Deaf Adults Without Attention Deficit Hyperactivity Disorder Display Reduced Perceptual Sensitivity and Elevated Impulsivity on the Test of Variables of Attention (T.O.V.A.) The Test of Variables of Attention (T.O.V.A.; R. A. Leark, T. R. Dupuy, L. M. Greenberg, C. L. Corman, & C. L. Kindeschi, 1996) is a continuous performance test used widely to help diagnose attention deficit hyperactivity disorder (ADHD) in both hearing and deaf people. The T.O.V.A. previously has been ... Research Article
Research Article  |   October 01, 2003
Deaf Adults Without Attention Deficit Hyperactivity Disorder Display Reduced Perceptual Sensitivity and Elevated Impulsivity on the Test of Variables of Attention (T.O.V.A.)
 
Author Affiliations & Notes
  • Ila Parasnis
    National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY
  • Vincent J. Samar
    National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY
  • Gerald P. Berent
    National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY
  • Contact author: Ila Parasnis, PhD, Department of Research, National Technical Institute for the Deaf, Rochester Institute of Technology, 96 Lomb Memorial Drive, Rochester, NY 14623. E-mail: impncr@ritvax.rit.edu
Article Information
Hearing Disorders / Attention, Memory & Executive Functions / Hearing / Research Articles
Research Article   |   October 01, 2003
Deaf Adults Without Attention Deficit Hyperactivity Disorder Display Reduced Perceptual Sensitivity and Elevated Impulsivity on the Test of Variables of Attention (T.O.V.A.)
Journal of Speech, Language, and Hearing Research, October 2003, Vol. 46, 1166-1183. doi:10.1044/1092-4388(2003/091)
History: Received March 27, 2002 , Accepted March 28, 2003
 
Journal of Speech, Language, and Hearing Research, October 2003, Vol. 46, 1166-1183. doi:10.1044/1092-4388(2003/091)
History: Received March 27, 2002; Accepted March 28, 2003
Web of Science® Times Cited: 25

The Test of Variables of Attention (T.O.V.A.; R. A. Leark, T. R. Dupuy, L. M. Greenberg, C. L. Corman, & C. L. Kindeschi, 1996) is a continuous performance test used widely to help diagnose attention deficit hyperactivity disorder (ADHD) in both hearing and deaf people. The T.O.V.A. previously has been normed only on the hearing population. The T.O.V.A. performance of 38 prelingually and severely-to-profoundly deaf young adults and 34 hearing young adults who did not have ADHD was examined in this study. Deaf and hearing participants did not differ on the T.O.V.A. omission variables. However, deaf participants had significantly lower d' scores than hearing participants, indicating reduced perceptual sensitivity to the distinction between target and distractor stimuli. Consistent with the existing literature on attentional reorganization in the deaf population, this result was interpreted as indicating a deafness-related reduction in attention to centrally presented stimuli. Deaf participants also showed 2 to 3 times more commission errors than hearing participants and displayed a higher incidence of anticipatory errors. These results suggest a deafness-related increase in impulsivity at the time of response initiation. Beta score analysis confirmed that deaf participants adopted an overall less conservative (more impulsive) response criterion that contributed to their total elevated commission errors. However, a portion of the commission errors was secondary to their reduced d', not to increased behavioral impulsivity. Separate factor analyses of the standard T.O.V.A. variables revealed highly similar factor structures for deaf and hearing participants, indicating similar construct validity of the T.O.V.A. for both groups. The evidence for increased inattention and impulsivity in a non-ADHD deaf sample are interpreted in the context of an adaptive attentional reorganization due to deafness. Along with the factor analytic results, these considerations suggest that separate T.O.V.A. norms must be developed for the deaf population to avoid overdiagnosis of ADHD in deaf individuals.

Acknowledgments
We thank the T.O.V.A. Research Foundation for providing the T.O.V.A. software for this research. We thank Santo James Triolo for permission to translate the ADSA into ASL. We thank Patrick Graybill of the National Technical Institute for the Deaf (NTID) Department of Cultural and Creative Studies, and June Reeves of the NTID Department of American Sign Language and Interpreter Education for their expert help in translating the ADSA items into ASL. We also thank Patrick Graybill for serving as the talent for the bilingual ADSA videotape. Finally, we thank Poorna Kushalnagar, Betsey Keys, Ann Mogavero, Kim Kelly, Rene Scanlon, Dana Wright, and Tara Goldgier for their help in data collection, and the students at the NTID and at the Rochester Institute of Technology for their participation.
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