the mere presence of distractors improved the utility of the test.ConclusionsThis study provides evidence that incorporation of environmental distractors into a CPT is useful in term of ADHD diagnosis. ADHD adolescents were more distracted than controls by all types of environmental distractors. ADHD adolescents were more distracted by pure visual distractors and by the combination of distractors than by pure auditory ones.