Feasibility of the Test of Variables of Attention (TOVA) and its relationship to intellectual function in children and adolescents with borderline intellectual functioning: A Norwegian mental health study

Continuous Performance Tests are commonly part of neuropsychological evaluations. This study investigates the feasibility and applicability of the Test of Variables of Attention (TOVA) in a clinical paediatric mental health sample, focusing on children with Borderline Intellectual Functioning (BIF; Full-Scale IQ [FSIQ] of 70-84). A total of 128 children and adolescents aged 6-15 years were assessed using the TOVA and the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V), alongside parent and teacher ratings of ADHD symptoms and evaluations of TOVA performance validity. 45% of the total sample met the criteria for BIF. The TOVA demonstrated high feasibility, evidenced by a 94% completion rate with no significant differences in test completion across groups. Children with BIF exhibited significantly more Commission Errors (CE), indicative of reduced inhibitory control, while sustained attention measures showed no significant differences. Hierarchical regression analyses revealed that FSIQ accounted for a small but significant proportion of variance in CE scores, and minimal variance in sustained attention measures. These findings support the TOVA's applicability in clinical paediatric settings, including populations with BIF, yet underscore the necessity of considering intellectual functioning when interpreting inhibitory control metrics. The results emphasize the importance of developing normative data for the TOVA across a broad IQ range to enhance clinical decision-making in cognitively diverse populations.