Effort Testing in Children: Can Cognitive and Symptom Validity Measures Differentiate Malingered Performances?

Abstract

Recent efforts have contributed to significant advances in the detection of malingered performances in adults during cognitive assessment. However, children's ability to purposefully underperform has received relatively little attention. The purpose of the present investigation was to examine children's performances on common intellectual measures, as well as two symptom validity measures: the Test of Memory Malingering and the Dot-Counting Test. This was accomplished through the administration of measures to children ages 6 to 12 years old in randomly assigned full-effort (control) and poor-effort (treatment) conditions. Prior to randomization, children's general intellectual functioning (i.e., IQ) was estimated via administration of the Kaufman Brief Intellectual Battery-Second Edition (KBIT-2). Multivariate analyses revealed that the conditions significantly differed on some but not all administered measures. Specifically, children's estimated IQ in the treatment condition significantly differed from the full-effort IQ initially obtained from the same children on the KBIT-2, as well as from the IQs obtained in the full-effort control condition. These findings suggest that children are fully capable of willfully underperforming during cognitive testing; however, consistent with prior investigations, some measures evidence greater sensitivity than others in evaluating effort.

Theories and measurement of intelligence.

“…Despite the potential of the TOMM, most studies examining the classification accuracy of the TOMM included only persons with ID functioning at the highest levels (often referred to as being in the mild range; Love et al, 2014). Furthermore, although Rambo et al (2015) have demonstrated the potential of the TOMM to identify children as young as age 6 who have been instructed to malinger, the test was not designed for children and adolescents nor has it been evaluated extensively with clinical populations (including those with ID) across that age range.…”