Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review.

We systematically reviewed the patterns of Continuous Performance Test (CPT) errors of omission and commission exhibited by normal children and children with Attention Deficit and Hyperactivity Disorder (ADHD) under no drug, placebo and methylphenidate drug conditions. Findings from 26 studies were submitted to a meta-analytic procedure. In contrast to the contradictory findings of individual reports, our results revealed that children with ADHD made significantly more errors of omission and commission than normal children. As well, in children with ADHD and treated with methylphenidate, statistically significant reductions in the rate of both error types were noted. The effects of methylphenidate on the percentage of hits (i.e. 1 - omissions) were greater in experiments using shorter stimulus duration, smaller number of trials and higher probability of a target. Using Signal Detection Theory (SDT) parameters, we found that children with ADHD were less sensitive to the difference between targets and non-targets than their normal counterparts, while showing a comparable response bias. Similarly, the effects of methylphenidate were restricted to improving the sensitivity, while not affecting response bias, in both normal children and those with ADHD.