Quotient ADHD Test
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Quotient ADHD Test

 

Overview: The Quotient ADHD Test is for the objective measurement of hyperactivity, impulsivity and inattention as an aid in the assessment of ADHD. The Quotient® System objectively measures micro-motion and analyzes shifts in attention state. The report provides concrete information needed to get Mom, Dad and the patient aligned and fully engaged in the treatment planning process. Follow-up tests help to assess whether the patient is getting the right intervention.

Age Range: Tests for 6-12, 13-14, 15+

Administration: Medical device with built-in software and Motion Tracking System

Report Options: Upload raw data to the server, download the report within minutes of test completion.

Commercially Available since 2008

Visit the Quotient website at: www.quotient-adhd.com

 
 
 

Product Details

The Quotient ADHD Test is for the objective measurement of hyperactivity, impulsivity and inattention as an aid in the assessment of ADHD. Better communication with objective data gets parents, teachers and the patient aligned and engaged in treatment planning. The Quotient report lets them see the severity of hyperactivity and the inability to sustain attention. This improves the efficiency of the visit.

Objective data improves the accuracy of your ADHD assessments.

  • See the Problem: Quantify the severity of deficits at baseline. Concrete data makes communication more efficient.
  • See the Progress: Evaluate progress to treatment goals. From Jake's case presented below: At Day 8, his motion was attenuated and his teacher reported improvement. However, sustained attention remained sub-optimal. Would clinical interviews reveal the attention problem this soon? We can do better!
  • Get on Track Sooner: Objective data helps inform decisions to optimize treatment for the individual. We're there!

The Quotient® ADHD Test helps to inform treatment decisions and helps to achieve clinical efficacy sooner.

AAP Guidelines: "Because stimulant medication effects are seen immediately, trials of different doses of stimulants can be accomplished in a relatively short time period. Stimulant medications can be effectively titrated on a 3- to 7-day basis." This case study illustrates how the Quotient System can help implement a protocol with frequent assessments.

Learn More at the Quotient Website. Visit Quotient-ADHD.com.

For more information

call 877-246-2397 or
email us at info@Quotient-ADHD.com

Resources

This bibliography lists most peer-reviewed papers on the Quotient System and links are provided to the publisher. You can read the abstract and, in some cases, you can read the entire paper. The posters are available as PDFs.

The Quotient ADHD System is FDA cleared to provide clinicians with objective measures of hyperactivity, impulsivity and inattention to aid in the clinical assessment of ADHD. This medical and scientific information is provided for educational purposes. Some uses may not have been cleared by the FDA for the Quotient ADH System. Financial interests, where applicable, are disclosed in individual papers.

Posters

F. Xavier Castellanos, FX, et. Al. A Preliminary Examination of Resting State Functional Connectivity Correlates of Motor Activity AACAP Poster Session 2010.

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Hasson H, Horvath, K, Wishik, J, Hartman, D. Does Implementation of Quantitative Measurements of Activity and Attention Improve Outcomes Associated with Optimal Medication Titration in Patients with ADHD? US Psych Congress 2013 Poster Session. 2013

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Hughes, C, Bolanos, G, Silver, C, Pickering, J, D., Hum., Baker, K. Assessment of Attention and Motion in Children with an Oral Language Disorder and Attention-Deficit/Hyperactivity Disorder. AACAP Poster Session. 2010.

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Polcari A, Fourligas N, Navalta C, Teicher MH. Hyperactivity Persists in Male and Female Adults with ADHD and Remains a Highly Discriminative Feature of the Disorder. AACAP Poster Session. 2010.

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Sumner, CR, Ritchie, CA, Hoadley, K. Pilot Study: Detecting Feigned ADHD with Computerized Technology. APSARD Poster Session. 2013.

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Sumner; CR, Sutton, VK; Newcorn J Does Placebo Response Differ Between Objective and Subjective ADHD Measures? AACAP Poster Session. 2009

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Publications about the Quotient System (Formerly known as MMAT)

Anderson C, Polcari A, Lowen S, Renshaw P, Teicher M. Effects of Methylphenidate on Functional Magnetic Resonance Relaxometry of the Cerebellar Vermis in Boys With ADHD. American Journal of Psychiatry. 2002; 159:(8), 1322.

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Heiser P, Frey J, Smidt C, Sommerlad P, Wehmeier M, Hebebrand J, Remschmidt H. Objective measurement of hyperactivity, impulsivity, and inattention in children with hyperkinetic disorders before and after treatment with methylphenidate. European Child & Adolescent Psychiatry. 2004;13: 100.

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Sumner, CR, Sutton, VS, Teicher, MH and Newcorn, JH. Does Placebo Response Differ Between Objective and Subjective ADHD Measures in Children with Attention-Deficit/Hyperactivity Disorder? Postgraduate Medicine. 2010; 122(5), 52-61.

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Sumner, CR New Tool for Objective Assessment of ADHD: The Quotient® ADHD System. The ADHD Report. 2010; 18(5), 6-9.

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Tabori-Kraft, Janne; Sorensen, Merete;Kerguard, Martin; Dalsgaard, Soren; Thomsen, Per Hove.Is MMAT (Quotient) useful for monitoring the effect of stimulants on hyperactivity and inattention? A brief report, European Child and Adolescent Psychiatry. May 2007.

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Teicher M, Ohashi K, Vialiano G, Polcari A. Unraveling the Nature of Hyperactivity in Children with Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry, 2010:67(4), 388-396.

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Teicher M, Polcari A, McGreenery C. Utility of Objective Measures of Activity and Attention in the Assessment of Therapeutic Response to Stimulants in Children with ADHD. Journal of Child and Adolescent Psychopharmacology. 2008:18,3, 265-270.

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Teicher M, Polcari A, Foley M, Valente E, McGreenery C, Chang W, McKay G, Midha K. Methylphenidate Blood Levels and Therapeutic Response in Children with ADHD: Effects of Different Dosing Regimens. Journal of Child and Adolescent Psychopharmacology.2006; 16:(4) 416-431.

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Teicher M, Lowen S, Polcari A, Foley M, McGreenery C. Novel Strategy for the Analysis of CPT Data Provides New Insight into the Effects of Methylphenidate on Attentional States in Children with ADHD. Journal of Child And Adolescent Psychopharmacology. 2004;14:2.

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Teicher M, Polcari A, Anderson C, Andersen S, Lowen S, Navalta C. Rate Dependency Revisited: Understanding the Effects of Methylphenidate in Children with Attention Deficit Hyperactivity Disorder. Journal of Child and Adolescent Psychopharmacology. 2003;13:1, 41.

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Teicher M, Anderson C, Polcari A, Glod C, Maas L, Renshaw P. Functional Deficits in Basil Ganglia of Children with Attention-Deficit/Hyperactivity Disorder Shown with Functional Magnetic Resonance Imaging Relaxometry. Nature Medicine 2000; 6 (4):470.

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Teicher M, Ito Y, Glod C, Barber N. Objective Measurement of Hyperactivity and Attentional Problems in ADHD. J American Academy of Child and Adolescent Psychiatry. 1996; 35(3): 334.

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Publications about ADHD

ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics 2011 128:1007-1022; doi:10.1542/peds.2011-2654

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Jensen PS et. al. Findings from the NIMH multimodal treatment study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22(1):60-73.

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Leslie, LK, et. al. Implementing the American Academy of Pediatrics Attention-Deficit/Hyperactivity Disorder Diagnostic Guidelines in Primary Care Settings. Pediatrics. 2004; 114(1):129-140.

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Waschbusch, DA, et. al. Are There Placebo Effects in the Medication Treatment of Children with Attention-Deficit Hyperactivity Disorder? Journal of Developmental and Behavioral Pediatrics. 2009; 30(2):158-168.

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Training

 

FAQs

Questions

Frequently asked questions follow. Click on a question to see the response.

  • Does Quotient take the place of rating scales?

    No, Quotient is complementary to symptom rating scales providing the "signs" to go along with the "symptoms."The current standards of care for diagnosis and management of ADHD recommend symptom rating scales, which are subjective in nature and are often affected by bias on the part of the parent/teacher informant. Experts in the field agree that an accurate, quantitative, objective test to measure the neurobehavioral functions relevant to ADHD is a needed addition to the physician's tool kit.

  • Did Pearson invent the Quotient ADHD System?

    Pearson develops, manufactures and markets proprietary diagnostic systems for the objective assessment of neurobiological disorders like ADHD. The Quotient® ADHD System Pearson is based on a patented research design developed in the Developmental Biopsychiatry Program at McLean Hospital, a Harvard Medical School Affiliate, and is exclusively licensed to Pearson.

  • How does Quotient work?

    Quotient® (formerly known as MMAT, the McLean Motion and Attention Test) is a non- invasive FDA-cleared device providing objective measures of a subject's ability to inhibit motor activity, sustain attention and suppress impulsive responses. Deficits in response inhibition in these neurological control functions are directly related to the core symptom domains of ADHD: hyperactivity, inattention, and impulsivity. With this technology, clinicians obtain objective, accurate and reliable information within minutes about brain function with a strong correlation to the presence or absence of a level of symptom burden sufficient for the diagnosis of ADHD.

    The Quotient technology has consistently demonstrated accurate quantification of the degree to which a person is able to control involuntary movement while maintaining voluntary movement efficiency, focus attention to stimuli, sustain attention during a lengthy attention task and inhibit impulsive reactions. By design, the developmental abilities measured by Quotient® coincide with the areas of deficit manifest in the triad of symptoms characteristic of ADHD (hyperactivity, inattention and impulsivity). Deficits in the capacity to control motor activity, attend to a task, and respond without impulsivity appear to be the result of inefficient and ineffective neurological processing particularly in the domain of response inhibition.

  • Isn't ADHD just a response to our modern U.S. society?

    ADHD was recognized as a valid psychiatric disorder over 100 years ago. Only in the last several decades has research clearly demonstrated that ADHD is a neurobiological disorder with specific behavioral symptoms, which demonstrates specific symptomatic improvement with treatments including medications that regulate the efficiency and synchronicity of catecholamine neurotransmission. World-wide epidemiologic data indicates that the prevalence of ADHD is similar in all countries and cultures, although the recognition of that disorder may vary from region to region.

  • Why do I need Quotient when I already use the Vanderbilt Symptom Rating Scale?

    Clinical disorders are defined by signs and symptoms and Quotient provides the signs complementary to the Vanderbilt's symptoms. The Vanderbilt and similar symptom rating scales count the symptoms described by the patient to determine if the patient meets the syndrome definition of ADHD disorder in DSM-5. Like most CNS disorders, ADHD is a recognized by certain signature symptoms (what the patient or others report) but there are few reliable signs (what we can directly measure) to inform the differential diagnosis. Quotient uniquely measures the objective signs of ADHD that complement the traditional assessment of symptoms of the disorder. The easily administered computerized test objectively quantifies neurobehavioral indicators of the same neurological control processes that have demonstrated correlation to the symptoms of ADHD. The results of Quotient® assessment also correlate strongly with areas of the brain known to be implicated in the control of motion, attention and inhibition of impulsivity manifest in the symptoms of the disorder.

  • Can I give the Quotient test to the same patient more than once?

    Yes, there are many benefits to serial Quotient testing in the management of ADHD. There is no "learning effect" from taking the test multiple times and the test demonstrated high test-retest reliability. The Quotient technology was developed as the McLean Motion and Attention Test by Dr. Martin Teicher and cleared by the FDA for marketing to clinicians for the objective assessment of the core symptoms of ADHD: hyperactivity, impulsivity and inattention. In effect, it serves as a 'bioassay' for assessing the state of neurological control on specific components of attention, activity and impulsivity. Teicher and other researchers have demonstrated that changes in Quotient scores observed on sequential tests pre- and post-treatment correlate well with other assessments of change in response to treatment.

  • Since insurers don't usually pay for screening tests, is Quotient reimbursed?

    Quotient is not designed as a screening test, but rather it is a very specific assessment of neurobehavioral domains salient to the diagnosis and ongoing management of ADHD. Most medical insurance companies recognize the importance of a comprehensive assessment for ADHD and reimburse clinicians for appropriate use of the Quotient® ADHD Test. Clearly, current standards and practices for ADHD require accurate disorder-specific information for optimal clinical care. Absence of that information in many cases impedes prompt accurate diagnosis and reduces the likelihood of effective and efficient therapy with sustained positive health outcomes for the vast majority of patients. Reimbursement for medical services of all types, including Quotient, vary from region to region and insurer to insurer.

  • Is Quotient cost effective in a Community Mental Health Center?

    There are lots of factors that affect cost-effectiveness but we can make several general observations. In all medical services, better management of chronic conditions reduces overall costs. ADHD is a chronic health issue so it stands to reason that early identification and proper management holds the promise of reducing overall costs through improved effectiveness of care (i.e., treat patients better and reduce burden of illness) and improved efficiency of care (i.e., avoid duplication and inadequacies in care that increase cost of current care). ADHD is most costly in systems of care when it isn't recognized or is inadequately treated.

  • Has Quotient been approved by the FDA?

    Yes. Quotient was the first diagnostic device to receive clearance for marketing from the FDA for the intended use of "providing clinicians with objective measurements of hyperactivity, impulsivity and inattention to aid in the clinical assessment of ADHD".

  • Is patient information secure on Quotient?

    In strict compliance with HIPAA guidance, all subject data is filed in a secure encrypted folder accessible only by the clinician's unique system credentials. The clinician with the necessary security credentials may access the reports of his or her patients at any time from any internet-connected computer.

  • What information gets sent back to me on the Quotient report?

    The Quotient report provides detailed analysis of patterns of motion, accuracy of attention to stimuli, and fluctuations in attention states over the course of the task. Proprietary algorithms on the Quotient server analyze the raw tests results in comparison to age and gender matched cohorts on multiple dimensions for both motion and attention. The test reports include graphical displays of the subject's behaviors during the test, tabular comparisons to age and gender norms and a percentile rank of the test performance relative to norms. In addition the computerized analysis integrates composite scores for attention and motion from a compilation of individual metrics to quantify subject's overall performance profile relative to developmentally expectable "normal" behavior.

Pricing & Ordering


Subscription plans for 10, 20 or 40 tests per month are available for the Quotient ADHD Test with no cost for the equipment. If you assess at least 1 new patient per week and manage at least 80 patients, the Quotient System might be right for your practice.

Providers have reported that reimbursement is available from Medicaid in many states and from private insurance companies. Contact us to learn more.

For more information

call 877-246-2397 or
email us at info@Quotient-ADHD.com

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P: 800.627.7271
F: 800.232.1223