We are aware that Axia currently does not use the Quantitative Behavioural (QB) test to assess for Attention Deficit Hyperactivity Disorder (ADHD) and wanted to provide you with an overview as of why. 

What is the QB test for ADHD:

The QB test is a diagnostic screening tool that uses age and gender matched comparisons to assess your impulsivity, ability to concentrate and your movement. Whilst there are many strengths of the QB test including its ability to allow for the assessment of ADHD symptoms outside of the clinic in the home settings (Ulberstad et al., 2020), it is also important to consider its limiting factors. Several studies have questioned its ability to discriminate between the ADHD presentations included in the DSM-5-TR (Predominately Inattentive, Predominately Hyperactive-Impulsive, and Combined) (Hult et al., 2018). It also must be noted that the QB test is a screening tool, which means it can be helpful to indicate potential symptoms of ADHD, but it does not necessarily provide enough information to make a full diagnosis. Furthermore, it may not be accessible for individuals with visual impairments or those who may heavily mask and can compensate for their difficulties for short periods of time (the QB test usually takes 15-20 minutes to complete). Many questions have also been raised regarding the measurements taken from the QB test, with journal articles indicating it may measure cognitive ability, rather than purely ADHD related symptoms (Johansson et al., 2021).

Axia’s approach to ADHD testing:

The methods used for an ADHD assessment at Axia, align with the current NICE guidelines, which do not state that it is a requirement for QB testing to be carried out, please see here for further specifications: https://www.nice.org.uk/guidance/ng87/chapter/Recommendations#diagnosis. 

Our neurodevelopmental assessments are informed by the Partnership model whereby parents are viewed as the experts on their children and individual’s experts on themselves. All assessments are conducted by qualified healthcare professionals in a semi-structured interview style format that aims to highlight the behaviour and symptoms of ADHD in the different domains and settings of the person’s everyday life. By adopting the Partnership model, we can share mutual expertise that is in the room in the spirit of openness, honesty and genuineness. This also allows us to explore the factors that may limit an ADHD diagnosis (or may not be capture by singular use of a screening/diagnostic tools) such as an individual masking their ADHD: hiding their symptoms of ADHD from other people. Additionally, we also obtain a full developmental history of the individual and collate other observer reports and assessments of the person’s personal state provided from other services. This further consolidates the diagnostic outcome. 

We hope this provides you a better understanding of our assessment process, particularly concerning an ADHD diagnosis.

References:

Hult, N., Kadesjö, J., Kadesjö, B., Gillberg, C., & Billstedt, E. (2018). ADHD and the QbTest: diagnostic validity of QbTest. Journal of attention disorders, 22(11), 1074-1080.

Johansson, V., Noren Selinus, E., Kuja-Halkola, R., Lundström, S., Durbeej, N., Anckarsäter, H., Lichtenstein, P., & Hellner, C. (2021). The quantified behavioral test failed to differentiate ADHD in adolescents with neurodevelopmental problems. Journal of attention disorders, 25(3), 312-321.

Ulberstad, F., Boström, H., Chavanon, M. L., Knollmann, M., Wiley, J., Christiansen, H., & Thorell, L. B. (2020). Objective measurement of attention deficit hyperactivity disorder symptoms outside the clinic using the QbCheck: Reliability and validity. International Journal of Methods in Psychiatric Research, 29(2), e1822.