A-176 Undercover Performance Validity Testing: Proposed Embedded Validity Indicators for Pediatric Neuropsychological Assessment

Abstract

Abstract Objective Literature supports the use of the Delis-Kaplan Executive Function System Trail Making Test Conditions 4/2 ratio (TMT 4/2) and Stroop Color Word Test Word Reading (WR) as embedded validity indicators (EVIs) with adults (Erdodi et al., 2018; Guise et al., 2012) and the Wechsler Abbreviated Scale of Intelligence, 2nd Edition Matrix Reasoning (MR) as an EVI with children (Sussman et al., 2017). This study assessed the utility of these measures as EVIs in healthy children, compared to the Test of Memory Malingering Trial 1 (TOMM1 < 45; Perna & Loughan, 2013) and Reliable Digit Span (RDS). Method Participants (n = 99, 68.7% male, Mage = 11.9) completed baseline neuropsychological evaluations for sport participation, including the aforementioned measures. Receiver operator characteristic curve analysis was used to determine whether TMT 4/2, MR, and WR accurately categorized valid performance. Results TMT 4/2 yielded adequate sensitivity (0.83–1.00) but poor specificity (0.07–0.09) when predicting TOMM1 and RDS pass/fail performances. MR yielded adequate sensitivity (1.00) and specificity (0.92) when predicting RDS pass/fail performance and adequate specificity (0.92) and poor sensitivity (0.18) when predicting TOMM1 pass/fail performance. The only EVI that produced better than chance accuracy was MR when predicting RDS pass/fail performance (area under the curve [AUC] = 0.98). All participants failed the WR cutoff, suggesting poor specificity. Conclusion Results suggest that MR was the only EVI that achieved minimally acceptable specificity (≥0.90) in children. MR performed adequately when detecting valid performances but variably when detecting invalid performances; therefore, MR may be used alongside well-established performance validity tests with children but not independently.