Search questions:
- What is Creyos and can it help diagnose or assess ADHD in my child?
- How do cognitive assessments help with ADHD treatment and what do they actually measure?
Here's a problem I've seen play out hundreds of times in my clinical practice. A child gets an ADHD diagnosis. A treatment plan is built. The family tries it for six months. Some things seem better. Some things don't. And no one can quite say why — or measure what actually changed.
The missing piece, almost always, is objective data. Not parent ratings, not teacher checklists, not clinical impression — actual measurement of what the brain can and can't do, before treatment and after. Without that baseline, we're flying blind.
Creyos cognitive assessments are one of the best tools I know for establishing that baseline and tracking real change over time. Let me explain what they measure and why it matters.
What Is Creyos?
Creyos (formerly Cambridge Brain Sciences) is a computerized cognitive assessment platform developed by neuroscientists at the University of Cambridge. It measures 12 core cognitive domains through short, gamified tasks that can be completed in 20–30 minutes on any device. The tasks were designed to assess the same cognitive functions that decades of neuropsychological research have identified as central to how the brain thinks, remembers, plans, and focuses.
The domains Creyos measures include working memory, sustained attention, response inhibition, processing speed, reasoning, planning, and cognitive flexibility — a profile that maps almost exactly onto the cognitive functions most affected by ADHD. This isn't coincidence. These are the same functions that the prefrontal cortex manages, and the prefrontal cortex is the brain region most consistently underperforming in ADHD.
Creyos compares each person's scores to age-matched norms, generating percentile scores in each domain. That comparison is what makes it clinically useful: you can see not just whether working memory is below average, but how far below — and in which specific tasks the gap is largest.
Why the ADHD Brain Reveals Itself Under Pressure
ADHD doesn't always show up in casual conversation or even in a clinical interview. Many children with ADHD are charming, articulate, and apparently organized for the first ten minutes of any interaction. The deficit becomes visible under pressure — specifically, under the pressure of timed, demanding cognitive tasks that require sustained attention, accurate inhibition of impulsive responses, and real-time working memory management.
Creyos includes several timed tasks that expose exactly these vulnerabilities. The key ones for ADHD assessment:
- Double Trouble — Measures response inhibition and the ability to resist an automatic, incorrect response. This is consistently the lowest-scoring subtest in ADHD profiles. The ability to pause, override an impulse, and select the correct response is precisely what the ADHD prefrontal cortex struggles with.
- Feature Match — Measures sustained attention over time. Distractibility shows up as inconsistency and error rates that increase across the task.
- Token Search — Working memory for spatial information. Children with ADHD frequently struggle to hold the "where I've already looked" map in mind.
- Digit Span — Verbal short-term memory. Difficulty holding auditory instructions in mind long enough to act on them — a daily problem for inattentive-type children.
The key pattern to look for: low scores on timed tasks with better (or normal) scores on untimed tasks. This gap — the ability to perform accurately when time doesn't matter, but not when it does — is one of the most reliable cognitive signatures of ADHD.
Different ADHD Subtypes, Different Cognitive Profiles
One of the most valuable things Creyos offers is the ability to distinguish between ADHD subtypes based on cognitive patterns, not just behavioral descriptions. This matters for treatment because a Pooh-type inattentive profile and a Tigger-type hyperactive profile have the same diagnosis but different cognitive vulnerabilities — and they respond to different interventions.
- Inattentive Type (Pooh): Low scores on Feature Match and Token Search. Works slowly, loses track of goals, misses details. The brain is underactivated — it doesn't sustain alertness long enough to perform consistently. Treatment priority: tools that increase activation without overstimulating.
- Hyperactive/Impulsive Type (Tigger): Low scores on Double Trouble and Reaction Time consistency. Fast but error-prone — acts before thinking, highly variable performance. The impulse fires before the inhibitory system can intervene. Treatment priority: building the pause between impulse and action.
- Over-Focused Type (Rabbit): Low scores on Double Trouble and spatial planning tasks. Gets locked onto one approach and struggles to shift. Perfectionistic, slow, may refuse to respond if unsure. Treatment priority: cognitive flexibility, not activation.
- Anxious Type (Piglet): Cautious across timed tasks — avoids errors but takes too long. Average reasoning scores, slower processing. Anxiety is consuming the cognitive resources that attention needs. Treatment priority: calm the alarm system first, then address attention.
- Sluggish/Low Mood Type (Eeyore): Mildly depressed scores across memory and processing speed. Slow initiation, poor planning, low engagement. The brain's motivational circuitry is underactivated. Treatment priority: engagement and mood support alongside cognitive training.
Creyos as a Treatment Tracking Tool
The diagnostic use of Creyos is valuable. The treatment-monitoring use may be even more valuable. When you establish a baseline before treatment begins and then reassess at 10-session intervals, you can see whether the intervention is actually changing the brain — not just whether the parent thinks the child is doing better.
Working memory scores going up after eight weeks of neurofeedback. Double Trouble scores improving after three months of CES and Dual-N-Back training. Processing speed normalizing after dietary changes and consistent sleep. These are measurable outcomes, not impressions. They allow you to make evidence-based decisions about whether to continue, modify, or redirect the treatment plan.
This is how treatment planning should work. Not "let's try this for a year and see how it goes" — but "here's where we are, here's what we're targeting, and here's how we'll know we're getting there."
Pairing Creyos with Self-Report Inventories
Creyos measures what the brain can do. Self-report inventories measure what the person experiences. Both are necessary — because ADHD affects subjective experience in ways that cognitive testing alone doesn't capture.
The most useful pairings:
- ASRS v1.1 (Adult ADHD Self-Report Scale) — 18 items mapping the DSM-5 criteria. When low Double Trouble scores on Creyos align with ASRS indicators, ADHD diagnosis is strongly supported by converging evidence from two different measurement modalities.
- GAD-7 — Because anxiety is present in a significant portion of ADHD cases and changes the cognitive profile substantially. Treating the cognitive symptoms without addressing the anxiety overlay produces incomplete results.
- PHQ-9 — Because depression, especially in the Eeyore subtype, is frequently the primary driver of cognitive sluggishness. Addressing mood improves cognition in ways that cognitive training alone often can't.
What To Do Starting Today
Request cognitive assessment if your treatment plan is based entirely on rating scales. Rating scales are useful starting points. They're not sufficient foundations for treatment planning when the brain's actual cognitive profile is unknown. Ask your clinician about computerized cognitive assessment as part of the initial workup.
Establish a baseline before starting any new intervention. If you're about to begin neurofeedback, CES, medication, or a significant dietary change, an objective cognitive baseline makes it possible to measure real change. Without the baseline, you're comparing "better" to a feeling rather than to data.
Use Creyos to identify the highest-leverage targets. If Double Trouble is in the 8th percentile but working memory is in the 35th, the most important target is response inhibition — and the treatment choices should reflect that priority.
Reassess every 10 sessions or 8 weeks, whichever comes first. The brain changes faster than we often expect when the right interventions are applied consistently. Regular measurement keeps treatment honest and focused.
Seeing What the Brain Is Actually Doing
ADHD has too long been treated on the basis of what people say — reports, ratings, impressions, observations. These are important. But they're not the same as measurement. A child who has "gotten better" at masking their struggles still has the same brain. A child whose scores on cognitive inhibition and sustained attention have moved from the 10th to the 40th percentile has a different brain than they had six months ago.
That's the difference between managing symptoms and actually changing the underlying condition. Creyos can show you which one you're doing. And that knowledge changes everything about what comes next.
References
- Hampshire, A., et al. (2012). Fractionating human intelligence. Neuron, 76(6), 1225–1237.
- Barkley, R.A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed.). Guilford Press.
- Faraone, S.V., et al. (2021). The World Federation of ADHD International Consensus Statement. Neuroscience & Biobehavioral Reviews, 128, 789–818.
- Willcutt, E.G., et al. (2005). Validity of the executive function theory of ADHD. Biological Psychiatry, 57(11), 1336–1346.
- Spitzer, R.L., et al. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.