Abstract
Rationale
The Test of Memory Malingering (TOMM) is a commonly utilized performance validity test currently recommended for pediatric use with children as young as 5 years of age. Yet, a small sample of children struggles to pass the TOMM due to true cognitive difficulties. The systematic search and review identified the reported cases of false positive and overall failing TOMM performance in children. The goal of this project was to increase the understanding of the cognitive constructs and minimum cognitive abilities necessary for children to pass the TOMM. The secondary goal was to use the existing data to suggest clinical guidelines related to use of the TOMM with children.
Methods and Results
A comprehensive search of PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO was conducted, returning an initial 12,052 results. After duplicate articles were removed, 10,583 remained; 61 were evaluated for eligibility and 22 were included as our final sample. Results suggested that false positives were observed in children with low IQ, memory issues, complex medical presentation, and younger children.
Conclusions
Without relevant, quality validation and normative studies, the TOMM should not be used clinically with young children or children suspected of having significant cognitive issues. Failing performance on the TOMM does not necessarily indicate poor effort or invalidate the neuropsychological profile. Instead, it may be reflective of other factors, particularly in children below age 6, children with lower intellectual abilities (especially FSIQ ≤ 75), children with multiple diagnoses, or children with more severe neurological diagnoses. Clinical recommendations are also discussed.
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References
Batt, K., Shores, E. A., & Chekaluk, E. (2008). The effect of distraction on the Word Memory Test and Test of Memory Malingering performance in patients with a severe brain injury. Journal of the International Neuropsychological Society, 14(6), 1074–1080. https://doi.org/10.1017/S135561770808137X.
Bauer, L., & McCaffrey, R. J. (2006). Coverage of the Test of Memory Malingering, Victoria Symptom Validity Test, and Word Memory Test on the Internet: is test security threatened? Archives of Clinical Neuropsychology, 21(1), 121–126. https://doi.org/10.1016/j.acn.2005.06.010.
Blaskewitz, N., Merten, T., & Kathmann, N. (2008). Performance of children on symptom validity tests: TOMM, MSVT, and FIT. Archives of Clinical Neuropsychology, 23(4), 379–391. https://doi.org/10.1016/j.acn.2008.01.008.
Brooks, B. L. (2012). Victoria Symptom Validity Test performance in children and adolescents with neurological disorders. Archives of Clinical Neuropsychology, 27(8), 858–868. https://doi.org/10.1093/arclin/acs087.
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. https://doi.org/10.1093/arclin/acr086.
Chafetz, M. D. (2008). Malingering on the social security disability consultative exam: predictors and base rates. The Clinical Neuropsychologist, 22(3), 529–546. https://doi.org/10.1080/13854040701346104.
Constantinou, M., & McCaffrey, R. J. (2003). Using the TOMM for evaluating children’s effort to perform optimally on neuropsychological measures. Child Neuropsychology, 9(2), 81–90. https://doi.org/10.1076/chin.9.2.81.14505.
Donders, J. (2005). Performance on the test of memory malingering in a mixed pediatric sample. Child Neuropsychology, 11(2), 221–227. https://doi.org/10.1080/09297040490917298.
Eglit, G. M., Lynch, J. K., & McCaffrey, R. J. (2017). Not all performance validity tests are created equal: the role of recollection and familiarity in the Test of Memory Malingering and Word Memory Test. Journal of Clinical and Experimental Neuropsychology, 39(2), 173–189. https://doi.org/10.1080/13803395.2016.1210573.
Gast, J. H., & Hart, K. J. (2010). The performance of juvenile offenders on the Test of Memory Malingering. The Performance of Juvenile Offenderson the Test of Memory Malingering, 10(1), 53–68. https://doi.org/10.1080/15228930903173062.
Gervais, R. O., Rohling, M. L., Green, P., & Ford, W. (2004). A comparison of WMT, CARB, and TOMM failure rates in non-head injury disability claimants. Archives of Clinical Neuropsychology, 19(4), 475–487. https://doi.org/10.1016/j.acn.2003.05.001.
Gunn, D., Batchelor, J., & Jones, M. (2010). Detection of simulated memory impairment in 6- to 11-year-old children. Child Neuropsychol, 16(2), 105–118. https://doi.org/10.1080/09297040903352564
Hilsabeck, R. C., Gordon, S. N., Hietpas-Wilson, T., & Zartman, A. L. (2011). Use of Trial 1 of the Test of Memory Malingering (TOMM) as a screening measure of effort: suggested discontinuation rules. The Clinical Neuropsychologist, 25(7), 1228–1238. https://doi.org/10.1080/13854046.2011.589409.
Hunt, S., Root, J. C., & Bascetta, B. L. (2014). Effort testing in schizophrenia and schizoaffective disorder: validity indicator profile and test of memory malingering performance characteristics. Archives of Clinical Neuropsychology, 29(2), 164–172. https://doi.org/10.1093/arclin/act069.
Iverson, G. L., Le Page, J., Koehler, B. E., Shojania, K., & Badii, M. (2007). Test of Memory Malingering (TOMM) scores are not affected by chronic pain or depression in patients with fibromyalgia. The Clinical Neuropsychologist, 21(3), 532–546. https://doi.org/10.1080/13854040600611392.
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. https://doi.org/10.1080/09297049.2010.533166.
Leclercq, E., Leflang, M. M., van Dalen, E. C, and Kremer, L. C. (2013). Validation of search filters for identifying pediatric studies in PubMed. Journal of Pediatrics 162(3), 629–634. https://doi.org/10.1016/j.jpeds.2012.09.012
Lezak, M. D. (2012). Neuropsychological assessment (5th ed.). Oxford: Oxford University Press.
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. https://doi.org/10.1093/arclin/acs072.
Loughan, A. R., & Perna, R. (2014). Performance and specificity rates in the Test of Memory Malingering: an investigation into pediatric clinical populations. Appl Neuropsychol Child, 3(1), 26–30. https://doi.org/10.1080/21622965.2012.670584
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. https://doi.org/10.1080/09297049.2015.1020774.
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. https://doi.org/10.1080/09297040902748226.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology, 62(10), 1006–1012. https://doi.org/10.1016/j.jclinepi.2009.06.005.
Mossman, D., Wygant, D. B., Gervais, R. O., & Hart, K. J. (2017). Trial 1 versus Trial 2 of the Test of Memory Malingering: evaluating accuracy without a “gold standard”. Psychological Assessment. https://doi.org/10.1037/pas0000449.
Nagle, A. M., Everhart, D. E., Durham, T. W., McCammon, S. L., & Walker, M. (2006). Deception strategies in children: examination of forced choice recognition and verbal learning and memory techniques. Archives of Clinical Neuropsychology, 21(8), 777–785. https://doi.org/10.1016/j.acn.2006.06.011.
Nijdam-Jones, A., Rivera, D., Rosenfeld, B., & Arango-Lasprilla, J. C. (2017). A cross-cultural analysis of the Test of Memory Malingering among Latin American Spanish-speaking adults. Law and Human Behavior, 41(5), 422–428. https://doi.org/10.1037/lhb0000250.
O'Bryant, S. E., Engel, L. R., Kleiner, J. S., Vasterling, J. J., & Black, F. W. (2007). Test of memory malingering (TOMM) trial 1 as a screening measure for insufficient effort. The Clinical Neuropsychologist, 21(3), 511–521. https://doi.org/10.1080/13854040600611368.
Perna, R. B., & Loughan, A. R. (2013). Children and the test of memory malingering: is one trial enough? Child Neuropsychology, 19(4), 438–447. https://doi.org/10.1080/09297049.2012.731500.
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. https://doi.org/10.1080/21622965.2012.686339.
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. https://doi.org/10.1080/21622965.2012.691067.
Ploetz, D. M., Mazur-Mosiewicz, A., Kirkwood, M. W., Sherman, E. M., & Brooks, B. L. (2016). Performance on the Test of Memory Malingering in children with neurological conditions. Child Neuropsychology, 22(2), 133–142. https://doi.org/10.1080/09297049.2014.986446.
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. https://doi.org/10.1080/21622965.2013.780238.
Rees, L. M., Tombaugh, T. N., & Boulay, L. (2001). Depression and the Test of Memory Malingering. Archives of Clinical Neuropsychology, 16(5), 501–506.
Rienstra, A., Spaan, P. E., & Schmand, B. (2010). Validation of symptom validity tests using a “child-model” of adult cognitive impairments. Arch Clin Neuropsychol, 25(5), 371–382. https://doi.org/10.1093/arclin/acq035
Rivera, D., Perrin, P. B., Weiler, G., Ocampo-Barba, N., Aliaga, A., Rodriguez, W., et al. (2015). Test of Memory Malingering (TOMM): normative data for the Latin American Spanish speaking adult population. NeuroRehabilitation, 37(4), 719–735. https://doi.org/10.3233/NRE-151287.
Rogers, R., Sewell, K. W., & Gillard, N. D. (2010). Structured interview of reported symptoms professional manual, 2nd. Odessa: Psychological Assessment Resources.
Schneider, H. E., Kirk, J. W., & Mahone, E. M. (2014). Utility of the test of memory malingering (TOMM) in children ages 4–7 years with and without ADHD. The Clinical Neuropsychologist, 28(7), 1133–1145. https://doi.org/10.1080/13854046.2014.960004.
Sherman, E. M. S., & Brooks, B. L. (2011). Pediatric forensic neuropsychology. Oxford: Oxford University Press.
Sherman, E. M. S., & Brooks, B. L. (2015). Memory Validity Profile (MVP). Lutz: Psychological Assessment Resources, Inc..
Slick, D. J., Hopp, G., Strauss, E., & Spellacy, F. J. (1996). Victoria Symptom Validity Test: efficiency for detecting feigned memory impairment and relationship to neuropsychological tests and MMPI-2 validity scales. J Clin Exp Neuropsychol, 18(6), 911–922. https://doi.org/10.1080/01688639608408313.
Strauss, E., Sherman, E. M. S., Spreen, O., & Spreen, O. (2006). A compendium of neuropsychological tests: administration, norms, and commentary (3rd ed.). Oxford: Oxford University Press.
Sweet, J. J., Benson, L. M., Nelson, N. W., & Moberg, P. J. (2015). The American Academy of Clinical Neuropsychology, National Academy of Neuropsychology, and Society for Clinical Neuropsychology (APA Division 40) 2015 TCN Professional Practice and ‘Salary Survey’: professional practices, beliefs, and incomes of U.S. neuropsychologists. The Clinical Neuropsychologist, 29(8), 1069–1162. https://doi.org/10.1080/13854046.2016.1140228.
Teichner, G., & Wagner, M. T. (2004). The Test of Memory Malingering (TOMM): normative data from cognitively intact, cognitively impaired, and elderly patients with dementia. Archives of Clinical Neuropsychology, 19(3), 455–464. https://doi.org/10.1016/S0887-6177(03)00078-7.
Tombaugh, T. N. (1996). Test of Memory Malingering North Tonawanda. New York: Multi-Helath Systems Inc.
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. https://doi.org/10.1093/arclin/acs063.
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Mazur-Mosiewicz, A., Ford, A.I., Chapman, W.D. et al. Why Children Fail the Test of Memory Malingering: Review of False Positive Performance in Pediatric Studies. J Pediatr Neuropsychol 4, 113–126 (2018). https://doi.org/10.1007/s40817-018-0059-2
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DOI: https://doi.org/10.1007/s40817-018-0059-2