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Embedded performance validity indicators within the California Verbal Learning Test, Children's Version.

David A Baker1, Amy K Connery, John W Kirk

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Area of Science:

  • Neuropsychology
  • Pediatric Psychology
  • Traumatology

Background:

  • Limited research exists on performance validity indicators in pediatric populations.
  • Mild traumatic brain injury (mTBI) in children can impact cognitive functioning.
  • Assessing genuine effort is crucial for accurate diagnosis and treatment planning in pediatric mTBI.

Purpose of the Study:

  • To evaluate the effectiveness of embedded validity indicators within the California Verbal Learning Test, Children's Version (CVLT-C).
  • To identify noncredible effort in a pediatric sample with mild traumatic brain injury (mTBI).
  • To determine which CVLT-C variables best predict inadequate effort.

Main Methods:

  • A sample of 411 clinically referred pediatric patients (ages 8-16) with mTBI was analyzed.
  • Performance validity was assessed using the Medical Symptom Validity Test and other measures.
  • Logistic regression was employed to identify predictors of noncredible effort on the CVLT-C.

Main Results:

  • 13% of participants demonstrated noncredible effort.
  • The noncredible effort group showed significantly poorer performance on most CVLT-C variables.
  • The Recognition Discriminability (RD) score was the strongest predictor of noncredible effort.

Conclusions:

  • The CVLT-C Recognition Discriminability (RD) score shows utility in detecting noncredible effort in pediatric mTBI.
  • An RD cutoff z-score of -0.5 yielded 55% sensitivity and 91% specificity.
  • A more conservative RD cutoff z-score of -1.0 yielded 41% sensitivity and 97% specificity, comparable to adult studies.