Welcoming a paradigm shift in occupational therapy: symptom validity measures and cognitive assessment

Until now, occupational therapists have been limited in their ability to access methods designed to ensure that formal cognitive and psychosocial testing results were valid. These standardized symptom validity tests (SVTs) are now considered mandatory during neuropsychological testing, particularly within a medical-legal context. The purpose of this study was to evaluate the use of symptom validity testing by occupational therapists involved in a medical-legal setting and to determine whether data obtained are in keeping with findings from other professions. Thirty-six consecutive medical-legal clients were administered the Nonverbal Medical Symptom Validity Test, the Medical Symptom Validity Test, or both during the course of standardized testing. Test administration revealed a failure rate on SVTs of 48%, indicating other occupational therapy formal cognitive or psychosocial test results within those assessments were invalid. These findings are in keeping with a vast international body of research on use of symptom validity measures. We recommend implementation of symptom validity measures in all cognitive and psychosocial test situations.