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Conducting Virtual ADHD Testing

 

OVERVIEW OF THE TEST 

  • Test Name: IVA-2 CPT (Integrated Visual and Auditory Continuous Performance Test)
  • Purpose: Evaluates visual and auditory attention and impulse control. Commonly used to help assess for ADHD in individuals ages 6 and up.
  • Duration: About 15 minutes total (including Warm-Up and Practice); the Main Test lasts approximately 12 minutes.
  • Test Task: The patient clicks the mouse only when they see or hear a “1” (target), and does not click when they see or hear a “2” (foil). The test is intentionally repetitive to measure sustained attention.

Pre-Test Preparation

Review Chart & Documents

  • Open the patient’s clinical note for the visit.

  • Navigate to: Additional > Behavior during ADHD testing

  • Review the completed “Checking Readiness for ADHD Remote Testing” form in the chart.

  • Review the patient’s current medication list to understand what may have been taken in the past 24 hours.

Greet Patient 

  • Log into zoom room.

  • A parent or guardian must be present to assist with setup and monitoring.

  • Greet and speak directly with the guardian at the beginning of the session.

Confirm Equipment Setup

Ask the guardian the following questions:

  • Do you have a second device (laptop or desktop PC) ready for the test? (Zoom should remain open on a different device.)

  • Are you using a wired or wireless mouse?

  • What type of audio output will be used? (Wired headphones or wired earbuds are strongly recommended. Built-in laptop or PC speakers can be used—but only if testing environment is completely quiet and free from auditory & visual distractions).

  • Have you reviewed the ADHD testing instructions sent by email?

  • Have you received the email titled “Remote ADHD Testing Test Code”?

Prepare the Testing Environment

Ensure:

  • A quiet room, free of distractions (auditory and visual)

  • No pets or siblings in the room

  • A stable table and chair (avoid swivel chairs)

  • Patient seated 15–24 inches from the monitor, with screen center 1–2 inches below eye level

  • Mouse placed on a mousepad directly in front; keyboard moved to the side

  • Minimal glare on the screen

Starting the Test

Instructions for the Test-Taker

  • Ask the patient to use the restroom beforehand; the test cannot be paused once started.

  • Explain mouse usage:

    • Click only with the left mouse button

    • Do not use the right mouse button at all during the test. 

    • Use the index finger only

    • No pressing & holding, double-clicking, or switching hands

  • Reassure them:

    • “This is like a really simple video game — probably one of the easiest you’ve ever played!”

  • Instruct them to follow the on-screen and spoken instructions carefully.

Instructions for the Guardian

  • Please observe quietly during the test.
  • Do not speak to the patient, offer reminders, or provide coaching.
  • If the patient becomes distracted, fidgety, or off-task, do not redirect them. 
  • If the patient asks questions like “When is it over?”, respond with the same phrase:
    “Keep working, do your best.”
  • If the patient appears confused or has difficulty understanding the test directions, the Virtual Medical Assistant (VMA) will step in at the appropriate time to assist.

  • Once the test has begun, the setup—including mouse, headphones, and other equipment—must not be changed.

Launch the Test

  • Ask Guardian to open the email titled "Remote ADHD Testing Test Code." This email includes test code, password and URL to take the test 
  • Sample Test Code: U-6B0E-D5CD
  • Sample Password: 450B-0AF4
  • Sample URL: https://braintraintests.com/ivats/iva2.aspx

  • Ask Guardian to copy and paste the provided URL into the Chrome browser on the laptop/PC being used for testing. Following screen will appear: 

  • Ask Guardian to maximize the Chrome browser window to fill the entire screen.
  • Ask Guardian to enter the Test Code and Password to start the test. Following screen will appear:

 

  • Ask Guardian to ensure that mouse is properly connected 
  • Ask patient to plug in wired headphones or external speakers and test and adjust the volume for comfort. 
  • Ask patient to begin the test click the Green Arrow on lower right corner of the screen to begin the test and follow the on-screen instructions as the test begins.

Document

Based on your observations during the session, complete the DrChrono note titled “Behavior during ADHD testing.” 

 

VMA GUIDELINES DURING THE TEST

Do’s:

  • If the patient asks questions like “When is it over?”, reply: “Keep working, do your best.”

  • During Practice/Warm-Up only:  If the test pauses after 3 errors (“OOPS”), explain the rules again to ensure understanding. This happens because patient is not able to understand the directions of the test. Hence, they need to be explained.

  • If the patient becomes emotionally distressed, you can ask Guardian to abort the test by pressing Ctrl + F1

Don’ts:

  • Do not coach or assist during the Main Test.

  • Do not redirect distracted, fidgety, or off-task behavior. Just say: “Keep working, do your best.”