The 15 to 20 Minute Quotient Computer Test

The medical field has spent decades attempting to define ADHD and determine how to best diagnose it. Dr. Neal has invested over thirty years answering the question “What is ADHD?” and researching how to measure the signs of ADHD in kids and adults. His ADHD assessment includes a comprehensive intake of rating scales, extensive history, and the Quotient computer test.

The Quotient ADHD computer test will help confirm the diagnosis of ADHD by measuring a person’s attention, impulsivity, and hyperactivity. We will also determine if other issues may be mimicking ADHD. If the client does not have ADHD, we will “break the code” to pinpoint exactly what may be presenting similar symptoms so that we can address it.

The Quotient ADHD computer test is a valuable diagnostic tool that offers quantitative data to bolster the qualitative interviews and assessments. This computer test also gives us a baseline to precisely measure inattention and impulsiveness. Based on the results of the test, we can determine whether the ADHD is mild or severe.

We use the Quotient ADHD Test because the information it gives is essential for determining between an ADHD diagnosis and another issue that may be mimicking ADHD. For the person considering medication or supplements to manage their ADHD symptoms, it is vital we have a baseline of the person’s performance off medication or supplements, so that we can accurately assess the level of their medication or supplements dosage. The Quotient test helps us ensure a person is not under or over medicated.

The Quotient ADHD Test takes 15 minutes for children under 13 and 20 minutes for adolescents and adults.

Historically, ADHD has been challenging to diagnose because many of the assessment tools rely largely on subjective information from parents and teachers, in addition to clinical evaluation. The Quotient ADHD test accurately measures motion and analyzes shifts in attention state to give a clear picture of ADHD symptoms compared to other people of the same age and gender. The Quotient ADHD Test gives objective and accurate data on the core symptom areas of ADHD:

  • Hyperactivity (inability to control movement and sit still while working)
  • Impulsivity (inability to inhibit inappropriate responses: self-regulation)
  • Inattention (difficulty in staying focused and on-task)

Interpretation of the Quotient ADHD Test Report

The Quotient ADHD test accurately measures motion and analyzes shifts in attention state to give a clear picture of the core symptom areas of ADHD. The software calculates results based on 19 or more parameters that combine to give greater than 90 percent accuracy in identifying ADHD.

The report is divided into 4 major sections:

  • Motion Analysis
  • Attention Analysis
  • Shift in Attention State
  • Quotient Composite Scores

The following examples compare the results of Billy (a boy with ADHD symptoms) and James (a boy who does not have ADHD symptoms), who are both in the same age category.

Motion Analysis

Research indicates that motion is one of the key indicators of hyperactivity. The Quotient ADHD test uses a motion tracking system to measure movement 50 times per second. Motion greater than one millimeter is counted and plotted in 5-minute segments. The graphics and the data tables clearly show significant differences between children with and without hyperactivity.

Billy, with ADHD symptoms, age 9 years 6 months, grade 3. No medication.

Head Motion - Billy

James, no ADHD symptoms, age 9 years 2 months, grade 3. No medication.

Head Motion - James

Attention Analysis

The attention analysis section of the report plots incorrect and correct hits and passes on a time scale. Patients with attention problems tend to make a lot of mistakes and the time of response tends to be more varied than people without attention problems. People with good attention tend to get into a rhythm and the graph shows a fairly tight distribution around the mean response time.

+ designates a target
x designates a non-target
+ commission errors: incorrect passes. (Measures inattention.)
x commission errors: incorrect hits. (Measures impulsivity.)
+ correct hits
x correct passes

Billy, with ADHD symptoms:

James, no ADHD symptoms:

Attention State Summary

The Quotient ADHD test analyzes 30 x 30-second blocks of data for the 15-minute test for children under 13 years old. The report summarizes the information on the attention state chart. It is easy to see how much time the patient is attentive/on task vs. impulsive, distracted, and disengaged from the task.

Billy, with ADHD symptoms:

30 x 30-second blocks of data are summarized on the attention state chart. For the first 30 seconds, this child showed disengaged/random behavior, followed by 30 seconds impulsive, followed by 60 of impulsivity, and so on. The table shows that he had 20 attention shifts. He was on task 10%, impulsive 20%, distracted 20% and disengaged 50% of the time, mostly randomly hitting the space bar.

Patients without ADHD tend to stay on task for the duration of the test. James 8 attention shifts, with 5 of 30 (16.7%) of the 30-second segments in the impulsive state. James, no ADHD symptoms:


As the graphs indicate, the Quotient ADHD test is a useful and effective tool that we use to gather data and accurately diagnose our clients who demonstrate ADHD behaviors.

We may run a series of Quotient ADHD tests to help inform medication management and help achieve better clinical efficacy. The Quotient test is used to evaluate progress toward goals and to help guide treatment planning. Once dosage is stable, we test periodically at medication check visits. A Quotient test may also be appropriate when considering a change in medication or dosage.

Dr. Neal’s approach to treating ADHD includes both a medication approach (in collaboration with healthcare providers) and/or a non-medication approach. Most parents with a child on medication for ADHD want to know whether the medication is working to the best degree possible. In Dr. Neal’s experience, many children who come to NPS already on medication are on an inaccurate dosage level or not on the correct medication for them. The Quotient test gives us a quantitative way to measure the results of medication and adjust as necessary.

Some adults we interview tell us they tried meds when they were young and it made little difference for them in school. Others say there were no significant beneficial changes at a job, or they had negative side effects from the medication, so they quit. Dr. Neal’s experience is that the client who is willing to take the necessary steps to fine-tune medication, while developing organizational and time management strategies with our ADHD coach, is most likely to have long-term success managing their ADHD. Because our computer test measures the hallmark signs of ADHD in adults, we know immediately if the medication is at the right dosage, without guessing and waiting weeks. Typically, a person will need to have one baseline test and then be tested one to two times while on a medication as dosage levels are adjusted by their medical prescriber.

If you want to talk in more depth about the Quotient test and the assessment process for ADHD, please call our office at (815) 477-4727 or contact us to schedule an appointment.


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