The go-no-go paradigm was used in the evaluation of children with attention deficit disorder (ADD) at the Dept of Pediatrics, Division of Neurology and Evaluation Center for Learning, Northwestern Univ Medical School, Evanston Hospital, Evanston, IL. The paradigm consisted of the taped presentation of 2 trials of 10 stimuli; 5 go signals (1 tap) to which the children were expected to respond by raising and lowering their index finger, and 5 no-go signals to which they should not respond. Commissions errors suggest impulsivity and omission errors suggest inattention. Children with ADD (44 boys) made more total errors than did 32 control subjects (p<.03). Nonhyperactive (ADDnoH) subjects made more commission errors than controls initially but improved with practice. Hyperactive ADD subjects (ADDH) made the same number of early commission errors as controls but failed to improve with practice. Omission errors were highest in the ADDH group. The paradigm provided an objective measure of inattention and impulsivity and a distinction between hyperactive and nonhyperactive children with ADD. [1]

COMMENT. Errors of commission are more common than errors of omission in children with ADD which suggests that impulsivity is more easily demonstrated than inattention. The DSM-III “impulsivity” criteria include inability to wait in turn at games, calling out in class, and shifting activities. The go-no-go paradigm offers a test for impulsivity at a cognitive level, the inability to give the most correct answer in a multiple choice setting, and supplements reports of behavioral manifestations of ADD.