Document Type : Original Articles



Background: Sustained visual attention is a prerequisite for learning and memory. The early evaluation of attention in childhood is essential for their school and career success in the future. The aim of this study was to design, development and investigation of psychometric properties (content, face and convergent validity and test-retest and internal consistency reliability) of the computer - based sustained visual attention test (SuVAT) for healthy preschool children aged 4-6 with their special needs.Methods: This study was carried out in two stages: in the first stage computer-based SuVAT in two versions original and parallel were developed. Then the test-retest and internal consistency reliability using intra-class correlation and Cronbach's alpha coefficients respectively were examined; Face validity was calculated through ideas gathering from 10 preschool children and content validity evaluated using CVI and CVR method and convergent validity of SuVAT with CPT was assessed using Pearson correlation.Results: The developed test showed a good content and faces validity, and also had excellent test-retest reliability. In addition, the assessment of internal consistency indicated the high internal consistency of the test (Cronbach’s alpha = 0.869). SuVAT and CPT test demonstrated a positive correlation upon the convergent validity testing.Conclusion: SuVAT with good reliability and validity could be used as an acceptable sustained attention assessment in preschool children.


  1. James W. Principles of psychology. New York: Holt. 1950.
  2. McClelland MM, Cameron CE. Self-regulation and academic achievement in elementary school children. New Dir Child Adolesc Dev 2011; 2011(133): 29-44.
  3. Welsh JA, et al. The development of cognitive skills and gains in academic school readiness for children from low-income families. Journal of educational psychology 2010; 102(1): 43.
  4. Posner K, et al. Clinical presentation of attention-deficit/hyperactivity disorder in preschool children: The Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). J Child Adolesc Psycho pharmacol 2007; 17 (5): 547-62.
  5. Mahone EM, Schneider HE. Assessment of attention in preschoolers. Neuro psychol Rev 2012; 22(4): 361-83.
  6. Graziano PA, Calkins SD, Keane SP. Sustained Attention Development during the Toddlerhood to Preschool Period: Associations with Toddlers' Emotion Regulation Strategies and Maternal Behavior. Infant Child Dev 2011; 20 (6):389-408.
  7. Craig F, et al. A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuro psychiatr Dis Treat 2016; 12: 1191-202.
  8. Verkerk G, et al. Attention in 3-Year-Old Children with VLBW and Relationships with Early School Outcomes. Phys Occup Ther Pediatr 2016; 36(1): 59-72.
  9. London AS, Landes SD. Attention Deficit Hyperactivity Disorder and adult mortality. Prev Med 2016; 90: 8-10.
  10. Graziano PA, Geffken GR, McNamara JP. Atypical behaviors and comorbid externalizing symptoms equally predict children with attention-deficit/hyperactivity disorder's social functioning. Child Psychiatry Hum Dev 2011; 42 (4): 377-89.
  11. Koyuncu A, et al. Attention deficit and hyperactivity in social anxiety disorder: relationship with trauma history and impulsivity. Atten Defic Hyperact Disord 2016; 8(2): 95-100.
  12. Miguel CS, et al. Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence. Drug Alcohol Depend 2016; 160: 97-104.
  13. Soendergaard HM, et al. Education, occupation and risk-taking behavior among adults with attention-deficit/hyperactivity disorder. Dan Med J 2015; 62(3).
  14. Barkley RA, Murphy KR, Fischer M. ADHD in adults: What the Science Says. New York: Guilford Press. 2010.
  15. Yazdani F, Akbarfahimi M, Hassani Mehraban A, Jalaei S, Torabi-Nami M. A computer-based selective visual attention test for first-grade school children: design, development and psychometric properties. Medical journal of the Islamic Republic of Iran 2015; 29:184.
  16. Conners CK, Conners MS (Eds.). Continuous Performance Test II: Computer Program for Windows Technical Guide and Software Manual. North Tonawanda, NY: Multi-Health Systems. 2000.
  17. Mead A, Drasgow F. Equivalence of Computerized and Paper-and-Pencil Cognitive Ability Tests. A Meta-Analysis. Psychological Bulletin 1993; 114:449-458.
  18. Ferdig R. Handbook of Research on Effective Electronic Gaming in Education. University of Florida: USA. 2008.
  19. Kovacs F. TOSSA Manual: Test of Sustained Selective Attention version 3.0 build 1 in Pyramid Productions 2012.
  20. Gelman SA, Markman EM. Young children's inductions from natural kinds: the role of categories and appearances. Child Dev 1987; 58 (6):1532-41.
  21. Gagatsis, A., et al., Exploring young children’s geometrical strategies. Nordic Studies in Mathematics Education 2006; 11(2): 23-50.
  22. Cardoso-Leite P, Bavelier D. Video game play, attention, and learning: how to shape the development of attention and influence learning? Current opinion in neurology 2014:27(2): 185-191.
  23. Brown CS. Language and Literacy Development in the Early Years: Foundational Skills that Support Emergent Readers.Language and Literacy Spectrum 2014; 24: 35-49.
  24. McClelland MM, et al. Links between behavioral regulation and preschoolers' literacy, vocabulary, and math skills. Developmental psychology 2007; 43 (4): 947.
  25. Yazdani F, et al. Determination factors affecting computer based assessment for selective attention in children with first grade of elementary. J Rehab Med 2014; 3(2):8-14.
  26. Lawshe CH. A quantitative approach to content validity Personnel Psychology 1975; 28: 563-575.
  27. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations.Research in nursing & health 2006; 29(5): 489-497.
  28. Sina,
  29. FleissJ. Design and Analysis of Clinical Experiments. New York: John Wiley & Sons. 1986.
  30. Mahone EM. Measurement of attention and related functions in the preschool child. Mental retardation and developmental disabilities research reviews 2005; 11(3): 216-225.
  31. White RF, Campbell R, Echeverria D, Knox SS, Janulewicz P. Assessment of neuropsychological trajectories in longitudinal population-based studies of children. Journal of Epidemiology and Community Health 2009; 63(Suppl 1): i15-i26.
  32. Curran W, Benton CP. Test stimulus characteristics determine the perceived speed of the dynamic motion aftereffect. Vision research 2006; 46(19):3284-3290.
  33. Lien MC, Proctor RW. Stimulus-response compatibility and psychological refractory period effects: Implications for response selection. Psychonomic Bulletin & Review 2002; 9(2): 212-238.
  34. Toates F. The interaction of cognitive and stimulus–response processes in the control of behaviour. Neuroscience & Biobehavioral Reviews 1997; 22 (1): 59-83.
  35. Bramão I, Faisca L, Petersson KM, Reis A. The contribution of color to object recognition. InTech. 2012.
  36. Passolunghi MC, et al. Mathematics Anxiety, Working Memory, and Mathematics Performance in Secondary-School Children. Front Psychol 2016; 7:42.
  37. Clements DH, Geometric and Spatial Thinking in Young Children. National Council of Teachers of Mathematics. 1998: 66-79.