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Embedded Performance Validity on the CVLT-C for Youth with Neurological Disorders
Brian L Brooks1, Danielle M Ploetz2
1Neurosciences (Brain Injury and Rehabilitation Programs), Alberta Children's Hospital, Calgary, Alberta, Canada Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada brian.brooks@albertahealthservices.ca.
This study found that a lower cutoff score for the California Verbal Learning Test, Children's Version (CVLT-C) recognition discriminability is needed to accurately identify noncredible performance in youth with neurological disorders.
Area of Science:
- Neuropsychology
- Pediatric Neurology
- Cognitive Assessment
Background:
- Embedded validity measures are crucial for detecting noncredible performance in cognitive assessments.
- Limited research exists on the effectiveness of these measures in pediatric populations with neurological disorders.
Purpose of the Study:
- To evaluate the California Verbal Learning Test, Children's Version (CVLT-C) recognition discriminability (RD) score as an embedded validity marker.
- To assess its utility in a sample of youth diagnosed with neurological conditions.
Main Methods:
- The study included 294 youth aged 5-16 with neurological diagnoses.
- Participants completed the CVLT-C and the Test of Memory Malingering (TOMM).
- The CVLT-C RD score was analyzed using established and lower cutoff scores (z ≤ -0.5 and z ≤ -3.0).
Main Results:
- A significant portion (5.4%) scored below the TOMM cutoff, exhibiting younger age, lower intellectual abilities, and poorer CVLT-C performance.
- Using the CVLT-C RD score of z ≤ -0.5 yielded sensitivity = .81 and specificity = .67.
- A lower cutoff of z ≤ -3.0 improved specificity to .90 but reduced sensitivity to .44.
Conclusions:
- The standard CVLT-C RD cutoff score of z ≤ -0.5 may not be optimal for identifying noncredible performance in youth with neurological disorders.
- A substantially lower cutoff score (z ≤ -3.0) is recommended for improved accuracy in this specific population.
- Further validation of embedded validity markers in pediatric neurological samples is warranted.
