The Press Got It Wrong: The Real Truth Behind a New Test for ADHD

It is called NEBA, and it can determine if a child’s symptoms are caused by ADHD or another condition.
Speak Up, Please | posted by Steven Snyder, Ph.D.
Steven Snyder, Ph.D.

After the FDA cleared NEBA as a biological test that can help a clinician evaluate a patient for ADHD, many have weighed in with their opinions. There were many misconceptions in the press criticizing NEBA as a replacement for the clinician’s diagnosis. Unfortunately, the press got it wrong. Nothing could be further from the truth. NEBA is intended to give the clinician key information about a patient that can lead to an ADHD diagnosis—or not.

How can a biological test help with a clinician’s ADHD diagnosis? That has always been the key question. When we were developing the test, many clinicians had explained that it is fairly straightforward to determine whether ADHD symptoms are present. This fact is readily supported by interviews, questionnaires, and rating scales. The challenge comes when the clinician must determine if the symptoms are due to ADHD or another condition. Clinicians need help with that.

NEBA Health spent eight years showing that a biological test could help. We showed that a 20-minute electroencephalogram (EEG) can be used to identify children and teenagers more likely to have other conditions that may better account for ADHD symptoms. Those conditions include head injury, substance abuse, and auditory processing disorder, among many others. We showed that our EEG biomarker is relatively lower in children and teenagers who are more likely to have these other conditions and relatively higher in children and teens who do have ADHD. The clinician ultimately resolves those cases when prompted by the lower biomarker, and performs further testing based on what they know about the individual.

Our main study showed this extra step improves the certainty of the clinician’s diagnosis. Most importantly, the child or teenager is more likely to receive targeted treatment that can help them.

Since the FDA announcement in July last year, many clinics nationwide have reviewed the evidence and adopted NEBA. Clinicians’ case studies and associated parent surveys have been positive. Here is a common example. A clinician determined that anxiety was present in a teenager, but he was not certain whether the teen’s inattention was due to anxiety or to ADHD. The lower NEBA biomarker supported that ADHD symptoms were more likely due to another condition. After consideration of all information available, including the data from the NEBA test, the clinician decided to treat and manage anxiety first while monitoring ADHD symptoms. The clinician found that, after successfully treating the teen’s anxiety, the teenager’s inattentive symptoms had been resolved, as well.

Here is another example. A clinician determined that ADHD was present, but the parent of the teen did not believe that ADHD was the source of the symptoms. The parent said that the real problem was that the teenager was not working hard enough. NEBA provided confirmatory support for the presence of ADHD. Our main study had also showed that when the EEG biomarker is relatively higher, it supports an ADHD diagnosis. The clinician used all available information, including that from NEBA, to help the parent feel more comfortable with the ADHD diagnosis. With support of the parent, the teenager was helped by the clinician’s treatment and management plan.

Research, FDA reviews, and clinical use support that a biological test like NEBA can help with a clinician’s ADHD evaluation and answer the critical question: Does a person have ADHD or something else?

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