Gordon Diagnostic System.docx

Gordon Diagnostic System.docx

《Gordon Diagnostic System.docx》由会员分享，可在线阅读，更多相关《Gordon Diagnostic System.docx（17页珍藏版）》请在冰豆网上搜索。

GordonDiagnosticSystem

Title:

TheGordonDiagnosticSystem., By:

Gordon,Michael,Vol.13

Database:

MentalMeasurementsYearbook

TheGordonDiagnosticSystem.

ReviewoftheGordonDiagnosticSystembyROBERTG.HARRINGTON,ProfessorofEducationalPsychologyandResearch,UniversityofKansas,Lawrence,KS:

TheGordonDiagnosticSystem（GDS）isaportable,solid-state,child-proof,microprocessor-basedunitoperatingindependentlyofamicrocomputer（Post,Burko,&Gordon,1990）,designedtoadministeraseriesofthreegame-liketests.TheGDShasbeenusedprimarilytoprovideabehavior-basedmeasureofthevigilanceorsustainedattentionspanandself-control（Gordon,1987）ofchildren,adolescents,andadultswithattentiondeficit/hyperactivitydisorder.Vigilanceandbehavioralinhibitionhavebeenconsideredtwoofthecentralcomponentsinthediagnosisofattentiondeficitdisorderinchildrenandadults.Thedevicealsocanbeusedtomonitorresponsestostimulantmedication（Barkley,Fisher,Newby,&Breen,1988;Brown&Sexton,1988）,aswellasintheevaluationofAIDS-relatedcomplex（Saykinetal.,1990）,closedheadinjury（Risser&Hamsher,1990）,FragileXSyndrome（Hagerman,Murphy,&Wittenberger,1988）,andAlzheimer'sdisease（Gordon,Beeber,&Mettelman,1987）.TheGDSprovidesareadingorprintoutofthenumberofcorrectresponses,incorrectresponses,andfailurestorespondandcomescompletewithparallelformsofeachtaskforretesting.TheGDShasbeenclearedasamedicaldevicebytheFoodandDrugAdministration.

ComputerizedassessmentofADD/Hyperactivityhasarisenasaresultofconcernwiththeunreliabilityofdiagnosticdecisionsbaseduponsubjectiveclinicaljudgments,informalinterviews,andratingscalesstandardizedonsmallsamplesofclinic-referredchildren（Gordon,1986,1987）.Approximately1,300nonhyperactiveboysandgirls,4-16yearsofage,wereincludedinthestandardization.Normsalsoareavailableforcollegestudents,adults,andgeriatricpopulations.'Anadditional1100hyperactiveandnonhyperactiveprotocolsfromvarioussubjectpopulations,includingdeaf,blind,emotionallydisturbed,learningdisabled,andSpanish-speakinghavealsobeengathered'（Gordon,1987,p.57）.OnelimitationofthisstandardizationsampleisthattheselectionwaslimitedmostlytotheupstateareaofNewYorkandthustherepresentativenessofthesamplemustbecalledintoquestion.Currently,researchisbeingconductedtoextendthestandardizationoftheGDStorepresentaPuertoRicansample（Bauermeister,1986;Bauermeister,Berrios,Jimenez,Acevedo,&Gordon,1990）.NormativedataarepresentedinThresholdTables,whichshowscorerangesdemarcatingNormal,Borderline,andAbnormalrangesofperformancebyage（4-5,6-7,8-11,12-16years）.TheauthorclaimsthatthenormsarenotpresentedbysexorsocioeconomicstatusbecausethesevariablesarenotcorrelatedwithGDSperformance,butthisfindingiscuriousbecauseotherresearchhasclearlyshownamuchhigherprevalenceofADD/hyperactivityinmalesthaninfemales（Ross&Ross,1982）.

InstudiesconductedbytheauthoroftheGDS,tasksontheGDShavebeenfoundtohavemoderatebutsignificantlevelsoftest-retestreliabilityover2to45days（r=.60orhigher）andstabilityoveraone-yeartimeperiod（r=.52orhigher）（Gordon&Mettelman,1988）.TheGDSalsoappearstocorrelatemoderatelybutsignificantlywithotherneuropsychologicalinstruments（Grant,Ilai,Nussbaum,&Bigler,1990）,behavior-basedmeasures（McClure&Gordon,1984）,andavarietyofteacherandparentratingsofattentiondeficithyperactivitydisorders（Gordon,Mettelman,Smith,&Irwin,1990）.Inanindependentstudyusingasampleof119age6to12year,11month-oldADHDmales,onlytwotasks,thenumberofcorrectresponsesforVigilanceandDistractibilityTasks,correlatedconsistentlywithothermeasures（WISC-R,theWRAT-RArithmetic,BeeryTestofVisualandMotorIntegration,andvarioussensory-motorvariablefromtheHalstead-Reitanneuropsychologicalbattery）（Grant,Ilai,Nussbaum,&Bigler,1990）.GordondefendsthislackofconcurrentvaliditywithothermajormeasuresusedinADDdiagnosisbycontendingthattheGDSmakesauniquecontributioninthemeasurementofattention,notassessedbymoretraditionaltests.GordonalsoarguesthateffortstovalidatetheutilityoftheGDShavebeenlimitedbydisagreementamongprofessionalswithregardtoaconsensusdefinitionofADD/Hyperactivity（Gordon,DiNiro,&Mettelman,1988）.DespitetheseargumentsitwouldseemclearthatthisresearchsuggeststhatcontinuousperformancetestssuchastheGDSmaybeuseful,butareinsufficientaloneinthediagnosisofdifficultiesinimpulsivityorsustainedattentioninchildren.

ScoresfromtheGDS,suchastheEfficiencyRatio（Gordon,1979）andtheDelayTask（McClure&Gordon,1984;Barkley,1991）,havedemonstratedsomediscriminantvaliditywithregardtodistinguishingaccuratelybetweengroupsclassifiedashyperactiveandnormal.Inanotherstudyofschool-referredchildren,theGDSdiscriminatedamongchildrenclassifiedasADDandthoseidentifiedasreading-disabled,overanxious,andnormal（Gordon&McClure,1983）.Inarecentstudy（Wherryetal.,1993）researchfailedtosupportthediscriminantvalidityofanyGDSscoreregardlessofwhethertheChildBehaviorChecklist-TeacherReportFormortheADHDRatingScalewasusedasacriterionmeasure.Theseauthorsconcludedthatteacherratingformsshouldremainthe'goldstandard'foridentifyingADHDyoungsters.InonerecentstudyconcernswereraisedabouttheextenttowhichtheGDSmayunderidentifychildrenwhoareclassifiedbyparentandteacherreportsasADHD（DuPaul,Anastopoulos,Shelton,Guevremont,&Metevia,1992）.Infact,ithasbeenfoundthatalthoughtheGDSwillclassifyanormalchildasADHDinonly2%ofthecases（Gordon,Mettelman,&DiNiro,1989）,itwillproducefalsenegativeclassificationsanywherefrom15to35%ofthetimedependingontheageofthechild,criteriaforsubjectselection,andthecombinationofscoresemployed（Gordonetal.,1989;Trommer,Hoeppner,Lorber,&Armstrong,1988）.Ontheotherhand,theVigilanceTaskCommissionScorehasbeenfoundtobeparticularlysensitivetotheeffectsofstimulantmedication,especiallyathigherdoses（Barkley&Edelbrock,1986）.Thereisdefinitelyneedforfurthervaliditystudies.AsGordon（1987）himselfhasindicated,themerecomputerizationofameasuredoesnotprecludetheneedfor'meaningfulstudiesofvalidity'（p.54）.Furthermore,becausemanyofthevaliditystudiesrelatedtotheGDShavebeenconductedbyitsdevelopers,Barkley（1991）hassuggestedthatthereisaneedforvaliditystudiesreplicatedbyotherindependentresearchers.

ToevaluateconsumersatisfactionwiththeGDS,Gordon（1994）sentasurveytoasampleof475GDSuserswhowererandomlyselectedfromalistof900users.HefoundthattheGDSwasusedmostfrequentlyinprivatepracticetoevaluateADDinchildrenandadolescents（89%）andadults（48%）.MostusedtheGDSaspartofamultifacetedtestbatterythatincludedstandardizedbehaviorchecklistsofparents（89%）andteachers（86%）,achievementandintelligencetests（75%）,formalobservations（50%）,andinterviewswiththechildandparent（33%）.UsersindicatedthattheGDSagreedwithotherclinicalinformationinabout73%ofcasesandwhenitdisagreed92%oftheclinicianssawthediscrepancyasajustificationforfurtherevaluationratherthanastesterror.Eighty-fourpercentofcliniciansfeltthattheGDSprovidedopportunitiesfordirectobservationsofachild'sactualbehaviorinastandardizedsituationthatrequiresattentionandself-control.AsomewhatdisconcertingfindingwasthathalfthesampleusedtheGDS,atleastinpart,becauseitsobjectivityhelped'sell'thediagnosistoparentsandschools.Eightypercentoftherespondentsmarkedeithera4or5,indicatingthattheywerelikelymoderatelyorveryconfidentwiththefinaldiagnosisofADDwhentheGDSwasusedforconfirmationasapartofamultidisciplinarybattery.

Insummary,ContinuousPerformanceTests（CPTs）havealonghistory（Rosvold,Mirsky,Sarason,Bronsone,&Beck,1956）andareplayinganincreasinglybroaderroleintheassessmentofattentionalprocesses.Unfortunately,researchontheabilityofCPTssuchastheGDStodiscriminatechildrenwithADHDfromtheirnormalcounterpartsortodetectstimulantdrugeffectsislimited.Researchishampered,inpart,bynuancesinsubjectselectioncriteriaforADHD/Hyperactivity.'Studiesemploydifferentratingscales,laboratorymeasures,observationaltechniquesandinterviewsinadditiontovaryingcutoffscoresandexclusionarycriteria'（p.539,Gordon,DiNiro,&Mettelman,1988）.ThereisaneedforagenerallyacceptedsetofresearchcriteriaindefiningasamplewithADD/HyperactivityofthesortsuggestedbyBarkley,Fischer,Newby,andBreen（1988）.Furthermore,likemostotherCPTstheGDSreliesonvisuallypresentedstimulusmaterials,despitethefactthatthereisrecentresearch（Baker,Taylor,&Leyva,1995）thatindicatesthatauditorypresentationsofstimulicanincreasethedifficultyoftasksandshouldbeconsideredintheevaluationofvigilanceandimpulsecontrol.Nevertheless,instrumentssuchastheGDSmayinthefutureprovideclinicallyuseful,objective,convenient,andrelativelyinexpensivemeasuresofsustainedattentionandimpulsecontrolforADHDchildren,adolescents,andadults.AsGordonconcedes,noscoreontheGDSshouldbethesoledeterminantofadiagnosisofADHD.Infact,Rasile,Burg,Burright,andDonovick（1995）foundthatinasampleofcollegestudentstheGDSisnotasubstitute