CPT performance, motor activity, and continuous relations to ADHD symptom domains: A developmental study
Abstract
Using a population-based sample consisting of 401 6- to 12-year-olds, this study examined normative age and sex distributions on motor activity as measured in an actigraphic-based motion tracking system (MTS) and on attention-related functions derived from a Continuous Performance Test (CPT). Specific objectives were to present new knowledge on age-related change in motor activity and to study age effects on changes in motor activity and CPT performance as a function of time on task. Further, continuous relations between the two ADHD symptom domains and CPT performance and motor activity, and importantly, age effects in these relations were examined. CPT performance improved, and level of motor activity decreased with age. Linear associations between the two ADHD symptom domains and several of the CPT and MTS parameters support available research describing the nature of ADHD as a continuous dimension with variable expression throughout the general population. Further, our study is one of the first to provide developmental data using a time on task design, particularly with regard to motor activity. Imperative for ADHD future research are our results showing that age matters in the relation between ADHD behaviours and neuropsychological function.
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Sustained attention abilities predict objective and subjective reports of classroom behavior, academic performance, special education placement, and comorbid learning disabilities.
“sustained attention abilities predict objective and subjective reports of classroom behavior (Brocki, Tillman, & Bohlin, 2010; Epstein et al., 2003; Rapport et al., 1987), academic performance (Molina et al., 2009; Rapport et al., 1994), special education placement, and comorbid learning disabilities (Faraone et al., 1993).”
From Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches (2014) · cites this paper as Brocki, Tillman, & Bohlin, 2010
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“The demonstrated general developmental trend of response execution during childhood, with decreasing latency and variability of responses, is in line with extant findings on the stop-signal task as well as other inhibition tasks, such as the CPT (Bedard et al., 2002; Brocki et al., 2006; Carver et al., 2001a; Ridderin…”
ResultSelf-citationThe Role of Attention in the Academic Attainment of Children with Autism Spectrum Disorder
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“For example, Brocki, Tillman, and Bohlin (2010 ) reported a modest association ( r = .”
BackgroundBehavioral Assessment of Core ADHD Symptoms Using the QbTest
Reh, V., Schmidt, M., Lam, L., Schimmelmann, B. G., Hebebrand, J., Rief, W., & Christiansen, H. (2015) · Journal of Attention Disorders · doi:10.1177/1087054712472981 · Cited by 51 · see citing works
“Second, consistent with the literature (Brocki et al., 2008), age also affected ADHD symptom scores measured with the QbTest.”
ResultMurillo, L. G., Cortese, S., Anderson, D., Martino, A. D., & Castellanos, F. X. (2015) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2015.03.001 · Cited by 48 · see citing works
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“The need for the activity domain to be objectively accessible and measurable in adult ADHD patients has been critically discussed, with reference to reduced levels of motor activity with increased age (Brocki et al., 2010) and the influence of diagnostic subtypes.”
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“Previous research on RTV in children has used SDRT or CV as a measure of sustained attention ability, often reporting a decrease with increasing age through childhood (Brocki et al., 2010; Klarborg et al., 2013).”
MethodResultInfluentialKofler, M. J., Wells, E. L., Singh, L. J., Soto, E. F., Irwin, L. N., Groves, N. B., Chan, E. S. M., Miller, C. E., Richmond, K. P., Schatschneider, C., et al. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000550 · Cited by 44 · see citing works
“Of note, individual difference studies have produced more mixed results, with several studies reporting links between inhibitory control tests and informant-rated ADHD symptoms (Alderson et al., 2010; Brocki et al., 2010) but other studies failing to find significant associations cross-sectionally or longitudinally (e.”
ResultScholtens, S., Diamantopoulou, S., Tillman, C. M., & Rydell, A. (2011) · Journal of Attention Disorders · doi:10.1177/1087054711417398 · Cited by 36 · see citing works
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Does Atomoxetine Improve Executive Function, Inhibitory Control, and Hyperactivity?
Wehmeier, P. M., Schacht, A., Ulberstad, F., Lehmann, M., Schneider-Fresenius, C., Lehmkuhl, G., Dittmann, R., & Banaschewski, T. (2012) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318267c304 · Cited by 30 · see citing works
“This method (referred to as ‘‘cb-CPT/MT’’) was developed on the basis of earlier approaches to measuring ADHD core symptoms, assessing attention, impulsivity, and hyperactivity quantitatively and has been found to reflect ADHD symptoms.(22,23) For the test, the patientwas seated in front of a screen,wearing a head ref…”
MethodClinical Gains from Including Both Dextroamphetamine and Methylphenidate in Stimulant Trials
Ramtvedt, B. E., Røinås, E., Aabech, H. S., & Sundet, K. S. (2013) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2012.0085 · Cited by 29 · see citing works
“Test performances were recorded and scored by a computer program using age-adjusted norms developed by Qb Tech with proven reliability and validity (Bergfalk 2003; Brocki et al. 2010), and test results were expressed in q-scores (mean = 0, SD = 1).”
MethodJiang, X., Chen, Y., Huang, W., Zhang, T., Gao, C., Xing, Y., & Zheng, Y. (2020) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376374 · Cited by 29 · see citing works
“Brocki’s research [12] shows the continuous relations between the two ADHD symptom domains and Continuous Performance Task (CPT) performance, and that age is important in the relation between ADHD behaviors and neuropsychological function.”
BackgroundLongitudinal Trajectories of Sustained Attention Development in Children and Adolescents with ADHD
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Effects of age on attention level: changes in performance between the ages of 12 and 90
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“Some objective measures of attention now incorporate motor activity measures using actigraphs [15] or infra-red motion analysis [10,16,17] to give a fuller picture of the range of symptoms associated with ADHD.”
MethodLi, F., Zheng, Y., Smith, S. D., Shic, F., Moore, C. C., Zheng, X., Qi, Y., Liu, Z., & Leckman, J. F. (2016) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-016-0135-2 · Cited by 20 · see citing works
“Our results aligned well with prior studies using other measures extracted from movement data, as children with ADHD performed less well and engaged in more movement than healthy control children when completing a neuropsychological task of attention and response inhibition while their body movements were recorded [20…”
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“The use of actigraphy and CPT together has been shown to have high discriminative validity in distinguishing children with ADHD from controls and has good test-retest reliability (Reichenbach et al. 1992; Teicher et al. 1996; Brocki et al. 2010).”
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“…Timmons, 1985; Tabori-Kraft, Sørensen, Kaergaard, Dalsgaard, & Thomsen, 2007; Teicher et al., 2000; Teicher, Ito, Glod, & Barber, 1996; Teicher, Polcari, & McGreenery, 2008), and has been found to reflect ADHD symptoms (Brocki et al., 2010; Oades, Myint, Dauvermann, Schimmelmann, & Schwarz, 2010).”
The association between hyperactive behaviour and cognitive inhibition impairments in young children
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“Brocki et al. (2010) explored whether the two main dimensions of ADHD – inattention and hyperactivity/impulsivity – were independently associated with measured activity levels within a large population-based sample of 401 children aged 6–12 years old that included no children diagnosed with ADHD.”
BackgroundResultInfluentialAssessment of ADHD Subtypes Using Motion Tracking Recognition Based on Stroop Color–Word Tests
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“This finding is similar to the conclusions of other studies related to RT in ADHD [22,47,48].”
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“RT and SDRT scores were standardized by age to minimize age effects on performance [68].”
MethodFuermaier, A., Tucha, O., Koerts, J., Send, T., Weisbrod, M., Aschenbrenner, S., & Tucha, L. (2018) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2018.1457139 · Cited by 9 · see citing works
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Sluggish Cognitive Tempo: realidades y controversias
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“, 2000) and has been found to reflect various ADHD symptoms (Brocki et al., 2010; Oades et al., 2010).”
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“Researchers who had a measure of the performance throughout the blocks of the CPT tests (Brocki et al., 2010; Conners, 2000; Mass, Wolf, Wagner, & Haasen, 2000; Smith et al., 2002) did not assess how MPH influenced the performance during the test.”
BackgroundMethodDiefenbach, C., Schmidt, M. F., Huß, M., König, J., Urschitz, M. S., The ikidS Study Group, Hoffmann, D., Blettner, M., Queißer-Wahrendorf, A., Wiesel, A., et al. (2021) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-021-01813-7 · Cited by 6 · see citing works
“Boys have a higher level of motor activity compared to girls [17], which decreases with age in both genders [18].”
BackgroundRuiz‐Robledillo, N., Lucas, I., Ferrer‐Cascales, R., Albaladejo-Blázquez, N., Sanchís, J., & Trujillo, J. C. (2025) · JMIR Serious Games · doi:10.2196/65170 · Cited by 4 · see citing works
“As expected, task performance improved with age [56,60], with both groups of adolescents exhibiting high performance.”
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“The participants also performed a Qb Test-Plus, which objectively measures all three symptoms of ADHD (hyperactivity, inattention and impulsivity) [30,31].”
MethodALUMNADO CON TDAH Y DEPORTES DE LUCHA STUDENTS WITH ADHD AND COMBAT SPORTS
Hernández, R. M., Llamas, G. R., Gómez, R. M., & Quintana, J. L. (2015)
Identification of Differential Predictors of ADHD Subtypes Using Laboratory Procedures
Grip, D. R. (2014) · Research Exchange (Washington State University)
Alumnado con TDAH y deportes de lucha
Hernández, R. M., Llamas, G. R., Gómez, R. M., & Quintero, J. L. (2014) · El Guiniguada · doi:10.20420/elguiniguada.2014.0067
Lee, S., Testa, R., Johnson, B. P., & Coghill, D. (2025) · JCPP Advances · doi:10.1002/jcv2.70021
Kim, H. J., Kim, K. J., Han, D. H., Kim, S. M., Hwang, H., & Hong, J. S. (2026) · Journal of Korean Medical Science · doi:10.3346/jkms.2026.41.e221
- Authors
- Brocki, K. C., Tillman, C. M., & Bohlin, G.
- Affiliations
- Uppsala University (SE)
- Corresponding author
- Brocki, Karin C.
- ORCID
- Brocki, Karin C.
- Venue
- European Journal of Developmental Psychology
- Publisher
- Informa UK Limited
- Published
- 2010-03
- Volume
- 7
- Issue
- 2
- Pages
- 178-197
- ISSN
- 1740-5610 (ISSN-L)
- 1740-5629
- OpenAlex
- W2051051285
- Cited by
- 53
- References
- 33
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 4 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 6
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Developmental Psychology (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, continuous performance test, motor activity, actigraphy, motion tracking, age differences, sex differences, time on task, attention, reference values, children and adolescents, developmental changes
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