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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
1a Department of Physical Medicine & Rehabilitation , University of Colorado Denver School of Medicine and Children's Hospital Colorado , Aurora , CO , USA.
Insights
The California Verbal Learning Test, Children
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.
Abstract:
To date, few studies have examined the use of embedded performance validity indicators in pediatric populations. The present study examined the utility of variables within the California Verbal Learning Test, Children's Version (CVLT-C) in detecting noncredible effort among a pediatric mild traumatic brain injury sample. The sample consisted of 411 clinically referred patients aged 8-16 years. A total of 13% of the participants failed both the Medical Symptom Validity Test and at least one other performance validity measure. No demographic or injury-related variables differentiated the noncredible and adequate effort groups. The noncredible group performed significantly worse than the adequate effort group across a majority of CVLT-C variables. Logistic regression analysis revealed that the Recognition Discriminability (RD) score was the most robust in predicting noncredible effort. Among this relatively high-functioning sample, an RD cutoff z-score of -0.5 resulted in sensitivity of 55% and specificity of 91%. A more conservative RD cutoff z-score of -1.0 resulted in sensitivity of 41% and specificity of 97%. These findings are comparable to the classification statistics found for many embedded indicators in the adult literature. Although only moderately sensitive, the RD score on the CVLT-C appears to have good utility in identifying noncredible effort in a relatively high-functioning pediatric mTBI population.
