ADHD / 25.05.2026
Objective Cognitive Testing for ADHD: How Modern Digital Assessments Are Changing Clinical Diagnosis
Attention Deficit Hyperactivity Disorder remains one of the most common yet often misdiagnosed neurodevelopmental conditions we see in clinical practice today. If you're a healthcare professional, you've likely experienced the challenge firsthand.
A patient walks into your office reporting concentration difficulties, but is it truly ADHD? Or are they dealing with anxiety, depression, or another condition that simply looks like ADHD on the surface?
This diagnostic puzzle has frustrated clinicians for decades. The traditional approach relies heavily on behavioral rating scales and clinical interviews. While these tools provide valuable information, they only tell part of the story.
They capture what patients report about their symptoms, but they don't measure what's actually happening in the brain during tasks that demand attention, planning, and self-control.
That's where modern digital cognitive testing enters the picture.
Prof. Guohua Li[/caption]
MedicalResearch.com Interview with:
Guohua Li, MD, DrPH
Finster Professor of Epidemiology and Anesthesiology
Columbia University Irving Medical Center
MedicalResearch.com: What is the background for this study? How was the ADHD diagnosis determined?
Response: The reported prevalence of ADHD in children and young adults in the United States has more than doubled since the 1990s because of improved diagnosis. Currently, ADHD affects about 13 percent of children under 18 years of age and eight percent of adults under 45 years of age. Little is known about the prevalence of ADHD in older adults although it is estimated that ADHD symptoms may persist throughout the lifespan in about one-third of children diagnosed with the disorder. Diagnostic criteria for adulthood ADHD include having five or more relevant symptoms, adverse impact on social, academic, and occupational activities, and onset of symptoms before age 12.
In this study, ADHD status is determined based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a doctor or other health professional that he or she had ADHD.
Sneha Vaddadi[/caption]
Sneha Vaddadi, BS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns.
The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population.
Dr. Shoaff[/caption]
Jessica Shoaff, MPH, PhD
Postdoctoral Research Fellow and
[caption id="attachment_55259" align="alignleft" width="150"]
Dr. Korrick[/caption]
Susan A. Korrick, MD
Pulmonary and Critical Care
Assistant Professor in the Department of Environmental Health
Harvard Medical School · Harvard T. H. Chan School of Public Health
Brigham and Women's Hospital
Channing Laboratory Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study posed the question: Do teenagers’ exposures to chemicals that are often found in consumer products increase behaviors that are common among individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD)? Our results suggest that teenagers exposed to chemicals often found in consumer products (particularly phthalates) may have increased behaviors that are common among individuals diagnosed with ADHD. However, we did not study the diagnosis of ADHD (most of our study teens did not have ADHD). This means our results cannot answer the question of whether these chemical exposures increase the likelihood of being diagnosed with ADHD. Also, in our study design, chemical exposures and ADHD-related behaviors were measured at the same time, so it is not possible to know with certainty whether the chemical exposures altered behavior or behavior altered chemical exposures. 
Dr. Piper[/caption]
Brian J. Piper, PhD, MS
Assistant Professor of Neuroscience
Department of Basic Sciences,
Geisinger Commonwealth School of Medicine,
Scranton PA 18509
MedicalResearch.com: What is the background for this study?
Response: The U.S. accounts for five percent of the world population but more than 92 percent of the world’s spending on pharmacotherapies for Attention Deficit Hyperactivity Disorder (ADHD). According to the 2011 National Survey of Children’s Health, ADHD increased to 11.0 percent of U.S. children, seven percent of girls and 15 percent of boys. Interestingly, ADHD rates were much lower among Hispanic children.
The 2013 revision to the Diagnostic and Statistical Manual of Mental Disorders broadened the criteria such that it became easier to diagnose adult ADHD. Together, we hypothesized that use of amphetamine (Adderall), methylphenidate (Ritalin), and lisdexamfetamine (Vyvanse) would be increasing. We also predicted that there would be some regional differences in stimulant use.
Dr. Barrett[/caption]
Charles Barrett. Ph.D.
School Psychologist
Loudon County Virginia
Public Schools
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD). However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females. For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys. Few empirical studies have examined differences between Black and White boys.
The present study sought to address several limitations in the field. Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children. Next, maternal figures, rather than teachers, were included as the informants.
The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of 
Ali Khashan, PhD
Senior Lecturer in Epidemiology
School of Public Health & INFANT Centre
University College Cork
Cork, Ireland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is some evidence to suggest an increased likelihood of neurodevelopmental disorders in relation to hypertensive disorders in pregnancy, however consensus is lacking. Considering hypertensive disorders in pregnancy are among the most common prenatal complication, we decided to synthesise the published literature on this topic by conducting a comprehensive systematic review and meta-analysis.
Our main findings suggest that hypertensive disorders in pregnancy are associated with about 30% increase in the likelihood of autism spectrum disorders (ASD) and ADHD in the offspring, compared to offspring not exposed to hypertensive disorders in pregnancy.
