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Assessment Layers
One Assessment Framework.
Multiple Evidence Layers.
NVOX does not rely on a single questionnaire, task, score, or signal. It brings together clinical history, functional impact, collateral input, task derived performance data, digital markers, voice derived support when interpretable, and quality and interpretability context within one clinician reviewed framework.
Each layer contributes a distinct view of the case. NVOX keeps evidence sources separate and organizes them so clinicians can see where they converge, where they diverge, and where further interpretation is needed.
No single layer determines the diagnosis.
The integrated clinical pattern is what matters.
Evidence Architecture
How the Evidence Layers Come Together
NVOX organizes multiple evidence layers within one clinical framework without reducing them to a single score or undifferentiated output.
Each layer contributes a distinct perspective on attention, regulation, development, functional impact, task performance, and context. The framework preserves source identity, highlights convergence and divergence, makes quality limitations visible, and brings the available evidence together for clinician reviewed integration.
Clinical Profile
Developmental, behavioral, functional, educational, medical, and contextual information.
Collateral Evidence
Observations from parents, teachers, caregivers, partners, relatives, or other relevant informants.
Objective Task Performance
Structured task data related to attention regulation, response timing, consistency, inhibition, and performance stability.
Digital, Behavioral, and Visual Signals
Task contextualized information related to gaze, fixation, blink patterns, movement, and engagement.
Voice Derived Support
Research informed vocal signal context when language, reading ability, audio quality, and recording conditions support responsible interpretation.
Quality and Interpretability
Information about technical conditions, cooperation, signal quality, and whether each layer can be interpreted responsibly.
Clinician Reviewed Integration
Synthesis of the available evidence, functional context, source differences, and relevant alternative explanations and co occurring concerns.
The value lies not in any single layer, but in how the available evidence is examined together.
Clinical Profile and Collateral Evidence
Understanding the Person
Beyond a Symptom Score
The NVOX Cognitive and Behavioral Profile™ organizes developmental, behavioral, functional, educational, medical, and contextual information into a structured clinical record.
It captures both ADHD related concerns and information that may shape their interpretation, including sleep, fatigue, anxiety, mood, learning, language, medication, medical history, stress, prior evaluations, strengths, and safety related context.
NVOX Cognitive and Behavioral Profile™
Provides a structured view of symptoms, developmental course, functional impact, strengths, and relevant alternative explanations and coexisting concerns.
Collateral Evidence
Adds observations from parents, caregivers, teachers, educational professionals, partners, relatives, or other relevant informants, depending on the person and assessment pathway.
Cross Setting Context
Helps clinicians examine how attention, regulation, organization, and functioning may differ across home, school, work, relationships, routines, and other real world settings.
Source Separation
Preserves the identity of each information source rather than blending all reports into one undifferentiated score.Agreement across sources can strengthen interpretation. Differences between sources can also be clinically meaningful and may clarify how context, demands, or environment affect functioning.
The goal is not simply to count symptoms,
but to understand their developmental, functional, and contextual meaning.
NVOX d CPT™ Objective Performance Layer
Structured Performance Under Sustained Task Demands
NVOX d CPT™ provides structured task derived performance data that complements the broader clinical record.
The task is designed to help clinicians examine how attention, response control, timing, consistency, and performance stability change across structured demands and periods of interference.
Attention Regulation
How consistently the person remains engaged and identifies relevant targets.
Response Timing and Consistency
How quickly responses occur and how stable performance remains across trials.
Response Inhibition
How effectively responses are withheld when the task requires restraint.
Distractor Sensitivity
How performance changes when interfering or distracting stimuli are introduced.
Spatial Attention Management
How performance changes when visual attention must shift or be redistributed across the screen.
Adaptation After Errors
How response patterns change following mistakes, including slowing, correction, stabilization, or continued variability.
Performance Stability Over Time
Whether attention, timing, accuracy, and response control remain stable or change as the task continues.
Structured task performance is one part of the broader assessment. It is not a standalone or independently sufficient ADHD test.
NVOX d CPT™ Objective Performance Layer
Structured Performance, Age Based Norms,
and Behavioral Observation
NVOX d CPT™ provides structured task performance data related to attention regulation, response timing, consistency, response inhibition, distractor sensitivity, spatial attention, adaptation after errors, and performance stability over time.
Performance is interpreted in relation to relevant age based norms and considered alongside behavioral observations during the task, testing conditions, and the broader clinical evidence. This integrated view helps clinicians understand not only the results, but also how the person responded to sustained task demands and how the findings fit within the wider clinical picture.
Clinical Profile
Developmental, behavioral, functional, educational, medical, and contextual information.
Response Timing and Consistency
How quickly responses occur and how stable performance remains across trials.
Response Inhibition
How effectively responses are withheld when the task requires restraint.
Distractor Sensitivity
How performance changes when interfering or distracting stimuli are introduced.
Spatial Attention Management
How performance changes when visual attention must shift or be redistributed across the screen.
Adaptation After Errors
How response patterns change following mistakes, including slowing, correction, stabilization, or continued variability.
Performance Stability Over Time
Whether attention, timing, accuracy, and response control remain stable or change as the task continues.
NVOX d CPT™ represents one structured performance layer within the broader assessment. Its findings support clinical interpretation but do not constitute a standalone diagnostic conclusion or an independently sufficient test for ADHD.
NVOX Cognitive Biomarker Analysis™ | NCBA
Research Based Signals Interpreted by Age,
Developmental Expectations, and Task Context
Research Based Signals Interpreted by Age, Developmental Expectations, and Task Context
NCBA adds a task contextualized layer of digital, behavioral, visual, oculomotor, blink,
and motor activity signals collected during structured assessment tasks.
The signal domains used in NCBA were selected from published peer reviewed research
and refined through NVOX’s internal scientific development work.
NVOX has also examined these signals within its internal operational data to support
ongoing analysis, refinement, quality review, and future validation work.
Findings are interpreted in relation to task phase, signal quality, screen and device
conditions, age and developmental expectations, behavioral observations, and the broader clinical record.
In NCBA, the term biomarker refers to task contextualized digital, behavioral, visual, blink,
and motor signal patterns. It does not refer to a biological or medical biomarker. NCBA
findings contribute supporting evidence to the broader clinical record and are not standalone proof of ADHD.
Motor Activity Level
Observable movement burden, variability, and changes in activity across the structured task phases.
Off Task Gaze and Visual Anchoring
Visual disengagement from task relevant areas and the efficiency of returning to the task after disengagement.
Blink Dynamics
Changes in blink rate, timing, and patterns as task demands change across the structured protocol.
Gaze Dispersion
How broadly calibrated gaze is distributed around task relevant visual information during task performance.
Fixation Duration and Stability
How consistently calibrated gaze remains held on task relevant visual information once engagement has begun.
Cross Module Analysis
Examines changes across task phases, return to task after visual disengagement, and signal quality across the NCBA modules to support responsible interpretation.
In NCBA, the term biomarker refers to task contextualized digital, behavioral, and visual signal patterns. It does not refer to a biological or medical biomarker, and NCBA findings are not standalone proof of ADHD.NCBA contributes research based, internally examined, age and developmentally contextualized signal evidence to the broader clinical picture when the available signals support responsible interpretation.
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NVOX WAVE™ Vocal Signal Layer
Research Informed Voice Derived Support
from Structured Reading
NVOX organizes multiple evidence layers within one clinical framework without reducing them to a single score or undifferentiated output.
Each layer contributes a distinct perspective on attention, regulation, development, functional impact, task performance, and context. The framework preserves source identity, highlights convergence and divergence, makes quality limitations visible, and brings the available evidence together for clinician reviewed integration.
Speech Timing
Patterns in the timing and pacing of speech during structured reading.
Pause Structure
The frequency, duration, and distribution of pauses across the reading task.
Vocal Modulation
Changes in vocal variation and modulation during sustained reading.
Fluency
The continuity and flow of speech, including interruptions or disruptions.
Speech Consistency
How stable speech timing, pacing, and delivery remain throughout the task.
Fragmentation
Patterns of interrupted, segmented, or less continuous speech.
Change Over Time
How vocal patterns shift as the structured reading task progresses.
Interpretability and Data Quality
Language, reading ability, accent, fatigue, medication effects, audio quality, and recording conditions are considered before voice derived findings are interpreted.
Voice derived findings may be influenced by language, accent, reading ability, anxiety, fatigue, sleep, medication effects, microphone quality, audio quality, and recording conditions. When these factors are present, interpretation must be appropriately qualified.
WAVE is research informed signal support, not voice diagnosis. It is not a standalone diagnostic test, an externally validated voice based ADHD diagnostic tool, or proof of ADHD by itself.
Its value lies in the additional context it may contribute when the signal is interpretable and considered as part of the broader clinical record.
Quality and Interpretability Context
No Signal Should Be Interpreted Without Context
NVOX is designed to avoid overinterpreting weak, missing, or technically limited signals.
Camera position, lighting, face and eye visibility, tracking continuity, screen and device conditions, audio quality, language, accent, reading context, cooperation, fatigue, medication effects, emotional state, and the assessment environment may all affect whether information can be interpreted responsibly.
Video and Visual Conditions
Camera position, lighting, visibility, tracking continuity, screen size, and device context.
Audio and Reading Conditions
Microphone and audio quality, language, accent, reading ability, fluency, and recording conditions.
Behavioral and Environmental Context
Cooperation, fatigue, medication effects, emotional state, distractions, and the assessment environment.
Visible Quality Limitations
Missing, limited, or technically constrained information remains visible within the assessment record.
A limited signal is not treated as a normal finding.
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Missing information is not automatically treated as negative evidence.
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Tracking loss is not treated as off task gaze.
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Poor visibility is not treated as poor fixation.
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Technical artifact is not treated as clinical behavior.
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A layer that cannot be interpreted responsibly is identified, qualified, or bounded within the broader clinical record.
Clinical Integration
The Full Clinical Pattern Matters
More Than Any Single Layer
NVOX brings the available evidence layers together without treating any one source, task, score, or signal as decisive on its own.
Clinical interpretation considers how developmental history, functional impact, collateral evidence, task performance, digital and voice related signals, behavioral observations, and quality limitations relate to one another within the broader case.
Evidence Convergence
Identifies where different sources and assessment layers support a consistent clinical pattern.
Meaningful Differences Between Sources
Preserves differences across settings, informants, and assessment conditions when they may add important clinical context.
Functional and Developmental Context
Considers how the findings relate to developmental course, daily functioning, impairment, strengths, and real world demands.
Alternative Explanations and Coexisting Concerns
Keeps relevant medical, emotional, learning, sleep, language, medication, and contextual factors visible during clinical interpretation.
Interpretation Within Quality Limits
Missing, limited, or technically constrained information is considered according to its quality and interpretability.
Clinician Reviewed Synthesis
The reviewing clinician examines the integrated evidence, determines its clinical meaning, and applies professional judgment to the final interpretation, recommendations, feedback, and next steps.
NVOX organizes the evidence.
The clinician interprets the integrated clinical pattern.
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