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Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest

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Abstract

Background

Neuropsychological assessment must include determinants of validity. This study sought to develop an embedded performance validity indicator for the Child and Adolescent Memory Profile (ChAMP) Lists verbal memory subtest.

Methods

Children and adolescents (N = 103; mean age = 14.6 years, SD = 2.4, range = 8–18) who were on average 25 weeks (SD = 15.1) post-traumatic brain injury (TBI; 85% mild and 15% moderate-severe) were administered ChAMP Lists and two stand-alone performance validity tests (PVTs; Test of Memory Malingering; Medical Symptom Validity Test). Nineteen patients were deemed to have invalid performance defined as failure on both PVTs. Binary logistic regression and classification statistics were used to determine a cutoff score for invalid performance on ChAMP Lists using failure on two PVTs as the criterion.

Results

Invalid performance was not associated with demographics, injury type, or time since injury, but was significantly correlated with ChAMP Lists scaled scores. Only ChAMP Lists Recognition predicted validity grouping and had excellent discrimination (area under the curve of 93%). A cutoff scaled score of 7 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 79% while maintaining specificity at 91%. A more stringent cutoff score of 5 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 63% with specificity at 95%.

Conclusion

This study yields a promising embedded performance validity indicator for ChAMP Lists Recognition with good sensitivity and excellent specificity for detecting invalid performance in youth with TBI.

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References

  • Baker, D. A., Connery, A. K., Kirk, J. W., & Kirkwood, M. W. (2014). Embedded performance validity indicators within the California Verbal Learning Test, Children’s version. The Clinical Neuropsychologist, 28(1), 116–127.

    Article  PubMed  Google Scholar 

  • Boone, K. B. (2009). The need for continuous and comprehensive sampling of effort/response bias during neuropsychological examinations. The Clinical Neuropsychologist, 23(4), 729–741.

    Article  PubMed  Google Scholar 

  • Brooks, B. L. (2012). Victoria symptom validity test performance in children and adolescents with neurological disorders. Archives of Clinical Neuropsychology, 27(8), 858–868.

    Article  PubMed  Google Scholar 

  • Brooks, B. L. (2016). Validity testing during pediatric clinical neuropsychological evaluations with medical populations. In M. W. Kirkwood (Ed.), Validity testing in child and adolescent assessment: Evaluating exaggeration, feigning, and noncredible effort. New York: Guilford Press.

    Google Scholar 

  • Brooks, B. L., & Ploetz, D. M. (2015). Embedded performance validity on the CVLT-C for youth with neurological disorders. Archives of Clinical Neuropsychology, 30(3), 200–206.

    Article  PubMed  Google Scholar 

  • Brooks, B. L., Sherman, E. M., & Krol, A. L. (2012). Utility of TOMM trial 1 as an indicator of effort in children and adolescents. Archives of Clinical Neuropsychology, 27(1), 23–29.

    Article  PubMed  Google Scholar 

  • Brooks, B. L., Sherman, E. M., & Iverson, G. L. (2014). Embedded validity indicators on CNS vital signs in youth with neurological diagnoses. Archives of Clinical Neuropsychology, 29(5), 422–431.

    Article  PubMed  Google Scholar 

  • Brooks, B. L., Ploetz, D. M., & Kirkwood, M. W. (2016). A survey of neuropsychologists’ use of validity tests with children and adolescents. Child Neuropsychology, 22(8), 1001–1020.

    Article  PubMed  Google Scholar 

  • Bush, S. S., Ruff, R. M., Troster, A. I., Barth, J. T., Koffler, S. P., & Pliskin, N. H. (2005). Symptom validity assessment: Practice issues and medical necessity NAN policy & planning committee. Archives of Clinical Neuropsychology, 20(4), 419–426.

    Article  PubMed  Google Scholar 

  • Carone, D. A. (2014). Young child with severe brain volume loss easily passes the word memory test and medical symptom validity test: Implications for mild TBI. The Clinical Neuropsychologist, 28(1), 146–162.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. (2003). Report to congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta, GA: Centers for Disease Control and Prevention.

    Google Scholar 

  • Cohen, M. J. (1997). Children’s memory scale. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Courtney, J. C., Dinkins, J. P., Allen 3rd, L. M., & Kuroski, K. (2003). Age related effects in children taking the computerized assessment of response bias and word memory test. Child Neuropsychology, 9(2), 109–116.

    Article  PubMed  Google Scholar 

  • Delis, D. C., Kramer, J. H., Kaplan, E., & Ober, B. A. (1994). California verbal learning test-children’s version. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Delis, D. C., Kramer, J. H., Kaplan, E., & Ober, B. A. (2000). California verbal learning test (2nd ed.). San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • DeRight, J., & Carone, D. A. (2015). Assessment of effort in children: a systematic review. Child Neuropsychology, 21(1), 1–24.

    Article  PubMed  Google Scholar 

  • Donders, J. (2005). Performance on the test of memory malingering in a mixed pediatric sample. Child Neuropsychology, 11(2), 221–227.

    Article  PubMed  Google Scholar 

  • Green, P. (2004). Manual for Green’s medical symptom validity test (MSVT). Edmonton, AB: Green’s Publishing Inc.

  • Green, P., & Flaro, L. (2003). Word memory test performance in children. Child Neuropsychology, 9(3), 189–207.

    Article  PubMed  Google Scholar 

  • Green, P., Flaro, L., Brockhaus, R., & Montijo, J. (2012). Performance on the WMT, MSVT, & NV-MSVT in children with developmental disabilities and in adults with mild traumatic brain injury. In C. R. Reynolds & A. Horton (Eds.), Detection of malingering during head injury litigation (2nd ed., pp. 201–220). New York: Plenum Press.

    Chapter  Google Scholar 

  • Green, C. M., Kirk, J. W., Connery, A. K., Baker, D. A., & Kirkwood, M. W. (2014). The use of the Rey 15-item test and recognition trial to evaluate noncredible effort after pediatric mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 36(3), 261–267.

    Article  PubMed  Google Scholar 

  • Heilbronner, R. L., Sweet, J. J., Morgan, J. E., Larrabee, G. J., & Millis, S. R. (2009). American Academy of Clinical Neuropsychology Consensus Conference Statement on the neuropsychological assessment of effort, response bias, and malingering. Clinical Neuropsychology, 23(7), 1093–1129.

    Article  Google Scholar 

  • IBM Corporation. (2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk, N.Y.

  • Kirk, J. W., Harris, B., Hutaff-Lee, C. F., Koelemay, S. W., Dinkins, J. P., & Kirkwood, M. W. (2011). Performance on the test of memory malingering (TOMM) among a large clinic-referred pediatric sample. Child Neuropsychology, 17(3), 242–254.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W. (Ed.). (2016). Validity testing in child and adolescent assessment: evaluating exaggeration, feigning, and noncredible effort. New York: Guilford Press.

    Google Scholar 

  • Kirkwood, M. W., & Kirk, J. W. (2010). The base rate of suboptimal effort in a pediatric mild TBI sample: performance on the medical symptom validity test. The Clinical Neuropsychologist, 24(5), 860–872.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W., Kirk, J. W., Blaha, R. Z., & Wilson, P. (2010). Noncredible effort during pediatric neuropsychological exam: a case series and literature review. Child Neuropsychology, 16, 604–618.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W., Hargrave, D. D., & Kirk, J. W. (2011). 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.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W., Connery, A. K., Kirk, J. W., & Baker, D. A. (2014a). Detecting performance invalidity in children: not quite as easy as A, B, C, 1, 2, 3 but automatized sequences appears promising. Child Neuropsychology, 20(2), 245–252.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W., Peterson, R. L., Connery, A. K., Baker, D. A., & Grubenhoff, J. A. (2014b). Postconcussive symptom exaggeration after pediatric mild traumatic brain injury. Pediatrics, 133(4), 643–650.

    Article  PubMed  Google Scholar 

  • Larrabee, G. J. (2003). Detecting of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17(3), 410–425.

    Article  PubMed  Google Scholar 

  • Lichtenstein, J. D., Erdodi, L. A., & Linnea, K. S. (2017). Introducing a forced-choice recognition task to the California Verbal Learning Test - children's version. Child Neuropsychology, 23(3), 284–299.

    Article  PubMed  Google Scholar 

  • Lichtenstein, J. D., Erdodi, L. A., Rai, J. K., Mazur-Mosiewicz, A., & Flaro, L. (2018). Wisconsin card sorting test embedded validity indicators developed for adults can be extended to children. Child Neuropsychology, 24(2), 247–260.

    Article  PubMed  Google Scholar 

  • Loughan, A. R., & Perna, R. (2014). Performance and specificity rates in the test of memory malingering: an investigation into pediatric clinical populations. Applied Neuropsychology: Child, 3(1), 26–30.

    Article  Google Scholar 

  • Loughan, A. R., Perna, R., & Hertza, J. (2012). The value of the wechsler intelligence scale for children-fourth edition digit span as an embedded measure of effort: an investigation into children with dual diagnoses. Archives of Clinical Neuropsychology, 27(7), 716–724.

    Article  PubMed  Google Scholar 

  • Loughan, A., Perna, R., Le, J., & Hertza, J. (2014). Abbreviating the test of memory malingering: TOMM trial 1 in children with ADHD. Archives of Clinical Neuropsychology, 29(6), 605–606.

    Article  Google Scholar 

  • Loughan, A. R., Perna, R., & Le, J. (2016). Test of memory malingering with children: the utility of trial 1 and TOMMe10 as screeners of test validity. Child Neuropsychology, 22(6), 707–717.

    Article  PubMed  Google Scholar 

  • MacAllister, W. S., Nakhutina, L., Bender, H. A., Karantzoulis, S., & Carlson, C. (2009). Assessing effort during neuropsychological evaluation with the TOMM in children and adolescents with epilepsy. Child Neuropsychology, 15(6), 521–531.

    Article  PubMed  Google Scholar 

  • Perna, R. B., & Loughan, A. R. (2013). Children and the test of memory malingering: is one trial enough? Child Neuropsychology, 19(4), 438–447.

    Article  PubMed  Google Scholar 

  • Perna, R., & Loughan, A. R. (2014). The influence of effort on neuropsychological performance in children: is performance on the TOMM indicative of neuropsychological ability? Applied Neuropsychology: Child, 3(1), 31–37.

    Article  Google Scholar 

  • Perna, R., Loughan, A. R., Hertza, J., & Segraves, K. (2014). The value of embedded measures in detecting suboptimal effort in children: an investigation into the WISC-IV digit span and CMS verbal memory subtests. Applied Neuropsychology: Child, 3(1), 45–51.

    Article  Google Scholar 

  • Ploetz, D., Mazur-Mosiewicz, A., Kirkwood, M. W., Sherman, E. M. S., & Brooks, B. L. (2016). Performance on the test of memory malingering in children with neurological conditions. Child Neuropsychology, 22(2), 133–142.

    Article  PubMed  Google Scholar 

  • Rambo, P. L., Callahan, J. L., Hogan, L. R., Hullmann, S., & Wrape, E. (2015). Effort testing in children: can cognitive and symptom validity measures differentiate malingered performances? Applied Neuropsychology: Child, 4(1), 1–8.

    Article  Google Scholar 

  • Ryan, J. J., Blacksmith, J. L., Kreiner, D. S., & Glass Umfleet, L. (2017). Use of the 21-item test with children and adolescents 5 to 16 years of age. Applied Neuropsychology: Child, 1–12.

  • Schwartz, E. S., Erdodi, L., Rodriguez, N., Ghosh, J. J., Curtain, J. R., & Flashman, L. A. (2016). CVLT-II forced choice recognition trial as an embedded validity Indicator: a systematic review of the evidence. Journal of the International Neuropsychological Society, 22(8), 851–858.

    Article  PubMed  Google Scholar 

  • Shay, N., & Holder, C. (2017). Validation of the MVP in an epileptic population. Archives of Clinical Neuropsychology, 32(6), 656–666.

    Article  Google Scholar 

  • Sherman, E. M. S., & Brooks, B. L. (2015). Child and adolescent memory profile (ChAMP). Lutz, FL: Psychological Assessment Resources, Inc..

    Google Scholar 

  • Slick, D. J., & Sherman, E. M. S. (2012). Differential diagnosis of malingering and related clinical presentations. In E. M. S. Sherman & B. L. Brooks (Eds.), Pediatric forensic neuropsychology (pp. 113–135). New York: Oxford University Press.

    Google Scholar 

  • Soble, J. R., Osborn, K. E., Mattingly, M. L., Vale, F. L., Benbadis, S. R., & Rodgers-Neame, N. T. (2016). Utility of Green’s word memory test free recall subtest as a measure of verbal memory: initial evidence from a temporal lobe epilepsy clinical sample. Archives of Clinical Neuropsychology, 31(1), 79–87.

    Article  PubMed  Google Scholar 

  • Sussman, Z. W., Peterson, R. L., Connery, A. K., Baker, D. A., & Kirkwood, M. W. (2017). Utility of matrix reasoning as an embedded performance validity indicator in pediatric mild traumatic brain injury. Appl Neuropsychol Child, 1–6.

  • Tombaugh, T. (1996). Test of memory of malingering (TOMM). North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Victor, T. L., Boone, K. B., Serpa, J. G., Buehler, M. A., & Ziegler, E. A. (2009). Interpreting the meaning of multiple symptom validity test failure. The Clinical Neuropsychologist, 23, 297–313.

    Article  PubMed  Google Scholar 

  • Welsh, A. J., Bender, H. A., Whitman, L. A., Vasserman, M., & MacAllister, W. S. (2012). Clinical utility of reliable digit span in assessing effort in children and adolescents with epilepsy. Archives of Clinical Neuropsychology, 27(7), 735–741.

    Article  PubMed  Google Scholar 

  • Wolfe, P. L., Millis, S. R., Hanks, R., Fichtenberg, N., Larrabee, G. J., & Sweet, J. J. (2010). Effort indicators within the California Verbal Learning Test-II (CVLT-II). The Clinical Neuropsychologist, 24(1), 153–168.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank all of those who helped collect, enter, and maintain these data in the BrainChild database, including (alphabetically) Kalina Askin, Christina Bigras, Dominique Bonneville, Shauna Bulman, Dr. Helen Carlson, Hussain Daya, Andrea Jubinville, Christianne Laliberté-Durish, Shelby MacPhail, Lonna Mitchell, Carlie Montpetit, Jasmine Santos, Emily Tam, Shane Virani, and Nikola Zivanovic. Thanks to the families who agreed to participate in our research.

Funding

The BrainChild database was supported by funding from the Kinsmen Chair of Pediatric Neurosciences, the ACHRI Neurotrauma Fund, and the ACH Neurosciences Program (Conny Betuzzi). Brian Brooks acknowledges salary funding from the Canadian Institutes for Health Research (CIHR) Embedded Clinician Researcher Salary Award.

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Authors and Affiliations

  1. Neuropsychology Service, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada

    Brian L. Brooks & William S. MacAllister

  2. Departments of Paediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Canada

    Brian L. Brooks

  3. Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada

    Brian L. Brooks & William S. MacAllister

  4. Faculty Saint-Jean, University of Alberta, Edmonton, Alberta, Canada

    Vickie Plourde

  5. Copeman Healthcare Centre, Calgary, Alberta, Canada

    Elisabeth M. S. Sherman

Authors
  1. Brian L. Brooks
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  2. Vickie Plourde
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  3. William S. MacAllister
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  4. Elisabeth M. S. Sherman
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Corresponding author

Correspondence to Brian L. Brooks.

Ethics declarations

Informed consent was obtained from the guardian(s) of all participants included in the study.

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.

Conflict of Interest

Brian Brooks and Elisabeth Sherman receive royalties for the sales of the Pediatric Forensic Neuropsychology textbook (2012, Oxford University Press) and three pediatric neuropsychological tests [Child and Adolescent Memory Profile (ChAMP, Sherman and Brooks, 2015, PAR Inc.), Memory Validity Profile (MVP, Sherman and Brooks, 2015, PAR Inc.), and Multidimensional Everyday Memory Ratings for Youth (MEMRY, Sherman and Brooks, 2017, PAR Inc.)]. Vickie Plourde and William MacAllister do not report a conflict of interest.

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Brooks, B.L., Plourde, V., MacAllister, W.S. et al. Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest. J Pediatr Neuropsychol 4, 105–112 (2018). https://doi.org/10.1007/s40817-018-0056-5

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  • DOI: https://doi.org/10.1007/s40817-018-0056-5

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