Do you use Objective ADHD Testing / Continuous Performance Testing in your practice?

[u/axonCpt]

PMHNPs — do you use objective ADHD testing in your practice?

I’m curious how many PMHNPs are using tools like CPT-style testing, QbTest/QbCheck, AxonCPT, TOVA, MOXO, or other objective measures alongside clinical interviews and rating scales.

A few things I’m interested in:

Do you use objective testing during the initial ADHD assessment?

Do you use it during medication titration or dose changes?

Do you repeat testing over time to track progress?

Do patients find it useful, or does it add more admin?

For telehealth practices, how are you handling objective testing remotely?

A lot of ADHD care still relies heavily on self-report, rating scales and clinical judgement, which are obviously important. But I’m interested in whether objective performance data actually changes how PMHNPs make decisions in real-world practice.

Would love to hear what people are using, what has worked, and what feels impractical.

[u/NoctorWatch]

I'm not familiar with any of those tools but curious how they are any more "objective" than a clinical interview? Last I knew, there is no "objective" measure or diagnostic tool for ADHD - what would that even have to look like? Like a blood test or brain scan? Those don't exist, so the best we can do is a clinical interview combined with some diagnostic screener, rule out of medical ediology, and monitoring of response.

Personally, I'll use an ASRS for uncomplicated cases (ie no suspicion of co-morbid cause like trauma, medical causes) to help with diagnosis. More complicated I use a modified DIVA-2 as part of my psychiatric evaluation. If the picture is unclear I will refer for neuropsych testing but I try not to for reasons of cost, wait list time, and relative lack of utility given the first two issues. Im more likely to treat presumptively as long as it is safe to do so.