Construct validity of the Auditory Continuous Performance Test for Preschoolers

Development of diagnostic instruments directed toward neuropsychological assessment of preschoolers lags significantly behind those available for school-age children (DeWolfe, Byrne, & Bawden, 2000). This is particularly true for measures of executive function (EF). The Auditory Continuous Performance Test for Preschoolers (ACPT-P; Mahone, Pillion, & Hiemenz, 2001) is a computerized, Go-No-go test developed to measure selected EF skills in preschoolers. First, to determine whether performance on the ACPT-P is associated with hearing impairment, we compared performance of children with mild hearing loss (MHL) to controls on the ACPT-P, and measures of spatial working memory (SWM) and motor persistence (MP). There were no differences between performance of the MHL group and controls on any of these measures. Second, to examine the construct validity of the ACPT-P, we compared performance of 40 preschoolers with ADHD to 40 age- and sex-matched controls, using the ACPT-P to measure response preparation, sustained attention, and inhibitory control. We also compared these groups on measures of SWM and MP. The group with attention deficit hyperactivity disorder (ADHD) performed significantly worse than controls on the ACPT-P (omissions, mean response time, variability) and MP. The ACPT-P was correlated with the MP, but not with the SWM measure. Both the ACPT-P and the MP measures showed low to moderate correlations with parent ratings of behavior associated with ADHD. These findings support the use of performance-based assessment of executive control skills in preschoolers suspected of having ADHD. In this age group, the ACPT-P may be particularly useful in assessing sustained attention and response preparation and may complement behavior rating scales.