Predictive power of frontal lobe tests in the diagnosis of attention deficit hyperactivity disorder.

A battery of tests presumed to assess various frontal lobe functions in children was evaluated for the accuracy of the tests in classifying children as having attention deficit hyperactivity disorder (ADHD). Two groups of children were tested: (1) 66 children, ages 6-11 years, with ADHD, and (2) a normal community control group of 64 children of the same age. Results indicated good positive predictive power (PPP) for seven of the tests (ranging from 80 to 90%), suggesting that abnormal scores on these tests may be indicative of the presence of ADHD. However, the rates of negative predictive power (NPP) even for these seven tests were modest (ranging from 50 to 66%). Sensitivity was also poor (ranging from 5 to 43%) as were the levels of false negatives (averaging 40%) creating fair-to-poor overall classification rates for all tests (49 to 70%). It is concluded that while these neuropsychological tests may have some value in clinical evaluations of children's psychological abilities, they may not be useful as the sole criteria for the diagnostic classification of children as ADHD.