COTAP: COgnitive Test for ADHD Profiling

It has been consistently proven that not just one cognitive deficit underlies
ADHD (Fair et al., 2012; Nigg et al., 2005; Sonuga-Barke et al., 2010; de Zeeuw
et al., 2012). Just like in the normal population, ADHD patients show relative
weakness of one or more cognitive functions in combination with normal
cognitive functions in other domains. This means that in clinical practice,
only a part of the patients with ADHD will show deficits on the most classical
ADHD-related disfunctions, such as sustained attention or inhibition (Nigg et
al., 2005). For a test that contributes to the diagnostic process of ADHD it is
essential to measure an amount as big as possible of cognitive processes on
which children with ADHD can show deficits. Due to the integration of all these
functions we can scetch a cognitive profile (subtypes) of the patient, in which
relative strengths and weaknesses can be shown. Cognitive weaknesses can
contribute to clinical seriousness, but are not necessarily needed to diagnose.
As such, cognitive diagnostics won't replace current diagnostic methods but she
is an addition. Generally, there is an assumption that cognitive subtypes
differ from one another in causational factors (for example genetcal
predisposition), the natural course from childhood to adulthood, and also the
sensitivity to certain treatment. As such, a test like the COTAP can bring
keystones in the future for prognosis and choosing the course of treatment.

Developing a short (+/- 30-40 minutes) computerised test which can measure a
large amount of cognitive characteristics of ADHD, and as such can identify a
profile of cognitive strengths and weaknesses. The identification of such a
subtype serves:
• For the support of explanatory diagnostics of ADHD
• For the support of giving a more focused treatmentadvice
• For the support of neuroscientific and genetical research to the causes of
ADHD (endophenotype).

Observational study.

Children newly diagnosed with ADHD (still off medication) are asked to
participate. Task administration is performed only once for N=500 children.
N=100 children are asked to participate twice, for test-retest reliability.
This doen not interfere with routine clinical practice: it normally takes
several months before medication treatment is initiated.

Control children are tested once, except for N=150 children who are asked to
participate twice to establish test retest reliability.

There are no risks. The burden is minimal because of the short duration and the
form of the task, which is presented as a game. Children normally like
participating in this kind of research. Furthermore they will receive a small
present afterwards and parents could if wanted get a short report about the
results of their child.