Introduction: Why Look Beyond QbTest?

The QbTest has become one of the most widely recognized objective tools for ADHD assessment and treatment monitoring, thanks to its ability to measure activity, inattention, and impulsivity. However, it is not the only option. Several other ADHD assessment tools exist—some focusing on continuous performance, others on brain-based markers like EEG. Understanding these alternatives helps clinicians and families make informed choices about objective ADHD diagnosis.

This article explores the best alternatives to QbTest, compares their strengths and limitations, and explains how they fit into a comprehensive ADHD evaluation.

1. NEBA (Neuropsychiatric EEG-Based Assessment Aid)

• Type: EEG-based diagnostic adjunct

• How it works: Measures the ratio of theta to beta brain waves, which tends to be higher in children with ADHD.

• Strengths:

  • FDA-approved for ages 6–17.

  • Provides a biological marker rather than just behavioral data.

• Limitations:

  • Only validated for children/adolescents.

  • Requires EEG setup, making it less accessible in routine practice.

2. Conners Continuous Performance Test (CPT-3)

• Type: Computerized Continuous Performance Test (CPT)

• How it works: Measures sustained attention and impulsivity through a repetitive task where responses must be controlled.

• Strengths:

  • Decades of validation in ADHD research.

  • Widely used globally.

• Limitations:

  • Focuses on attention/impulsivity only; does not track hyperactivity like QbTest.

3. Test of Variables of Attention (TOVA)

• Type: Computerized test of attention

• How it works: Uses geometric shapes as stimuli to evaluate vigilance and impulse control.

• Strengths:

  • Non-verbal and culture-free.

  • Available in visual and auditory formats.

• Limitations:

  • Does not measure hyperactivity.

  • Test results can be influenced by motivation or fatigue.

4. IVA-2 (Integrated Visual and Auditory CPT)

• Type: Visual + auditory CPT

• How it works: Combines tasks requiring responses to both sounds and images.

• Strengths:

  • More ecologically valid as attention demands are multimodal.

  • Provides multiple subscales like vigilance, prudence, and consistency.

• Limitations:

  • Takes longer to administer.

  • Smaller normative database compared to CPT-3.

5. MOXO d-CPT (Distractor CPT)

• Type: Continuous Performance Test with real-life distractors

• How it works: Introduces visual and auditory distractions (like background noise or moving images) to mimic real-world settings.

• Strengths:

  • Closer to real-life challenges children face in classrooms.

  • Measures attention, timing, impulsivity, and hyperactivity.

• Limitations:

  • Less widely available compared to CPT-3 or TOVA.

  • Cultural differences may influence distractor interpretation.

6. CANTAB (Cambridge Neuropsychological Test Automated Battery)

• Type: Neurocognitive test battery

• How it works: A collection of computerized tasks measuring memory, attention, and executive function.

• Strengths:

  • Provides a broader cognitive profile beyond ADHD.

  • Research-backed across many neurodevelopmental disorders.

• Limitations:

  • Time-consuming and not ADHD-specific.

  • Requires specialized software and equipment.

7. Open-Source & Research Tools (Psychopy, ANT, Go/No-Go)

• Examples:

  • Attention Network Task (ANT)

  • Go/No-Go Task

  • Stop-Signal Task

• Strengths:

  • Free and customizable for research purposes.

  • Excellent for experimental psychology and academic studies.

• Limitations:

  • Require programming skills.

  • Not standardized for clinical diagnosis.

QbTest vs Alternatives: A Quick Comparison

Conclusion: Which ADHD Test is Best?

The QbTest remains unique because it directly quantifies hyperactivity alongside attention and impulsivity. However, alternatives like NEBA, CPT-3, TOVA, IVA-2, and MOXO d-CPT can provide equally valuable insights depending on the clinical context.

• For a biological adjunct, NEBA stands out.

• For traditional attention/impulsivity measures, CPT-3 and TOVA are strong.

• For a real-world simulation, MOXO d-CPT is excellent.

• For comprehensive cognition, CANTAB is best suited.

A comprehensive ADHD diagnosis should always combine clinical interviews, rating scales, and one or more of these objective tests to ensure accuracy and effective treatment monitoring.

✦ About the Author

I’m Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), Consultant Psychiatrist at Mind and Memory Clinic, Apollo Clinic, Velachery, Chennai (Opp. Phoenix Mall).

I specialize in ADHD, neurodevelopmental disorders, neuromodulation therapies (rTMS, tDCS, neurofeedback), and digital tools like QbTest. My approach integrates clinical expertise with objective technologies to provide personalized, evidence-based care.

📞 Contact: +91 85951 55808
🌐 Visit: srinivasaiims.com