title: The Medical Symptom Validity Test Measures Effort Not Ability in Children: A Comparison Between Mild TBI and Fetal Alcohol Spectrum Disorder Samples.
abstract: Inadequate effort during neuropsychological examination results in inaccurate representations of an individual's true abilities and difficulties. As such, performance validity tests (PVTs) are strongly recommended as standard practice during adult-based evaluations. One concern with using PVTs with children is that failure reflects immature cognitive ability rather than non-credible effort. The current study examined performance on the Medical Symptom Validity Test (MSVT) in two large pediatric clinical samples with strikingly different neuropsychological profiles: (1) mild traumatic brain injury (mTBI; n = 510) and (2) fetal alcohol spectrum disorder (FASD; n = 120). Despite higher IQ scores and reading ability, the mTBI group performed significantly worse than the FASD group on all effort indices. Sixteen percent of the mTBI group failed the MSVT, whereas only 5% of the FASD group did. Our findings support the idea that the MSVT measures effort, not ability, in most cases and help to justify incorporating PVTs into pediatric neuropsychological batteries.
authors: Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.
authors: Jennifer C
authors: JC
authors: Gidley Larson
authors: Private Practice Neuropsychologist, Edmonton, AB, Canada.
authors: Lloyd
authors: L
authors: Flaro
authors: Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
authors: Robin L
authors: RL
authors: Peterson
authors: Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
authors: Amy K
authors: AK
authors: Connery
authors: Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
authors: David A
authors: DA
authors: Baker
authors: Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA michael.kirkwood@childrenscolorado.org.
authors: Michael W
authors: MW
authors: Kirkwood
mesh_terms: D000293:Adolescent; D001076:Aptitude; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000523:psychology*; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests
keywords: Children; MSVT; Performance validity testing; Symptom validity testing; Traumatic brain injury