Simulation of dyslexia. How literacy and cognitive skills can help distinguish college students with dyslexia from malingerers.

Madelon Van Den Boer,Elise H De Bree,Peter F De Jong,Laszlo A Erdodi

doi:10.1371/journal.pone.0196903

Abstract

Academic accommodations associated with a diagnosis of dyslexia might be incentives for college students without reading or spelling difficulties to feign dyslexia and obtain the diagnosis unfairly. In the current study we examined malingering practices by comparing the performance of college students instructed to malinger dyslexia (n = 28) to that of students actually diagnosed with dyslexia (n = 16). We also included a control group of students without reading and spelling difficulties (n = 28). The test battery included tasks tapping literacy skills as well as underlying cognitive skills associated with literacy outcomes. These tasks are commonly used in diagnosing dyslexia. We examined patterns in the performance of malingerers across tasks and tested whether malingerers could be identified based on their performance on a limited number of tasks. Results indicated that malingerers scored significantly lower than students with dyslexia on reading and spelling skills; i.e., the core characteristics of dyslexia. Especially reading performance was extremely low and not in line with students’ age and level of education. Findings for underlying cognitive skills were mixed. Overall, malingerers scored lower than students with dyslexia on tasks tapping mainly speed, whereas the two groups did not differ on tasks reflecting mainly accuracy. Based on word and pseudoword reading and letter and digit naming, the three groups could be distinguished with reasonable sensitivity and specificity. In all, results indicate that college students seem to understand on which tasks they should feign dyslexia, but tend to exaggerate difficulties on these tasks to the point where diagnosticians should mistrust performance.

Highlights

For college students with dyslexia, academic accommodations are often available to compensate the effect their reading and spelling difficulties might have on academic learning
The availability of academic accommodations based on a diagnosis of dyslexia might evoke students to simulate the symptoms of dyslexia in the absence of true reading or spelling difficulties
In order to better understand potential malingering strategies, we examined whether students can simulate dyslexia

Summary

Introduction

For college students with dyslexia, academic accommodations are often available to compensate the effect their reading and spelling difficulties might have on academic learning. These accommodations are necessary for students diagnosed with dyslexia, and appeal to students who do not experience reading or spelling difficulties. Word reading fluency: Word reading fluency was assessed with the One Minute Test [39] This test is often used as a measure of decoding abilities, both in schools and in diagnosing dyslexia. Participants were asked to read aloud a list of 116 words of increasing difficulty. They were asked to read as quickly and accurately as possible for 1 minute. Test-retest reliability is between .89 and .92 [39]

Objectives

Methods

Results

Conclusion