QbCheck provides with objective measurements of hyperactivity, impulsivity, and inattention to aid in the assessments of ADHD and in the evaluation of treatment interventions in patients with ADHD. Only qualified professionals should interpret QbCheck results. QbCheck shall always be interpreted in combination with other clinically relevant information, such as clinical interview and/or standard symptom scales. QbCheck test will be taken at the computer. No medications, needles or physical contact is required. QbCheck requires a computer with web camera. Test involves a system check of the computer, instructions on how to perform a QbCheck, a practice test, a QbCheck and the presentation of results.
Test taker sits on a chair with back support but no arm support. In taking the QbCheck test, test taker will watch and /or listen to certain information and prompts and will respond using a keyboard. QbCheck report will present an overall ADHD symptom level indicator score, scores of all three main symptoms of ADHD, a visual presentation of the test data and data for comparison. QbCheck test results are not intended to be a stand alone diagnosis of ADHD, rather test results will merely provide an indication of patient’s risk of having ADHD.
No known contraindications for conducting QbCheck.
QbCheck Administration Procedure
To maximize the validity and reliability of the test results, it is important to standardize the test conditions e.g. the instructions and the test environment, see section 5.1 Test Room Environment. This section will cover specific instructions for administering a QbCheck, beginning with preparations before the test taker enters the room, test instructions and troubleshooting.
It is important that everyone who is being tested with QbCheck is informed of the purpose and the nature of the test and clearly understand what is expected of them. please avoid referring to QbCheck as a “computer game”. Instead refer to it a “computer task” when describing the test, to avoid associating QbCheck with amusement.
Before the Test Taker Enters the Room
We recommend that you turn on and log on to the computer before administration to prevent any automatic anti-virus or windows updates to interferes with the QbCheck web tool. Close all other Programs opened on your computer. We also recommend that you have a printed copy of the QbCheck Behaviour Observation From available for taking notes during testing (this can be found Under the ‘Administration’ tab) as well as a stopwatch to keep accurate track of the time.
- Select ‘Login for pro users’ in the top menu on the landing page. Log in using your password and security verification device. Select ‘New test’.
- Choose the appropriate seating available according to instructions. Younger children performing QbCheck (6-11) should be seated on a hard stool without a backrest or armrests whereas older children and adults performing QbCheck (12-60) Should be seated on a hard chair with a backrest but no armrests. it is important that there is some sort of sturdy footrest available for those test takers who, because of their height, will not be able to rest their feet comfortably on the floor while seated. it’s also important that chair or stool doesn’t swivel or have wheels.
- Also prepare the test environment if necessary by drawing the curtains of any window in the room to avoid reflections and distractions. Ensure normal lighting conditions and that the test takers field of vision is clear of distractions, e.g. clocks, Paintings, office clutter. Also make sure that the computer with a built in or separate camera is placed on a stable table.
When the Test Taker Enters the Room
- . Ask the test taker to enter the test room and to please turn off his/her mobile phone and take off any coats/jackets. Sometimes, especially when you are testing younger children, it might be a good idea to ask if they need a drink or to use toilet before starting the test since it is not possible to take a break during the QbCheck.
- Fill out the test taker data, collect test taker consent and check the mandatory box for consent collected. it is particularly important that the gender and date of birth is filled out correctly as this will determine which normative data the test takers results will be compared to. Also note down the automatically generated and unique test taker-ID displayed on this page in the test takers health record. the id will needed to retrieve the test takers QbCheck result.
- Explain the test procedure, e.g.: This is a computer based task that is used to measure your ability to pay attention overtime and your activity level. The test will continue for 15/20 minutes (15 minutes if you are using QbCheck (6-11 years), 20 minutes for QbCheck (12-60years)). The test might feel long and boring but it is designed this way to test your ability to stay focused. The camera will trace your movements but it will not film you at any point during the task? “
- Ask the test taker to be seated on the stool/chair in front of the screen. Please ensure that the test taker is able to place his/her feet comfortably on the ground on a sturdy footrest if the Cannot reach the floor. The test taker should also be able to move freely on the stool/chair without being restricted by the walls, table or any other object. Adjust the distance form the Camera to the test takers head to about 60cm or 26.3 inches
- . Continue to the camera and computer check. if needed allow the QbCheck web tool to access your web camera. During the check as well as during the test make sure to move outside of the Camera view. The test taker won’t be filmed at any time during QbCheck. Instead only data on the test takers movements will be stored
- . Next, show the instruction video. You could say something like: “I will now show you a short animation that will explain the task in more detail. please look carefully. are you ready?”. Start the animated instruction video. The following will be explained in the animated instruction depending on the test type”
During testing the figures below are shown on the screen, One at a time.
The task is to press the spacebar when a circle is shown and withhold pressing when the circle is crossed out for QbCheck (6-11). The task in QbCheck (12-60) is to respond by pressing the Spacebar whenever a figure of the same shape and colour repeats itself. In both versions of test the test taker is instructed to press the spacebar as quickly and accurately as possible.
- After the animated instruction video ask test taker to repeat the test instructions using the ‘stimulus card’. Of he/she makes any errors, explain the task again using the same card. Emphasize that he/she should try to respond as quickly and accurately as possible and that he/ she is not expected to respond before the target disappears. This is especially important when testing younger children who might believe this is required if not instructed otherwise.
- Before starting the practice test, make sure the test taker has his/her dominant hand on the spacebar. Its okay to rest the wrist on the table or computer but the test taker should not be leaning on the table.
- Start the practice test. if it is child performing the test, give him/her positive feedback during the test for the initial correct responses. for test takers using QbCheck (12-60), any remarks during the practice test are generally perceived as distracting so retrain from commenting while they are performing the practice test. if the test taker appears unsure of the test rules during or after the practice test, provide further verbal instructions using the ‘stimulus card’ and make a note of this on the ‘QbCheck observation sheet’. Be especially observant on test takers performing QbCheck (12-60) if they systematically misunderstand the task and try to only indentify identical pairs rather than respond to all consecutive targets.
- If the test taker has done more than 50% commission errors on the practice test, a message saying Too many errors were done in the practice test, please review test instructions and try again“ will appear. Review the test instructions and repeat the practice test. You can also use the stimulus cardtaker has understood. After the test taker has successfully completed the practice test he/she can continue to the actual QbCheck. Discontinue after three practice tests he/she can continue to make more that 50% commission or omission errors and your clinical decision is that this due to understanding the instructions.
- Tell the test taker: “well done, you are now ready to start the task. The task will last for 15/20 minutes. Please try to respond as quickly as accurately as you can out remember that you are not expected to press the spacebar before the figure disappears. Also, we can’t talk during the test. Do you have any questions? OK, let’s begin.”
- . During the test it can be helpful to observe the test taker, just make sure that you are outside his/her field of vision, personal sphere and outside what the camera picks up. You should however still be but at a distance where you can see the screen and hear the button presses. This will allow you to make behsaviral observations whilst not distracting the test taker during the test.
- When the test has finished a “Well Done” Screen will automatically appear. Press “Next” to generate a test report. The report will be available on the screen as well as in a PDF-Format.
For a quick guide to administration of QbCheck see Appendix B
Problems and possible solutions during test administration
- Below are some problem situations described and possible solutions. However, irrelevant of the situation, it is always important that the admistrator’s behaviour be guided by the basic principle of intervening as little as possible. Please note any interaction with the test taker during test in the ‘QbCheck observation Form’. This form can be retrieved under the administration menu whom logged in to QbCheck for professionals, See Appendix C.
- If the test taker talks to the administration or asks questions, if possible the administration or asks questions, if possible the administrator should ignore the test taker while maintaining focus on the screen avoiding interaction and eye contact as much as possible. if the test taker persists, the administrator may respond softly. “Remember that we can’t talk until the task is finished.”
- If the test taker disengages from the tats and does not appear to self-regulate back to the test, encourage the test taker to continue by saying : “please continue to do your best. Don’t worry if you make mistakes, everyone does”. Try not to offer this encouragement more than twice. if the test taker refuses to continue, prompt him/her by saying : “Please continue to work on the task a bit more, it will only last for another X minutes”. If he/she continues to refuse, discontinue the test.
- If the test taker appears to continuously press the spacebar indiscriminately, you may say: “Remember to only press the spacebar when there is a circle without a cross on the screen/a figure of the same shape and colour that repeats itself”.
- If the test taker walks away from the test, ask him/her to : “Please sit down and continue with the task”. If he/she refuses, discontinue the test.
- If the test taker does not press the spacebar at all during the first two minutes of the test, encourage them to: “Remember to press the spacebar when there is a circle without the cross on the screen/a figure of the same shape and colour that repeats itself”. Discontinue the test if this continues for more than two minutes at the minutes at the beginning of the test.
- Do not comment on the test takers activity level unless their behaviour constitutes a risk to themselves or to the equipment (e.g. they falling off the chair)
Cancel / Stop On going Test
If necessary, it is possible to stop an on-going test by pressing the escape (ESC) or F11 button on your keyboard. Please be aware that it is not possible to continue that testing from where it was interrupted.
After a QbCheck is finished the result is immediately analyzed and compared to an age and gender adjusted norm group. The test result is then visualized on the screen and in a PDF-report that can be downloaded and printed. The QbCheck report can also be accessed later through the QbCheck webpage for professionals under the tab ‘Existing tests’