Written by Bethany Blankenhiem, LPC, ADHD-CCSP, CACII | Licensed Professional Counselor & Certified ADHD Clinical Services Provider at InDepth Therapy

This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional regarding your child’s specific needs.

Key Takeaways

• The T.O.V.A. is a 21.6-minute computerized test that measures four objective variables: response time, response time variability, omissions (inattention), and commissions (impulsivity).
• It is FDA-cleared as a medical device for the assessment of attention deficits, including ADHD, and has appeared in over 300 peer-reviewed studies.
• The T.O.V.A. cannot diagnose ADHD on its own. Only a qualified clinician can make a diagnosis — the test is one objective tool within a comprehensive evaluation.
• Accuracy is strong but not absolute: research shows it correctly identifies 90% of hyperactive-type ADHD, 84% of inattentive-type ADHD, and 87% of individuals without ADHD.
• Test day preparation matters: no caffeine, a good night’s sleep, a light breakfast, and a conversation with your prescriber about medications beforehand.
• The T.O.V.A. is appropriate for ages 4 and up, including adults who have never been formally evaluated.
• InDepth Therapy offers T.O.V.A. testing in Broomfield, CO for $225 (or $200 cash), with superbills available for most insurance plans.

If you’ve been wondering whether your child’s struggles with focus, impulsivity, or restlessness might be ADHD, you’re not alone — and you don’t have to keep guessing. According to theCDC’s 2022 National Survey of Children’s Health, an estimated 7 million U.S. children ages 3–17 — roughly 1 in 9 — have been diagnosed with ADHD. For families in Broomfield and Fort Collins, Colorado, theT.O.V.A. (Test of Variables of Attention) offers a clear, objective, and FDA-cleared path toward answers.

This guide walks you through exactly what the T.O.V.A. assessment is, how it works, what to expect on test day, and what happens after — so you and your child can walk in prepared and walk out with clarity.

What Is the T.O.V.A. Test?

The Test of Variables of Attention (T.O.V.A.) is a computerized neuropsychological assessment designed to measure two core challenges associated with ADHD: sustained attention and inhibitory control (the ability to stop yourself from reacting to something you’re not supposed to).

Unlike subjective rating scales or questionnaires that rely on memory and perception, the T.O.V.A. collects hard, objective data. According to CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), a comprehensive ADHD evaluation should include multiple tools — and no single test can diagnose ADHD on its own. The T.O.V.A. is one critical piece of that puzzle: it generates quantifiable measures of how a person’s brain processes and responds to stimuli over time, giving clinicians objective data that questionnaires simply cannot provide.

The T.O.V.A. is FDA-cleared as a medical device — cleared by the U.S. Food and Drug Administration for use in the assessment of attention deficits, including ADHD — and has been studied in over 300 peer-reviewed papers. It can be administered to individuals ages 4 and up, making it appropriate for young children, teens, and adults alike.

How Does the T.O.V.A. Work? A Step-by-Step Breakdown

Many parents are surprised to learn that the T.O.V.A. looks and feels a lot like a simple video game. Here’s what actually happens during the test:

1. Visual and Auditory Stimuli Are Presented

Your child will sit in front of a computer screen. The test presents a series of simple shapes or symbols — one at a time. There are two types: a target stimulus and a non-target stimulus. Your child’s job is to press a button when they see the target, and hold back when they see the non-target.

Sounds simple, right? That’s by design. The challenge isn’t the task itself — it’s sustaining attention and controlling impulses over the full length of the test.

2. The Test Runs for About 21.6 Minutes

The T.O.V.A. is divided into separate visual and auditory components, each administered individually. As described on The TOVA Company’s official site, both components are 21.6 minutes long (a shorter 10.8-minute version is used for children ages 4–5.5). The total appointment takes roughly one hour when you factor in setup, instructions, and clinician review time — which is why we ask families to block out a full hour.

3. The Software Measures Four Key Variables

While your child completes the task, the software is quietly tracking four critical data points:

• Response Time — How quickly does your child respond to the target? Slow or inconsistent response times can indicate attention difficulties.
• Response Time Variability — Does their speed stay consistent, or does it fluctuate wildly? High variability is a hallmark of ADHD.
• Omissions — Did they miss the target when they should have pressed the button? This reflects inattention and difficulty sustaining focus.
• Commissions — Did they press the button when they shouldn’t have? This reflects impulsivity and poor inhibitory control.

Together, these four variables paint a detailed picture of how your child’s attention and impulse control actually function — not how a teacher or parent perceives them to function.

4. Results Are Compared to Normed Data

Your child’s performance is compared against a large, age- and gender-matched normative database, as well as against a sample population of individuals independently diagnosed with ADHD. This comparison is what gives the results clinical meaning. The clinician receives a detailed report with scores, graphs, and interpretive indices — and, importantly, only a qualified clinician can interpret these results and make a diagnosis.

How Accurate Is the T.O.V.A.?

The T.O.V.A. has meaningful accuracy data behind it. Research shows it correctly identifies:

• 90% of individuals with hyperactive-type ADHD
• 84% of individuals with non-hyperactive (inattentive) ADHD
• 87% of individuals who do not have ADHD

These figures underscore both the value and the limits of the test. A 90% identification rate is clinically significant — but it also means that no computerized test is infallible. As CHADD clearly states, there is no single test to diagnose ADHD; a comprehensive evaluation is always necessary to rule out other causes and assess for co-occurring conditions.

At InDepth Therapy, our clinicians use T.O.V.A. results as one component of a broader clinical picture — alongside a comprehensive interview, history, and, where appropriate, behavioral rating scales — to ensure your family receives the most accurate assessment possible.

How to Prepare Your Child for the T.O.V.A. Test

Preparation makes a real difference in the quality of the results. Here’s what InDepth Therapy recommends for test day:

The night before:

• Prioritize a full, restful night of sleep. Fatigue significantly impacts attention and reaction time, which can skew results.

The morning of the test:

• Serve a light, balanced breakfast. Don’t let your child test on an empty stomach.
• Skip the caffeine. Coffee, energy drinks, caffeinated sodas — all of these can artificially alter attention and concentration, affecting how the results reflect your child’s baseline.
• Discuss ADHD medications with your prescriber ahead of time. If your child is already on stimulant or non-stimulant ADHD medication, speak with your prescribing physician before the appointment about whether to hold the dose on test day. Medication effects can influence the assessment results, and your doctor is best positioned to advise on this for your child’s specific situation.

When you arrive:

• Plan to be present and relaxed. Children pick up on parental anxiety. The more calm and matter-of-fact you can be about the appointment, the more comfortable your child will feel.
• Let them know it’s not a test they can pass or fail — it’s just information to help them.

What Happens After the T.O.V.A.?

The T.O.V.A. serves as one objective component of our comprehensive ADHD evaluations. By integrating these results with clinical interviews and behavioral observations, we ensure a well-rounded understanding of your unique cognitive profile.

For clients referred to us through one of our partnership psychiatrists, the T.O.V.A. plays a specific role in bridging the gap between clinical testing and medical management. Once the assessment is complete, your InDepth Therapy clinician will review the data alongside you. You’ll receive a detailed report explaining the scores in plain language, and we will collaborate with you to determine the next steps—whether that involves pursuing a formal diagnosis, exploring targeted treatment options, or ruling out ADHD entirely.

If ADHD is identified as part of a broader clinical picture, InDepth Therapy offers multiple pathways forward, including individual therapy, family therapy, and integrative approaches like neurofeedback and brainmapping. Research published in peer-reviewed journals, including a systematic review of 67 randomized controlled trials, suggests neurofeedback is associated with meaningful reductions in ADHD symptoms over time — though it is typically recommended as part of a broader treatment plan determined by your clinician.

T.O.V.A. Testing Costs at InDepth Therapy

The T.O.V.A. assessment is available at InDepth Therapy for:

• $225 for a 60-minute session
• $200 with a cash discount

InDepth Therapy is unable to accept most insurance for T.O.V.A. testing; however, individuals with Medicaid coverage may be able to use their insurance. For other insurance plans, InDepth can provide a superbill that you can submit directly to your insurer, potentially applying the cost toward your deductible. Contact the office to discuss your options.

Who Should Consider T.O.V.A. Testing?

You might want to schedule a T.O.V.A. assessment if your child:

• Has been flagged by a teacher for difficulty paying attention or following directions
• Struggles to complete tasks, homework, or chores without frequent reminders
• Acts impulsively — interrupting, speaking out of turn, or having trouble waiting
• Has already received an informal ADHD “suspicion,” but you want objective data before pursuing further evaluation or medication
• Has previously been assessed, but you want an additional objective measure as part of a broader evaluation
• Is an adult who has always suspected they might have ADHD but never pursued formal testing

The T.O.V.A. visual test is appropriate for ages 4 and up. The National Institute of Mental Health (NIMH) notes that ADHD is a condition diagnosed across the lifespan, and that it is never too late to seek evaluation and appropriate support.

Why Families in Broomfield and Fort Collins Choose InDepth Therapy

InDepth Therapy is a trauma-informed, integrative mental health practice with offices in Broomfield (1008 Depot Hill Road #200) and Fort Collins (3307 South College Ave, Suite #217), as well as telehealth options for Colorado residents.

What sets InDepth apart isn’t just the tools they use — it’s the philosophy behind them. Every assessment and every therapy session is grounded in the belief that you are more than your struggles, and that healing (and understanding) is absolutely possible. The team of licensed, trauma-informed clinicians brings advanced training and decades of combined experience across diverse populations, including children, teens, and families navigating ADHD. Beyond testing, the practice also offers specialized modalities like Brainspotting for trauma and emotional processing — making InDepth a truly whole-person practice for families who want more than a diagnosis.

Getting clarity about ADHD doesn’t have to be a long, uncertain process. With the right assessment tool and the right clinical team, it can be a turning point.

About the Author

Bethany Blankenhiem, LPC, ADHD-CCSP, CACII is a Licensed Professional Counselor at InDepth Therapy with 20 years of experience in the psychology field. She holds the ADHD-CCSP (ADHD Certified Clinical Services Provider) designation through Evergreen Certifications, along with a CACII (Certified Addiction Counselor Level II) credential — a rare combination that allows her to address the complex overlap between ADHD, substance use, and co-occurring conditions.

Bethany is an Advanced Brainspotting trained clinician and brings specialized expertise in complex trauma, grief, childhood sexual abuse recovery, and the treatment of adolescents and young adults navigating major life transitions. She takes an integrated, strength-based, collaborative approach to care — believing that the therapeutic alliance is the most powerful driver of lasting change.

When it comes to ADHD, Bethany doesn’t just administer the T.O.V.A. — she interprets it within the full context of a person’s history, relationships, and lived experience. That’s what makes the difference between a test result and a real answer.

Ready to Schedule Your Child’s T.O.V.A. Assessment?

If you’re ready to stop wondering and start knowing, InDepth Therapy is here to help.

Broomfield: 1008 Depot Hill Road #200, Broomfield, CO 80020 

(720) 538-HELP (4357)

HelpNow@indepththerapy.org

Schedule Your T.O.V.A. Assessment

InDepth Therapy offers compassionate, trauma-informed mental health services including individual therapy, couples counseling, family therapy, ADHD testing, neurofeedback, brainspotting, and holistic studio services in Broomfield and Fort Collins, Colorado.