1
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Mitchell DL, Shlobin NA, LoPresti MA, Scoville JP, Winterhalter E, Lam S. Post-Surgical Cognitive Outcomes of Moyamoya Disease: A Systematic Review. World Neurosurg 2023; 178:181-190.e1. [PMID: 37506837 DOI: 10.1016/j.wneu.2023.07.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Moyamoya disease (MMD) is an occlusive arteriopathy leading to stroke. Progressive if left untreated, revascularization surgery has become the mainstay of treatment. Although clinical and radiographic outcomes of MMD after intervention are well-characterized, cognitive outcomes in pediatric patients remain unclear. We aimed to examine postoperative cognitive outcomes in children with MMD, examine factors associated with cognitive changes after intervention, and define the effect of revascularization surgery on cognitive outcomes. METHODS A systematic review was conducted following PRISMA guidelines searching PubMed, Embase, and Scopus databases. Articles met inclusion criteria if they studied pediatric patients undergoing revascularization surgery for MMD and examined cognitive outcomes either qualitatively or quantitatively. All data extracted from included articles was examined descriptively. RESULTS Of 1091 resultant articles, 12 articles containing 446 patients were included. Surgery was associated with maintained or improved full scale intellectual quotient (IQ), performance IQ, perceptual IQ, memory quotient and verbal memory. However, 70% of patients had impaired cognitive function, with associated poor school performance. Improvements in cognition were associated with increased cerebral blood flow, particularly to the middle cerebral artery, due to the development of collaterals. Female sex, shorter duration from symptom onset to surgery, and surgery after age 7 were predictive of cognitive improvement. Completed ischemic stroke prior to surgery was associated with poorer cognitive outcomes. CONCLUSIONS Although children with MMD have improved cognitive outcomes following revascularization overall, a distinct subset experience cognitive impairment. Consideration of patient-specific and treatment-related factors is important to enable proper risk stratification and inform management approaches.
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Affiliation(s)
- Devon L Mitchell
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Nathan A Shlobin
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Melissa A LoPresti
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Jonathan P Scoville
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Emily Winterhalter
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Sandi Lam
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA.
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2
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Berrill LM, Quagliano Q, Boyce T, Donders J. Performance and Symptom Validity in Outpatient Pediatric Neuropsychological Evaluations. Dev Neuropsychol 2023; 48:56-64. [PMID: 36891638 DOI: 10.1080/87565641.2023.2186411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
This study aimed to clarify the value of using different types of validity measures in pediatric neuropsychological evaluations. We examined the relationship between performance (PVT) and symptom (SVT) validity tests as well as demographic variables and results from a screening test of learning and memory (i.e. Child and Adolescent Memory Profile [ChAMP]) in a mixed pediatric sample (n = 103). There was minimal overlap between PVT and SVT failures. Regression analyses demonstrated that PVT results, parental education, and history of special education were statistically significant predictors of ChAMP results, whereas SVT results were not.
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Affiliation(s)
- Lauren M Berrill
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, USA
| | - Quinton Quagliano
- Department of Psychology, Calvin College, Grand Rapids, Michigan, USA
| | - Timothy Boyce
- Department of Psychology, Hope College, Holland, Michigan, USA
| | - Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, USA
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3
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Gur N, Hegedish O, Hoofien D, Pilowsky Peleg T. The Temporal Memory Sequence Test (TMST) in children: Validity test performance in clinically referred children. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:9-16. [PMID: 34870554 DOI: 10.1080/21622965.2021.2008936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Validity evaluation is fundamental in neuropsychological assessment in adults, with increasing interest among pediatric neuropsychologists. Although some measures exist, given time constraints placed on clinicians, and children's limited sustained attention, development of less time-consuming measures is beneficial. We explored the use of the Temporal Memory Sequence Test (TMST), a new performance validity test, in clinically referred children. One minor adaptation included reading the instructions and labels to non-fluent readers. Participants were 68 consecutive clinically referred children and adolescents, aged 6-18 years, with neurological (n = 46) or behavioral (n = 22) difficulties. Applying the adult cutoff, 83.8% passed the TMST. Age, gender, and diagnosis did not differ between children passing the TMST cutoff and those who failed it. Classification accuracy calculated against three embedded measures of performance validity (Wechsler scale Digit Span, Coding, and Processing Speed Index) indicated specificity over 90% (Digit Span: 94%, Coding: 96%, Processing Speed Index: 92%) and sensitivity between 30 and 33%. For individuals without Intellectual Disability (ID), 90.9% passed the TMST, and intelligence did not predict success. Thus, the use of the TMST with the adult cutoff was supported in children without ID, offering an additional validity measure for clinically referred children.
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Affiliation(s)
- N Gur
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,The Neuropsychological Unit, Schneider Children's Medical Center, Petach Tikvah, Israel
| | - O Hegedish
- Department of Psychology, University of Haifa, Haifa, Israel
| | - D Hoofien
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Psychology, Tel Aviv-Jaffa Academic College, Israel.,The National Institute for Neuropsychological Rehabilitation, Israel
| | - T Pilowsky Peleg
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,The Neuropsychological Unit, Schneider Children's Medical Center, Petach Tikvah, Israel
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4
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Nayar K, Ventura LM, DeDios-Stern S, Oh A, Soble JR. The Impact of Learning and Memory on Performance Validity Tests in a Mixed Clinical Pediatric Population. Arch Clin Neuropsychol 2021; 37:50-62. [PMID: 34050354 DOI: 10.1093/arclin/acab040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined the degree to which verbal and visuospatial memory abilities influence performance validity test (PVT) performance in a mixed clinical pediatric sample. METHOD Data from 252 consecutive clinical pediatric cases (Mage=11.23 years, SD=4.02; 61.9% male) seen for outpatient neuropsychological assessment were collected. Measures of learning and memory (e.g., The California Verbal Learning Test-Children's Version; Child and Adolescent Memory Profile [ChAMP]), performance validity (Test of Memory Malingering Trial 1 [TOMM T1]; Wechsler Intelligence Scale for Children-Fifth Edition [WISC-V] or Wechsler Adult Intelligence Scale-Fourth Edition Digit Span indices; ChAMP Overall Validity Index), and intellectual abilities (e.g., WISC-V) were included. RESULTS Learning/memory abilities were not significantly correlated with TOMM T1 and accounted for relatively little variance in overall TOMM T1 performance (i.e., ≤6%). Conversely, ChAMP Validity Index scores were significantly correlated with verbal and visual learning/memory abilities, and learning/memory accounted for significant variance in PVT performance (12%-26%). Verbal learning/memory performance accounted for 5%-16% of the variance across the Digit Span PVTs. No significant differences in TOMM T1 and Digit Span PVT scores emerged between verbal/visual learning/memory impairment groups. ChAMP validity scores were lower for the visual learning/memory impairment group relative to the nonimpaired group. CONCLUSIONS Findings highlight the utility of including PVTs as standard practice for pediatric populations, particularly when memory is a concern. Consistent with the adult literature, TOMM T1 outperformed other PVTs in its utility even among the diverse clinical sample with/without learning/memory impairment. In contrast, use of Digit Span indices appear to be best suited in the presence of visuospatial (but not verbal) learning/memory concerns. Finally, the ChAMP's embedded validity measure was most strongly impacted by learning/memory performance.
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Affiliation(s)
- Kritika Nayar
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lea M Ventura
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Pediatrics, University of Illinois College of Medicine, Chicago, IL, USA
| | - Samantha DeDios-Stern
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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5
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Sweet JJ, Heilbronner RL, Morgan JE, Larrabee GJ, Rohling ML, Boone KB, Kirkwood MW, Schroeder RW, Suhr JA. American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering. Clin Neuropsychol 2021; 35:1053-1106. [PMID: 33823750 DOI: 10.1080/13854046.2021.1896036] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Citation and download data pertaining to the 2009 AACN consensus statement on validity assessment indicated that the topic maintained high interest in subsequent years, during which key terminology evolved and relevant empirical research proliferated. With a general goal of providing current guidance to the clinical neuropsychology community regarding this important topic, the specific update goals were to: identify current key definitions of terms relevant to validity assessment; learn what experts believe should be reaffirmed from the original consensus paper, as well as new consensus points; and incorporate the latest recommendations regarding the use of validity testing, as well as current application of the term 'malingering.' Methods: In the spring of 2019, four of the original 2009 work group chairs and additional experts for each work group were impaneled. A total of 20 individuals shared ideas and writing drafts until reaching consensus on January 21, 2021. Results: Consensus was reached regarding affirmation of prior salient points that continue to garner clinical and scientific support, as well as creation of new points. The resulting consensus statement addresses definitions and differential diagnosis, performance and symptom validity assessment, and research design and statistical issues. Conclusions/Importance: In order to provide bases for diagnoses and interpretations, the current consensus is that all clinical and forensic evaluations must proactively address the degree to which results of neuropsychological and psychological testing are valid. There is a strong and continually-growing evidence-based literature on which practitioners can confidently base their judgments regarding the selection and interpretation of validity measures.
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Affiliation(s)
- Jerry J Sweet
- Department of Psychiatry & Behavioral Sciences, NorthShore University HealthSystem, Evanston, IL, USA
| | | | | | | | - Martin L Rohling
- Psychology Department, University of South Alabama, Mobile, AL, USA
| | - Kyle B Boone
- California School of Forensic Studies, Alliant International University, Los Angeles, CA, USA
| | - Michael W Kirkwood
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Ryan W Schroeder
- Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine, Wichita, KS, USA
| | - Julie A Suhr
- Psychology Department, Ohio University, Athens, OH, USA
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6
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Wilson K, Lesica S. Performance on the Memory Validity Profile in a mixed clinic-referred pediatric sample. Child Neuropsychol 2021; 27:516-531. [PMID: 33504273 DOI: 10.1080/09297049.2020.1870676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The primary purpose of this study was to evaluate performance on the Memory Validity Profile (MVP) in a mixed pediatric clinical population. Goal 1, assessing MVP pass rates, yielded a slightly higher pass rate (98.58%) compared to research on other performance validity tests (PVTs) in youth when using manual-based cutoffs and a slightly lower pass rate (84.40%) using an experimental cutoffs (PASS Total ≥31) similar to others' research. Goal 2, determining if MVP performance was contingent on variables other than effort, yielded significant differences in age, sex, and intelligence (p < 0.05); but not parental education or occurrence/nonoccurrence of previous neurological issues, ADHD, or psychiatric disorders. Goal 3, investigating the agreement of an embedded PVT (Children and Adolescent Memory Profile [ChAMP] List Recognition [LR] subtest) with the MVP in classification of adequate vs. suboptimal effort, showed that the highest levels of consistency (81%) were achieved when experimental MVP and LR ss ≤5 cutoffs were utilized. In conclusion, the MVP is a useful tool in detecting suboptimal effort in children in a broad clinical sample and the ChAMP LR subtest adds to identification of suboptimal effort as an ePVT with the MVP. The established cutoffs stated in the MVP manual should be used, as these better identify suboptimal effort in children by age than experimental cutoffs (i.e., 31 and 32 PASS). The ChAMP LR cutoff should be ss ≤5, with MVP manual-based (75%) or experimental cutoffs (81%).
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Affiliation(s)
- Kate Wilson
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Sofia Lesica
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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7
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Tewolde F, Svingos A, Norheim N, Turner E, Jones L, Heaton S. New cut-score to improve performance of the Memory Validity Profile (MVP) in heterogenous clinical populations. Child Neuropsychol 2021; 27:601-612. [PMID: 33499739 DOI: 10.1080/09297049.2021.1876013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Memory Validity Profile (MVP) is a standalone performance validity test developed specifically for use with children. Prior research has demonstrated the MVP's strength in its ease of administration to children with a wide range of intellectual abilities. However, it has been found to lack sensitivity in detecting noncredible performance in select clinical populations using published cutoffs. The current study examines the MVP's performance in a diagnostically heterogeneous clinical sample and proposes a new cutoff for optimization of sensitivity and specificity. Archival clinical data were examined from 96 participants referred for a comprehensive neuropsychological evaluation (ages 6-18). Receiver operating characteristic analysis was used to assess the discriminative ability of MVP in detecting cases of noncredible performance defined as failures on both the Test of Memory Malingering and Reliable Digit Span. Using published cutoffs, the MVP demonstrated perfect specificity (100%) but suboptimal sensitivity (33.3%). Receiver operating characteristic analysis revealed strong discrimination using MVP Total score (AUC = 0.891 (p < 0.001)) and a MVP Total cut-score of ≤30 resulted in optimal sensitivity (89%) and specificity (63%). Our findings provide additional evidence that published MVP cutoffs may be too lenient to adequately capture instances of noncredible performance and indicate an MVP Total score cutoff of ≤30 may be more appropriate for use with heterogeneous clinical populations.
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Affiliation(s)
- Furtuna Tewolde
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Adrian Svingos
- Department of Physical Medicine and Rehabilitation, Kennedy Krieger, Baltimore, MD, USA
| | - Nicole Norheim
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Elise Turner
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Laura Jones
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Shelley Heaton
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
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8
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Apple RW, Stran BM, Tross B. Psychologists' Role in Concussion Assessments for Children and Adolescents in Pediatric Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207549. [PMID: 33080778 PMCID: PMC7589585 DOI: 10.3390/ijerph17207549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
An estimated 1.1 to 1.9 million children and adolescents in the United States are treated for a sports- or recreationally-related concussion each year. The importance of formalized assessment and measurement of concussion symptoms has been widely recognized as a component of best-practice treatment. The present paper reviews a sample of the most commonly used measures of concussion symptomology and explores psychologists' role in their application in a pediatric practice. In addition, other issues such as accessibility and the appropriateness of application with child and adolescent patients are discussed. Literature is reviewed from journals pertaining to pediatric and adolescent medicine, sports medicine, neuropsychology, and testing and measurement.
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9
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Harrison AG, Armstrong I. The license plate test performance in Canadian adolescents with learning disabilities: A preliminary study. APPLIED NEUROPSYCHOLOGY. CHILD 2020; 9:360-366. [PMID: 32286886 DOI: 10.1080/21622965.2020.1750111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Accurate identification of symptom exaggeration is essential when determining whether data obtained in pediatric evaluations are valid or interpretable. Performance validity measures identify performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with preexisting cognitive difficulties such as Specific Learning Disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired reading, processing or memory skills. The purpose of this study was to evaluate the newly developed License Plate Test (LPT) performance in students with identified SLD providing good effort, to examine the influence of severe reading or learning problems on LPT performance. Participants were 29 students with SLDs aged 11-14 years (M = 12.1), who completed psycho-educational assessments as part of a transition program to secondary school. Results indicate that recognition memory measures on the LPT were insensitive to cognitive impairments in these children; all students achieved scores of 80% or higher on these tasks. Performance was more variable as test demands of the LPT increased, and the difference between performance on easy and hard subtests was related to greater difficulties with working memory. These results provide preliminary data regarding how children with SLD perform on the LPT, allowing for development of appropriate cut scores to maximize sensitivity and specificity of this test for use with child and adolescent populations.
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Affiliation(s)
- Allyson G Harrison
- Regional Assessment and Resource Centre, Queen's University, Kingston, Ontario, Canada
| | - Irene Armstrong
- Regional Assessment and Resource Centre, Queen's University, Kingston, Ontario, Canada
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10
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Identifying Novel Embedded Performance Validity Test Formulas Within the Repeatable Battery for the Assessment of Neuropsychological Status: a Simulation Study. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09382-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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11
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Kirk JW, Baker DA, Kirk JJ, MacAllister WS. A review of performance and symptom validity testing with pediatric populations. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 9:292-306. [DOI: 10.1080/21622965.2020.1750118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- John W. Kirk
- Kirk Neurobehavioral Health, Louisville, CO, USA
| | - David A. Baker
- Department of Physical Medicine & Rehabilitation, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - William S. MacAllister
- Alberta Children’s Hospital Research Institute and Alberta Health Sciences, Alberta, Canada
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12
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Nicholls CJ, Winstone LK, DiVirgilio EK, Foley MB. Test of variables of attention performance among ADHD children with credible vs. non-credible PVT performance. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 9:307-313. [DOI: 10.1080/21622965.2020.1751787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Christopher J. Nicholls
- The Nicholls Group, Scottdale, AZ, USA
- Adjunct Faculty, Department of Psychology, Arizona State University, Tempe, AZ, USA
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13
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Harrison AG, Armstrong IT. Differences in performance on the test of variables of attention between credible vs. noncredible individuals being screened for attention deficit hyperactivity disorder. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 9:314-322. [DOI: 10.1080/21622965.2020.1750115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Allyson G. Harrison
- Regional Assessment and Resource Centre, Queens University, Kingston, Canada
| | - Irene T. Armstrong
- Regional Assessment and Resource Centre, Queens University, Kingston, Canada
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14
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Lace JW, Merz ZC, Kennedy EE, Seitz DJ, Austin TA, Ferguson BJ, Mohrland MD. Examination of five- and four-subtest short form IQ estimations for the Wechsler Intelligence Scale for Children-Fifth edition (WISC-V) in a mixed clinical sample. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:50-61. [PMID: 32297810 DOI: 10.1080/21622965.2020.1747021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Evaluating general cognitive ability (i.e., intelligence) is common in neuropsychological practice, and identifying abbreviated assessments of intelligence is often advantageous. Despite the Wechsler Intelligence Scale for Children, Fifth Edition's (WISC-V) widespread contemporary use, limited research has identified clinically useful short form (SF) full scale IQ (FSIQ) estimations in clinical samples. This study sought to address this gap in the literature. Two hundred sixty-eight pediatric participants (M age = 9.79; 69% male; 88% Caucasian/White) who underwent psychological/neuropsychological evaluation were included. Mean scores for WISC-V scores fell in the low average-to-average ranges, consistent with the clinical nature of this sample (e.g., M FSIQ = 85.3). Ten unique SF combinations with five (pentad) and four (tetrad) subtests, each intentionally selected to represent a breadth of domains subsumed by WISC-V FSIQ, were described by summing subtest age-corrected scaled scores. Regression-based and prorated FSIQ estimates were calculated, and mean differences suggested some prorated estimates should be arithmetically adjusted. Both regression-based and prorated/adjusted methods provided FSIQ estimates that were accurate within five Standard Score points of true FSIQ for approximately 81-92% (pentad) and 65-76% (tetrads) of participants. Prorated/adjusted estimates appeared to provide somewhat better accuracy than regression-based estimates. Relationships between SFs and true FSIQ did not appear to be moderated by participant age, gender, nor how many WISC-V subtests were administered to participants within this archival sample (i.e., 7 vs. 10). Implications of these findings, including benefits, detriments, and other considerations of each SF combination, in addition to limitations of this study, are discussed in detail.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA.,Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Zachary C Merz
- Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Erin E Kennedy
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Dylan J Seitz
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Tara A Austin
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Bradley J Ferguson
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA.,Department of Radiology, University of Missouri, Columbia, MO, USA.,Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, USA
| | - Michael D Mohrland
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA.,Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, USA
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15
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Bosworth C, Dodd JN. Noncredible effort on the Nonverbal-Medical Symptom Validity Test (NV-MSVT): Impact on cognitive performance in pediatric mild traumatic brain injury. APPLIED NEUROPSYCHOLOGY. CHILD 2020; 9:367-374. [PMID: 32223424 DOI: 10.1080/21622965.2020.1742717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined failure rates on the Nonverbal-Medical Symptom Validity Test (NV-MSVT) and its impact on cognitive performance in a sample of youths with mild traumatic brain injury (mTBI). Participants were 184 children and adolescents who presented to a multidisciplinary concussion clinic for a targeted neuropsychological evaluation. Performance Validity Tests (PVTs) were a part of the standard battery, including the NV-MSVT. Twenty-eight participants (15.2%) failed the NV-MSVT, none of whom displayed a genuine memory impairment profile (GMIP). Participants who failed the NV-MSVT performed significantly worse than those who passed the NV-MSVT on measures of IQ, memory, and immediate attention/working memory. There was no significant difference between groups on processing speed, sustained attention, cognitive flexibility, or sight word reading level. Aside from a slight difference in age, NV-MSVT failure was not impacted by demographic variables (sex, race), premorbid risk factors (pre-injury ADHD, learning disabilities, psychiatric diagnoses or treatment, developmental delays, or prior special education), injury-related variables (time since injury, positive neuroimaging findings, post-traumatic amnesia, number of prior mTBIs, etc.) or post-mTBI anxiety/depression. That said, participants who failed NV-MSVT endorsed significantly more severe postconcussive symptoms. These findings support the use of the NV-MSVT in neuropsychological evaluation of children and adolescents with mTBI.
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Affiliation(s)
- Christopher Bosworth
- St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Jonathan N Dodd
- Department of Neuropsychology, WellStar Medical Group-Psychological Services, Marietta, GA, USA
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16
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Weber Ku E, Oliveira JS, Cook NE, McCurdy K, Kavanaugh B, Cancilliere MK, Holler KA. Assessing performance validity with the TOMM and automatized sequences task in a pediatric psychiatric inpatient setting. Child Neuropsychol 2020; 26:801-816. [PMID: 31937183 DOI: 10.1080/09297049.2020.1712345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the performance of children consecutively admitted to an inpatient psychiatric unit on the Test of Memory Malingering (TOMM) (aged 5-12; n = 96) and Automatized Sequences Task (aged 8-12; n = 67). Eighty-three percent of children passed the TOMM Trial 2 (M raw score = 47.7, SD = 4.7) and 76% of children passed the Automatized Sequences Task total time (M = 23.1 seconds; SD = 8.2). The concordance rate between the TOMM and the total time on the Automatized Sequences Task was 73.1%. Receiver operating characteristic curves indicated that of the Automatized Sequences Task subtests, only Counting 1-20 significantly differentiated children who passed Trial 2 of the TOMM from those who did not pass Trial 2 of the TOMM (area under the curve = .756, p = .006). Performance on both PVTs was unrelated to demographic characteristics and measures of psychological and neuropsychological functioning on both the TOMM and Automatized Sequences Task. Further research is needed to determine whether the nearly 1 in 4 children (23.9%) who performed below recommended cutoffs on Automatized Sequences Task reflects genuine suboptimal effort, cognitive difficulties among these children, and/or other factors.
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Affiliation(s)
- Elyssa Weber Ku
- Clinical Psychology, University of Massachusetts Boston , Boston, MA, USA
| | - Jane S Oliveira
- Clinical Psychology, Antioch University - New England, Keene, NH, USA
| | - Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital and Harvard Medical School , Boston, USA
| | - Kyle McCurdy
- Department of Counseling, Leadership, & Expressive Arts, Salve Regina , Newport, RI, USA
| | - Brian Kavanaugh
- Department of Psychiatry & Human Behavior E.P. Bradley Hospital/ Alpert Medical School of Brown University , Providence, RI, USA
| | | | - Karen A Holler
- Department of Psychiatry & Human Behavior E.P. Bradley Hospital/ Alpert Medical School of Brown University , Providence, RI, USA
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Duda TA, Ris MD, Yeates KO, Mahone EM, Haut JS, Raghubar KP. [Formula: see text] Reliable change in pediatric brain tumor: A preliminary investigation. Child Neuropsychol 2020; 26:15-26. [PMID: 31161873 PMCID: PMC10155288 DOI: 10.1080/09297049.2019.1620715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/11/2019] [Indexed: 12/30/2022]
Abstract
Children treated for brain tumor show evidence of declines in general intellectual abilities (i.e., IQ). Group-level data indicate subtle declines over time on average, but no study has utilized a clinical criterion to identify and describe a reliable change in survivors of pediatric brain tumor (PBT). In this study, we discuss the utility of reliable change index (RCI) methodology to supplement group-level analysis (e.g., repeated measures ANOVA). This pilot sample consisted of 22 children (M age = 10.47 years) treated for PBT who completed initial and follow-up assessments (M interval = 23.58 months). Cognitive data included composite scores from the WISC-IV. An RCI z-score was calculated for each participant on each composite score based on two different test-retest reliability coefficients. As a group, survivors of PBT did not demonstrate a statistically significant change from initial to follow-up on any WISC-IV composite score. When RCI was calculated based on reliability coefficients with shorter test-retest intervals provided by the test publisher, 77% of survivors demonstrated a reliable change in performance on at least one measure. The frequency of RCI decreases in working memory was significantly higher than expected. In contrast, only 32% of survivors showed reliable changes on at least one measure when RCI was based on a reliability coefficient derived from a clinical sample with a longer retest interval. This study demonstrates that highly divergent results may be obtained with RCI and the importance of the source of reliability estimates.
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Affiliation(s)
- Thomas A. Duda
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - M. Douglas Ris
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - E. Mark Mahone
- Department of Neuropsychology, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer S. Haut
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Kimberly P. Raghubar
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
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Ventura LM, DeDios-Stern S, Oh A, Soble JR. They're not just little adults: The utility of adult performance validity measures in a mixed clinical pediatric sample. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:297-307. [PMID: 31703167 DOI: 10.1080/21622965.2019.1685522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Performance validity tests (PVTs) have become a standard part of adult neuropsychological practice; however, they are less widely used in pediatric testing. The current study aimed to obtain a better understanding of the application of PVTs within a mixed clinical pediatric sample with a wide range of diagnosis, IQ, and age. Cross-sectional data were analyzed from 130 consecutive pediatric patients evaluated as part of clinical care and diagnosed with a variety of medical/neurological, developmental, and psychiatric disorders. Patients were administered a battery of neuropsychological tests; results of intellectual functioning measures (i.e., Wechsler Intelligence Scale for Children-Fifth Edition [WISC-V] or Wechsler Adult Intelligence Scale-Fourth Edition [WAIS-IV]), and PVTs (i.e., Test of Memory Malingering [TOMM] and Digit Span [DS] subtests of the WISC-V/WAIS-IV) were analyzed to assess PVT performance across the sample as well as age- and Full-Scale IQ-related (FSIQ) effects on pass rate. Results suggested that the TOMM is an effective validity test for youth, as the TOMM adult cutoff score was also valid for children (88% pass rate on TOMM trial 1 cut-score ≥41, 71% pass rate on TOMM trial 1 cut-score ≥45). In contrast, Reliable Digit Span (RDS) was less accurate (34% failed RDS [cut-score ≤6], 54% failed RDS-r [cut-score ≤10], and 25% failed DS ACSS [cut-score ≤5]) using standard adult cutoffs. Notably, although TOMM scores were not strongly influenced by IQ, DS scores increased as IQ increased. Overall, further analysis of PVTs can champion new standards of practice through additional research establishing PVT accuracy within pediatric populations.
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Affiliation(s)
- Lea M Ventura
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Pediatrics, University of Illinois College of Medicine, Chicago, IL, USA
| | - Samantha DeDios-Stern
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Abeare CA, Messa I, Zuccato BG, Merker B, Erdodi L. Prevalence of Invalid Performance on Baseline Testing for Sport-Related Concussion by Age and Validity Indicator. JAMA Neurol 2019. [PMID: 29532050 DOI: 10.1001/jamaneurol.2018.0031] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Importance Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. Objectives To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. Design, Setting, and Participants This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Interventions Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Main Outcomes and Measures Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Results Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P < .001). Conclusions and Relevance The results for base rate of failure were surprisingly high overall and varied widely depending on the specific validity indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that the clinical interpretation and utility of baseline testing in this age group is questionable. These findings underscore the need for close scrutiny of performance validity indicators on baseline testing across age groups.
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Affiliation(s)
| | - Isabelle Messa
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Brandon G Zuccato
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Bradley Merker
- Department of Behavioral Health, Henry Ford Health System, Detroit, Michigan
| | - Laszlo Erdodi
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
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One-Minute PVT: Further Evidence for the Utility of the California Verbal Learning Test—Children’s Version Forced Choice Recognition Trial. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2018. [DOI: 10.1007/s40817-018-0057-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The present study introduces the Verbal Associated Pairs Screen (VAPS) as a new measure for assessing performance validity in pediatric populations. This study presents initial data on psychometric properties and establishes construct validity for the VAPS in a sample of 30 adolescent healthy controls and 206 youths with traumatic brain injury (TBI: moderate/severe, N = 30; mild, N = 176). The control group's age (M = 14.93, SD = 1.8) was significantly higher than the moderate/severe TBI (M = 13.9, SD = 2.8), t(68.508) = -3.038, p = .003, and mild TBI (mTBI) groups (M = 14, SD = 2.8), t(54.147) = 2.038, p = .046. The TBI groups were administered the VAPS in accord with other established performance validity tests (PVTs) and well-established memory tests as part of routine clinical evaluations. The healthy control group was administered the VAPS only. VAPS score distributions for the control group were negatively skewed and highly kurtotic. VAPS scores from the moderate/severe TBI and control groups were indistinguishable for Trial 2 (U = 274, p < .01) and the Delay (U = 396, p = .218). In the mTBI group, convergent and divergent validity was established with other well-validated PVTs and memory tests, respectively. ROC curve analyses identified optimal cutoff scores for the VAPS Total Score, with acceptable sensitivity (55%) and excellent specificity (100%), as well as strong detectability (AUC = .829, 95% CI: 0.731 - 0.928, p < .001). Clinical applications, limitations, and directions for future research with the VAPS are discussed.
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Affiliation(s)
- Jonathan Dodd
- a Department of Psychology , St. Louis Children's Hospital , St. Louis , MO , USA.,b Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA
| | - Samantha Murphy
- c Department of Psychology , University of Missouri - St. Louis , St. Louis , MO , USA
| | - Meghan Doherty
- d Department of Occupational Therapy , St. Louis Children's Hospital , St. Louis , MO , USA
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Emhoff SM, Lynch JK, McCaffrey RJ. Performance and Symptom Validity Testing in Pediatric Assessment: A Review of the Literature. Dev Neuropsychol 2018; 43:671-707. [DOI: 10.1080/87565641.2018.1525612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Stephanie M. Emhoff
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Julie K. Lynch
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
- Albany Neuropsychological Associates, Albany, New York, USA
| | - Robert J. McCaffrey
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
- Albany Neuropsychological Associates, Albany, New York, USA
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Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2018. [DOI: 10.1007/s40817-018-0056-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2018. [DOI: 10.1007/s40817-018-0058-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ryan JJ, Blacksmith JL, Kreiner DS, Glass Umfleet L. Use of the 21-Item Test with children and adolescents 5 to 16 years of age. APPLIED NEUROPSYCHOLOGY. CHILD 2018; 7:354-365. [PMID: 28707956 DOI: 10.1080/21622965.2017.1346507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goals of the present study were to: (a) collect preliminary normative data on the 21-Item Test in children and adolescents and to determine if cutoffs for biased responding in adults can be generalized to a younger population; (b) determine if Caucasian and Hispanic children perform differently on the test; and (c) ascertain the relationships of age and verbal intelligence with effort test performance. The 21-Item Test was administered to 153 children attending either a public (n = 96) or private (n = 57) school. The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was also administered to the private school sample. The results indicated that the 21-Item Test has potential as a tool for identifying children who do not put forth maximal effort during formal assessment and that the adult cutoffs appear applicable to children 8 years and older. Caucasian and Hispanic participants performed similarly on the test. Forced-choice scores ≤12 were associated with age and lower levels of performance on the Verbal Comprehension Index of the WISC-IV.
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Affiliation(s)
- Joseph J Ryan
- a Department of Psychological Science , University of Central Missouri , Warrensburg , Missouri
| | - Jennifer L Blacksmith
- a Department of Psychological Science , University of Central Missouri , Warrensburg , Missouri
| | - David S Kreiner
- a Department of Psychological Science , University of Central Missouri , Warrensburg , Missouri
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Brooks BL, Fay-McClymont TB, MacAllister WS, Vasserman M, Sherman EM. A new kid on the block: The Memory Validity Profile (MVP) in children with neurological conditions. Child Neuropsychol 2018; 25:561-572. [DOI: 10.1080/09297049.2018.1477929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Brian L. Brooks
- Neuropsychology Service, Alberta Children’s Hospital, Calgary, Canada
- Departments of Paediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Taryn B. Fay-McClymont
- Neuropsychology Service, Alberta Children’s Hospital, Calgary, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
- Department of Paediatrics, University of Calgary, Calgary, Canada
| | - William S. MacAllister
- Neuropsychology Service, Alberta Children’s Hospital, Calgary, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Marsha Vasserman
- Neuropsychology Service, Alberta Children’s Hospital, Calgary, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
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Real and virtual worlds alike: Adolescents' psychopathology is reflected in their videogame virtual behaviors. PLoS One 2017; 12:e0181209. [PMID: 28708879 PMCID: PMC5510843 DOI: 10.1371/journal.pone.0181209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/27/2017] [Indexed: 11/25/2022] Open
Abstract
Current research refers to videogames as a constant variable. However, games today are designed to be highly interactive and versatile: two players may be using the same videogame, but as a result of different using patterns, the game will not necessarily encompass the same content and gameplay. The current study examined the possible relationship between psychopathology and in-game playing patterns. We hypothesized that adolescents would play videogames differently, in a manner that would reflect their particular psychopathologies. We examined 47 male adolescents from three diagnostic groups: those suffering from externalizing psychopathologies, internalizing psychopathologies and controls. We performed a high-resolution examination of their gameplay, using in-game quantitative statistics mechanisms of two fundamentally different games, a structured racing game and an unstructured adventure game. While there was no difference in the groups' using patterns of the structured game, there was a high variability between the groups' using patterns when they were using a non-structured game. These findings suggest that virtual behavior in unstructured games is reflective of adolescent-players psychopathology, and might shed light on an unexplored facet of videogames research. Possible implications are discussed.
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28
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Lichtenstein JD, Erdodi LA, Rai JK, Mazur-Mosiewicz A, Flaro L. Wisconsin Card Sorting Test embedded validity indicators developed for adults can be extended to children. Child Neuropsychol 2016; 24:247-260. [DOI: 10.1080/09297049.2016.1259402] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jonathan D. Lichtenstein
- Department of Psychiatry, Neuropsychology Services, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Laszlo A. Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, ON, USA
| | - Jaspreet K. Rai
- Department of Psychology, Neuropsychology Track, University of Windsor, ON, USA
| | - Anya Mazur-Mosiewicz
- Department of Psychology, Chicago School of Professional Psychology, IL, USA
- Department of Psychiatry and Behavioral Science, Oklahoma State University, Tulsa, OK, USA
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Sawyer RJ, Testa SM, Dux M. Embedded performance validity tests within the Hopkins Verbal Learning Test – Revised and the Brief Visuospatial Memory Test – Revised. Clin Neuropsychol 2016; 31:207-218. [DOI: 10.1080/13854046.2016.1245787] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- R. John Sawyer
- Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
| | - S. Marc Testa
- Berman Brain and Spine Institute, Sinai Hospital, Baltimore, MD, USA
| | - Moira Dux
- Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
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Chin EY, Nelson LD, Barr WB, McCrory P, McCrea MA. Reliability and Validity of the Sport Concussion Assessment Tool-3 (SCAT3) in High School and Collegiate Athletes. Am J Sports Med 2016; 44:2276-85. [PMID: 27281276 DOI: 10.1177/0363546516648141] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Sport Concussion Assessment Tool-3 (SCAT3) facilitates sideline clinical assessments of concussed athletes. Yet, there is little published research on clinically relevant metrics for the SCAT3 as a whole. PURPOSE We documented the psychometric properties of the major SCAT3 components (symptoms, cognition, balance) and derived clinical decision criteria (ie, reliable change score cutoffs and normative conversation tables) for clinicians to apply to cases with and without available preinjury baseline data. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 2. METHODS High school and collegiate athletes (N = 2018) completed preseason baseline evaluations including the SCAT3. Re-evaluations of 166 injured athletes and 164 noninjured controls were performed within 24 hours of injury and at 8, 15, and 45 days after injury. Analyses focused on predictors of baseline performance, test-retest reliability, and sensitivity and specificity of the SCAT3 using either single postinjury cutoffs or reliable change index (RCI) criteria derived from this sample. RESULTS Athlete sex, level of competition, attention-deficit/hyperactivity disorder (ADHD), learning disability (LD), and estimated verbal intellectual ability (but not concussion history) were associated with baseline scores on ≥1 SCAT3 components (small to moderate effect sizes). Female sex, high school level of competition (vs college), and ADHD were associated with higher baseline symptom ratings (d = 0.25-0.32). Male sex, ADHD, and LD were associated with lower baseline Standardized Assessment of Concussion (SAC) scores (d = 0.28-0.68). Male sex, high school level of competition, ADHD, and LD were associated with poorer baseline Balance Error Scoring System (BESS) performance (d = 0.14-0.26). After injury, the symptom checklist manifested the largest effect size at the 24-hour assessment (d = 1.52), with group differences diminished but statistically significant at day 8 (d = 0.39) and nonsignificant at day 15. Effect sizes for the SAC and BESS were small to moderate at 24 hours (SAC: d = -0.36; modified BESS: d = 0.46; full BESS: d = 0.51) and became nonsignificant at day 8 (SAC) and day 15 (BESS). Receiver operating characteristic curve analyses demonstrated a stronger discrimination for symptoms (area under the curve [AUC] = 0.86) than cognitive and balance measures (AUCs = 0.58 and 0.62, respectively), with comparable discrimination of each SCAT3 component using postinjury scores alone versus baseline-adjusted scores (P = .71-.90). Normative conversion tables and RCI criteria were created to facilitate the use of the SCAT3 both with and without baseline test results. CONCLUSION Individual predictors should be taken into account when interpreting the SCAT3. The normative conversion tables and RCIs presented can be used to help interpret concussed athletes' performance both with and without baseline data, given the comparability of the 2 interpretative approaches.
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Affiliation(s)
- Esther Y Chin
- Alexian Brothers Neurosciences Institute, AMITA Health, Elk Grove Village/Hoffman Estates, Illinois, USA
| | - Lindsay D Nelson
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - William B Barr
- Department of Neurology, New York University School of Medicine, New York, New York, USA
| | - Paul McCrory
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Michael A McCrea
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Abstract
BACKGROUND Youth have been assumed historically to be less capable of deception than adults, even though acts of deception in childhood are not uncommon. Relatively little attention has focused on how frequently they feign or exaggerate during healthcare evaluations. PURPOSE The current article reviews the literature relevant to using validity tests in children and adolescents, as well as provides a case example of a young adolescent providing noncredible effort and exaggerated symptomatology during neuropsychological evaluation after a mild traumatic brain injury. CONCLUSION Numerous case reports and case series have documented clearly that medical and neuropsychological noncredible presentations occur in children, likely more often than many practitioners believe. Thus far, research has found that the base rates of pediatric noncredible presentations are highest in children seen frequently by rehabilitation providers (i.e., children with persistent problems after mild traumatic brain injury and children from families seeking disability benefits on their behalf). Subjective clinical judgment is apt to be ineffective in consistently detecting noncredible presentations. Fortunately, recent research supports the use of several stand-alone validity tests in identifying noncredible pediatric data including the Test of Memory Malingering, Word Memory Test, and Medical Symptom Validity Test. If feigning and exaggeration are not considered in work-ups by rehabilitation practitioners, mismanagement and iatrogenic harm to the child can result.
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Connery AK, Peterson RL, Baker DA, Kirkwood MW. The impact of pediatric neuropsychological consultation in mild traumatic brain injury: a model for providing feedback after invalid performance. Clin Neuropsychol 2016; 30:579-98. [PMID: 27142647 DOI: 10.1080/13854046.2016.1177596] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In recent years, pediatric practitioners have increasingly recognized the importance of objectively measuring performance validity during clinical assessments. Yet, no studies have examined the impact of neuropsychological consultation when invalid performance has been identified in pediatric populations and little published guidance exists for clinical management. Here we provide a conceptual model for providing feedback after noncredible performance has been detected. In a pilot study, we examine caregiver satisfaction and postconcussive symptoms following provision of this feedback for patients seen through our concussion program. METHODS Participants (N = 70) were 8-17-year-olds with a history of mild traumatic brain injury who underwent an abbreviated neuropsychological evaluation between 2 and 12 months post-injury. We examined postconcussive symptom reduction and caregiver satisfaction after neuropsychological evaluation between groups of patients who were determined to have provided noncredible effort (n = 9) and those for whom no validity concerns were present (n = 61). RESULTS We found similarly high levels of caregiver satisfaction between groups and greater reduction in self-reported symptoms after feedback was provided using the model with children with noncredible presentations compared to those with credible presentations. CONCLUSION The current study lends preliminary support to the idea that the identification and communication of invalid performance can be a beneficial clinical intervention that promotes high levels of caregiver satisfaction and a reduction in self-reported and caregiver-reported symptoms.
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Affiliation(s)
- Amy K. Connery
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
| | - Robin L. Peterson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
| | - David A. Baker
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
| | - Michael W. Kirkwood
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
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Lichtenstein JD, Erdodi LA, Linnea KS. Introducing a forced-choice recognition task to the California Verbal Learning Test – Children’s Version. Child Neuropsychol 2016; 23:284-299. [DOI: 10.1080/09297049.2015.1135422] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chafetz MD, Williams MA, Ben-Porath YS, Bianchini KJ, Boone KB, Kirkwood MW, Larrabee GJ, Ord JS. Official Position of the American Academy of Clinical Neuropsychology Social Security Administration Policy on Validity Testing: Guidance and Recommendations for Change. Clin Neuropsychol 2015; 29:723-40. [DOI: 10.1080/13854046.2015.1099738] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
BACKGROUND In clinical neuropsychological practice, assessment of response validity (e.g., effort, over-reporting, under-reporting) is an essential component of the assessment process. By contrast, other health care professionals, including those in neurorehabilitation settings, often omit assessment of this topic from their evaluations or only rely on subjective impressions. OBJECTIVE To provide the first comprehensive review of response validity assessment in the neurorehabilitation literature, including why the topic is often avoided, what methods are commonly used, and how to decrease false positives. METHODS A literature review and documentation of personal experience and perspectives was used to review this topic. RESULTS There is a well-established literature on the necessity and utility of assessing response validity, particularly in patients who have external incentives to embellish their presentation or to under-report symptoms. There are many reasons why non-neuropsychologists typically avoid assessment of this topic. This poses a significant problem, particularly when patients exaggerate or malinger, because it can lead to misdiagnosis and it risks increasing the cost of healthcare by performing unnecessary tests and treatments, unfair distribution of disability/compensation resources, and a reduced access to these and other health resources by patients who genuinely need them. CONCLUSIONS There is a significant need for non-neuropsychologists to develop and incorporate symptom and performance validity assessments in clinical evaluations, including those in neurorehabilitation settings.
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Brooks BL, Ploetz DM, Kirkwood MW. A survey of neuropsychologists’ use of validity tests with children and adolescents. Child Neuropsychol 2015; 22:1001-20. [DOI: 10.1080/09297049.2015.1075491] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lyberg-Åhlander V, Brännström KJ, Sahlén BS. On the interaction of speakers' voice quality, ambient noise and task complexity with children's listening comprehension and cognition. Front Psychol 2015; 6:871. [PMID: 26157416 PMCID: PMC4478373 DOI: 10.3389/fpsyg.2015.00871] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/12/2015] [Indexed: 11/27/2022] Open
Abstract
Suboptimal listening conditions interfere with listeners’ on-line comprehension. A degraded source signal, noise that interferes with sound transmission, and/or listeners’ cognitive or linguistic limitations are examples of adverse listening conditions. Few studies have explored the interaction of these factors in pediatric populations. Yet, they represent an increasing challenge in educational settings. We will in the following report on our research and address the effect of adverse listening conditions pertaining to speakers’ voices, background noise, and children’s cognitive capacity on listening comprehension. Results from our studies clearly indicate that children risk underachieving both in formal assessments and in noisy class-rooms when an examiner or teacher speaks with a hoarse (dysphonic) voice. This seems particularly true when task complexity is low or when a child is approaching her/his limits of mastering a comprehension task.
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Affiliation(s)
- Viveka Lyberg-Åhlander
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University Lund, Sweden
| | - K J Brännström
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University Lund, Sweden
| | - Birgitta S Sahlén
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University Lund, Sweden
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Brooks BL, Ploetz DM. Embedded Performance Validity on the CVLT-C for Youth with Neurological Disorders. Arch Clin Neuropsychol 2015; 30:200-6. [DOI: 10.1093/arclin/acv017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Holland AA, Hughes CW, Harder L, Silver C, Bowers DC, Stavinoha PL. Effect of motivation on academic fluency performance in survivors of pediatric medulloblastoma. Child Neuropsychol 2015; 22:570-86. [PMID: 25825959 DOI: 10.1080/09297049.2015.1023272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
It has been proposed previously that extrinsic motivation may enable survivors of childhood medulloblastoma to significantly improve aspects of neurocognitive performance. In healthy populations, enhanced motivation has been shown to promote academic fluency, a domain likely more relevant to the educational outcomes of pediatric medulloblastoma survivors than academic skill development. The present study investigates the effect of enhanced extrinsic motivation on fluent (i.e., accurate and efficient) academic performance in pediatric medulloblastoma survivors. Participants were 36 children, ages 7-18, who had completed treatment for medulloblastoma. Participants completed a neuropsychological battery that included administration of equivalent tasks on Forms A and B of the Woodcock-Johnson III Tests of Achievement. Half were randomly assigned to an incentive condition prior to the administration of Form B. Provision of a performance-based incentive resulted in statistically significant improvement, but not normalization of function, in performance on measures of academic fluency. No demographic, treatment-related, academic, neuropsychological, or self-perception variables predicted response to incentive. Findings suggest that academic performance of survivors may significantly improve under highly motivating conditions. In addition to implications for educational services, this finding raises the novel possibility that decreased motivation represents an inherent neuropsychological deficit in this population and provides a rationale for further investigation of factors affecting individual differences in motivational processes. Further, by examining effort in a context where effort is not inherently suspect, present findings also significantly contribute to the debate regarding the effects of effort and motivation on neuropsychological performance.
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Affiliation(s)
- Alice Ann Holland
- a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.,b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Carroll W Hughes
- b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Lana Harder
- a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.,b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Cheryl Silver
- c Department of Rehabilitation Science , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Daniel C Bowers
- d Department of Neuro-Oncology , Children's Medical Center Dallas , Dallas , TX , USA.,e Department of Pediatrics , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Peter L Stavinoha
- a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.,b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
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Gidley Larson JC, Flaro L, Peterson RL, Connery AK, Baker DA, Kirkwood MW. The Medical Symptom Validity Test Measures Effort Not Ability in Children: A Comparison Between Mild TBI and Fetal Alcohol Spectrum Disorder Samples. Arch Clin Neuropsychol 2015; 30:192-9. [DOI: 10.1093/arclin/acv012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 11/13/2022] Open
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Ploetz DM, Mazur-Mosiewicz A, Kirkwood MW, Sherman EM, Brooks BL. Performance on the Test of Memory Malingering in children with neurological conditions. Child Neuropsychol 2014; 22:133-42. [DOI: 10.1080/09297049.2014.986446] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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DeRight J, Jorgensen RS. I just want my research credit: frequency of suboptimal effort in a non-clinical healthy undergraduate sample. Clin Neuropsychol 2014; 29:101-17. [PMID: 25494327 DOI: 10.1080/13854046.2014.989267] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although performance validity testing is becoming fairly routine in clinical settings, research protocols involving neuropsychological tests infrequently include assessments of performance validity. The current study utilized an embedded measure of effort over two administrations of CNS Vital Signs to determine the frequency of poor effort in non-clinical healthy undergraduate students participating in a research study for course credit. Results indicate that more than 1 in 10 college students participating in a cognitive test battery for research showed test scores consistent with inadequate effort, which was associated with poor performance on testing across many domains. This conclusion was supported by poor performance on many other subtests. Healthy college students with suboptimal effort (n = 11) had an overall score in the 15th percentile on average compared to the 48th percentile in the rest of the students (n = 66). Those who failed validity indicators on the baseline administration were more likely to fail validity indicators on the repeat administration. Those who were tested in the morning were also more likely to fail validity indicators. The current study provides evidence for the potential limitations of conducting research using neuropsychological tests with healthy college student volunteers in the absence of performance validity testing. Revised college-level cutoffs are proposed.
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Affiliation(s)
- Jonathan DeRight
- a Department of Psychology , Syracuse University , Syracuse , NY , USA
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