The role of neuropsychological evaluation in the diagnosis of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) is a growing area of research and clinical interest. Our review of the literature indicates that adults with ADHD demonstrate subtle impairments on select measures of attention and executive functions, auditory-verbal list learning, and complex information processing speed relative to normal controls. The validity of these findings is nonetheless hampered by several limitations, including methodological and sample variability, a restricted range of interpretive techniques, and uncertain discriminant validity. Recommendations are offered to advance the cognitive and neurobehavioral understanding of this disorder and to enhance the utility of neuropsychological methods for diagnosis and management of adults with ADHD.

ADHD adults (N = 26) were compared to normal controls (N = 26) on 6 neuropsychological measures believed sensitive to frontal lobe–executive functioning. MANOVA analyses and subsequent univariate tests indicated that most of the neuropsychological measures discriminated between the two groups. To address clinical significance, diagnostic classification rates were also generated for each measure individually, and for the battery as a whole. Levels of positive predictive power (PPP) for each of the 6 measures (83–100%) indicated that abnormal scores on these tests were good predictors of ADHD. However, estimates of negative predictive power (NPP) suggested that normal scores poorly predicted the absence of ADHD. When classification rates were calculated for the overall battery classification accuracy improved substantially. Thus, neuropsychological tests can differentiate adults suffering from ADHD from adults without ADHD, while also providing good classification accuracy. Finally, the pattern of neurobehavioral impairments exemplified through the Summary Index scores was interpreted as consistent with conceptualizations of ADHD depicting mild neurologic dysfunction in networks associated with the frontal lobes. (JINS, 1999, 5, 222–233.)

Surveyed parents of children with and without ADHD for their perceptions of their children's sleep patterns. All children had been referred for learning or behavior problems to an outpatient assessment center. Diagnoses of ADHD were based on DSM-III-R, rather than DSM-III criteria, avoiding a possible confound from diagnostic criteria that formerly included sleep disturbance as a defining characteristic of ADHD. Data replicated past findings showing that parents perceive children with ADHD to have greater sleep difficulty than normally developing children. Parents perceived few differences between sleep patterns of children with ADHD who were taking or not taking stimulant medication. Implications of these findings are discussed in the context of past literature and present clinical practice.

While the application of normative standards is vital to the practice of clinical neuropsychology, data regarding normative change remains scarce despite the frequency of serial assessments. Based on 285 normal individuals, we provide co-normed baseline data with demographic adjustments and test-retest standardized regression based (SRB) models for three time points for several measures. These models delineate normal, expected change across time, and yield standardized z-scores that are comparable across tests. Using a new approach, performance on any previous trial was accounted for in the subsequent models of change, yielding serial normative formulas that model change trajectories rather than simple change from point to point. These equations provide indices of deviation from expected baseline and change for use in clinical or research settings.

Surveys regarding practitioner perceptions of time requirements for psychological testing were mailed to a national sample of clinical psychologists. There were 228 (36%) returns from 630 mailings actually received. On the basis of 151 usable returns from respondents who conduct psychological testing services, data are presented separately for time requirements associated with administering, scoring, and interpreting the 24 most commonly used tests. Data are also presented regarding the composition of typical test batteries and practitioner usage of technician and/or computer assistance in psychological testing. The implications of these data for research and practice are discussed.