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Before examining and interpreting participant’s individual scores I first provide some notes on how to interpret the case study results presented.

Participants completed the Connors’ Adult ADHD self-report short version (CAARS-S: S). This is an assessment instrument designed to help inform consideration of an ADHD diagnosis and related problems. The scale has a normative sample of 1026 adults. The score of an adult who completes the scale can be compared to the normative sample and provides a profile of scores that will indicate the subscales that are elevated. Table 8 can be used to interpret an individual's scores across the five subscales:

1. Inattention / memory problems: Difficulties may include trouble concentrating, difficulty planning or completing tasks, forgetfulness, absent- mindedness, being disorganised.

2. Hyperactive / restlessness: Difficulties may include problems with working at the same task for long periods of time, feeling more restless than others seems to be, fidgeting

3. Impulsivity / emotional lability: Difficulties may include engaging in more impulsive acts than others do, low frustration tolerance, quick and frequent mood changes, feeling easily angered and irritated by people. 4. Problems with self-concept: Difficulties may include poor social relationships, low self-esteem and self-confidence.

5. ADHD index: Identifies individuals “at risk” for ADHD

Table 7. Interpreting the CAARS T- scores

45 - 55 Typical score (should not raise concerns)

56 - 60 Slightly elevated (borderline: should raise concern) 61 - 65 Mildly atypical (possible significant problem)

66 - 70 Moderately atypical (indicates a significant problem) 70 + Markedly atypical (indicates a significant problem)

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Participants completed the Autism Spectrum Quotient-10 (AQ-10) questionnaire (Woodbury et al., 2005). This is a brief screening questionnaire. It is suggested that an individual who scores 7 or greater should be considered for a referral for a

specialist diagnostic assessment.Given that only participant 1016 had a score of 7 or greater autism symptoms were not considered a confound for the training and assessment of participants.

Interpreting the Training Performance and Different Graphs

These graphs provide information on individual participant’s performances while completing the training intervention, that is, the training between the pre- and post- assessments. For each participant there are five graphs showing the five main training tasks, i.e., timing task, sudden distractor task, anti-saccade task, stop signal task, and jumping bomb task. The Y-axis is timing in milliseconds and the x-axis is the number of the training session. A repeated number on the x-axis indicated that this task was completed more than once for that training session.

The Timing Task figure: shows saccade timing accuracy (red) (temporal proximity to the target duration) and the target duration (blue). When interpeting this graph it must be noted that the timing accuracy is effected by the target duration, the longer the duration the greater the inaccuracy. However, near the start and end of the training intervention participants were given a repeat of the 1500 ms duration. This allows us to compare their performance for a specif duration near the start of training and near the end of the training. Examined was the distance between the target duration and accuracy at these two training sessions to see if there has been an improvement as a result of training.

The Sudden Distractor Task: shows the response window which I changed across the sessions to encourage participants to respond quicker, and the reaction time, which shows the saccade latency in response to the appearance of the 'go' signal (that is the second bomb stimulus).

The Anti-Saccade Task: shows the response window which changed across sessions to encourage faster RTs and RT’s for correct responses.

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Stop Signal Task: shows the response window (period within which successful responses must fall) and stop signal delay. Both were changed across training sessions to increase the difficulty. Also shown are the SSRT and the Go RT.

The Jumping bomb Task: the main performance indicator here is the mean jumping RT which is the reaction time in response to the 'go' stimuli. The other parameters are measures of task difficulty that were manipulated across training sessions. The “jumping distractor duration” is the period of time distracter bombs appear for, the “final jumping distractor duration” is the period of time the final distractor appears for and is thus also a cue to prepare for a saccade to the target, and the “target duration” is the period of time the target appears for (response window).

Interpreting the Assessment Tables

Individual participant’s assessment score tables (tables 9 – 19) provide a breakdown of the participant’s scores on the pre- and post-training assessment tasks. Given the speculative nature of the pupil dilation data, the reading, and spot the difference data these were not included in these individual tables. Also removed from the case study assessment task results tables are those measures for which we do not see group improvements: the WRAT reading and arithmetic, and the CANTAB IED and IST. The interpretation of these measures at the individual case level would be inappropriate given that no group effect was observed.

Some tasks have more than one performance parameter listed. For each

performance parameter listed their raw score and Z score is given for assessment one, assessment two, and the improvement (difference between assessment one and two). A positive raw score indicates better performance in all cases. The Z-score for any single performance parameter (e.g. Timing task – Short wait) is calculated by first obtaining the mean and standard deviation for all participants’ scores for

assessments one and two for that performance parameter. An individual score (e.g. Timing task – Short wait – Assessment one for participant 1016) is then calculated by subtracting the mean from this score and then dividing it by the standard deviation, i.e. Z = (data point – mean) / standard deviation.

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The z-score provide an indication of how a participant performed compared to the other participants and how much he or she improved between assessments. Also in the table in the final column is the overall z-score improvement and standard deviation for the group, this indicates how much participants improved on average between assessments one and two and how much variability there is between participants with regard to this improvement. As the individual z-scores are based on the pooled scores from assessment one and two, if there is an overall

improvement between assessments one and two it is more likely to see negative z- scores for assessment one.

For the Qb score instead of raw score the Qb Q-scores are provided. The Q-scores is the participant's z-score for that parameter using the normative sample data set. A negative score indicates a better than average score (compared to the noramtive data set).

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11.1

Participant 1016

Gender Female

Age 19

Diagnosis Combined

Medication Strattera (25 mg per day)

Weight 48.3 Kg

Comorbid diagnosis

No

Other issues Sleep problems and anxiety but not serious