Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs
Accurate identification of symptom exaggeration is essential when determining whether or not data obtained in pediatric evaluations are valid or interpretable. Apart from using freestanding performance validity tests (PVTs), many researchers encourage use of embedded measures of test-related motivation, including the newly developed automatized sequences test (AST). Such embedded measures are based on identification of performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with pre-existing cognitive difficulties such as specific learning disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired learning of basic sequences. This study examined the specificity of the AST by reviewing performance of 83 SLD adolescents. Anywhere from 22 to 41% of SLD adolescents investing good effort failed one or more of the tasks included in the AST, and those with lower intelligence scores had higher rates of failure. Clinicians should therefore be cautious if using this PVT with individuals who have a documented history of reading, learning, or intellectual problems.
KeywordsAssessment Effort testing Performance validity Embedded measures Automatized sequences Adolescents
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Right
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- Babikian, T., & Boone, K. (2007). Intelligence tests as measures of effort. In K. Boone (Ed.), Assessment of feigned cognitive impairment: a neuropsychological perspective. New York: Guilford Press.Google Scholar
- Bush, S., Ruff, R., Troster, A., Barth, J., Koffler, S., Pliskin, N., Reynolds, C., & Silver, C. (2005). Symptom validity assessment: practice issues and medical necessity NAN policy & planning committee. Archives of Clinical Neuropsychology, 20, 419–426. https://doi.org/10.1016/j.acn.2005.02.002.CrossRefGoogle Scholar
- Flaro, L., & Boone, K. (2009). Using objective effort measures to detect noncredible cognitive test performance in children and adolescents. In J. E. Morgan & J. J. Sweet (Eds.), Neuropsychology of malingering casebook (pp. 369–376). New York: Psychology Press.Google Scholar
- Green, P. (2003). Word Memory Test for Windows: user’s manual and program. Edmonton: Green’s Publishing.Google Scholar
- Green, P. (2004). The medical symptom validity test: test manual and MS Windows computer program. Edmonton: Green’s Publishing.Google Scholar
- Green, P., & Flaro, L. (2003). Word memory test performance in children. Child Neuropsychology, 9, 189–207.Google Scholar
- Guilmette, T. J. (2013). The role of clinical judgement in symptom validity testing. In D. A. Carone & S. S. Bush (Eds.), Mild traumatic injury: symptom validity assessment and malingering (pp. 31–43). New York: Springer.Google Scholar
- Heilbronner, R. L., Sweet, J. J., Morgan, J. E., Larrabee, G. J., Millis, S. R., & Conference Participants 1. (2009). American Academy of clinical neuropsychology consensus conference statement on the neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 23(7), 1093–1129. https://doi.org/10.1080/13854040903155063.CrossRefGoogle Scholar
- Kaufman, A. S., & Kaufman, N. L. (with Breaux, K. C). (2014). Technical & interpretive manual: Kaufman Test of Educational Achievement (3rd ed.). Bloomington: NCS Pearson.Google Scholar
- Kirkwood, M. W., Hargrave, D. D., & Kirk, J. W. (2011a). The value of the WISC-IV digit span subtest in detecting noncredible performance during pediatric neuropsychological examinations. Archives of Clinical Neuropsychology, 26(5), 377–384. https://doi.org/10.1093/arclin/acr040.CrossRefGoogle Scholar
- Kirkwood, M.W., Yeates, K.O., Randolph, C., & Kirk, J.W. (2011b). The implications of symptom validity test failure for ability-based test performance in a pediatric sample. Psychological Assessment. Advance online publication. https://doi.org/10.1037/a0024628.
- Kirkwood, M. W., Connery, A. K., Kirk, J. W., & Baker, D. A. (2014). Detecting performance invalidity in children: Not quite as easy as A, B, C, 1, 2, 3 but automatized sequences appears promising. Child Neuropsychology, 20, 245–252. https://doi.org/10.1080/09297049.2012.759553.CrossRefGoogle Scholar
- Martin, P., Schroeder, R., & Odland, A. (2015). Neuropsychologists’ validity testing beliefs and practices: a survey of North American professionals. Online first. https://doi.org/10.1080/13854046.2015.1087597
- McCaffrey, R. J., & Lynch, J. K. (2009). Malingering following documented brain injury: neuropsychological evaluation of children in a forensic setting. In J. E. Morgan & J. J. Sweet (Eds.), Neuropsychology of malingering casebook (pp. 377–385). New York: Psychology Press.Google Scholar
- Salekin, R. T., Kubak, F. A., & Lee, Z. (2007). Deception in children and adolescents. In R. Rogers (Ed.), Clinical assessment of malingering and deception (3rd ed., pp. 343–364). New York: Guilford.Google Scholar
- Schrank, F. A., McGrew, K. S., & Mather, N. (2014). Woodcock-Johnson IV. Rolling Meadows: Riverside.Google Scholar
- Torgesen, J. K., Wagner, R. K., & Rashotte, C. A. (2012). Test of word Reading efficiency–second edition (TOWRE-2). Austin: Pro Ed.Google Scholar
- Wagner, R., Torgesen, J., & Rashotte, C. (1999). Comprehensive test of phonological processing. Austin: Pro-Ed.Google Scholar
- Wechsler, D. (2003). Wechsler intelligence scale for children–fourth edition: American manual. San Antonio: The Psychological Corporation.Google Scholar