Attention-Based Performance Validity Assessment in Paediatric Samples

Neuropsychological assessments require adequate task engagement, yet paediatric performance validity testing (PVT) remains limited. This study evaluated the Groningen Effort Test (GET) as an attention-based PVT in children and adolescents using a simulation design. Participants were typically developing controls (N = 113), instructed simulators (N = 40) and outpatient referrals (N = 47), aged 6-17 years, who completed the Test of Memory Malingering (TOMM Trial-1), Reliable Digit Span (RDS) and the GET. GET performance improved with age, and outpatient referrals scored below controls. Age-stratified cutoffs (<13 years vs. >13 years) produced high specificity and strong sensitivity in children, comparable to TOMM Trial-1 and RDS, while all PVTs showed reduced sensitivity in adolescents. ROC analyses indicated excellent accuracy in children and good to moderate accuracy in adolescents. Regression analyses revealed significant GET effects of group and age. Findings support the GET as a promising paediatric PVT requiring further clinical validation.