#Backward digit span program series
In a mild traumatic brain injury (TBI) case series of ours consisting of 193 children and adolescents referred exclusively for clinical neuropsychological evaluation, 17% of the sample failed the Medical Symptom Validity Test (MSVT), which was the same percentage estimated to have put forth noncredible effort more broadly across the examinations ( Kirkwood & Kirk, 2010). Two other recent studies suggest that, under certain conditions, rates of negative response bias in children are likely to be considerably higher. Several recent clinical case series have also consistently found that a small percentage of general pediatric patients perform suboptimally because of effort-related problems ( Carone, 2008 Donders, 2005 Kirk et al., 2011 MacAllister, Nakhutina, Bender, Karantzoulis, & Carlson, 2009). However, a number of single-case reports have clearly documented that children can feign cognitive impairment during neuropsychological examination ( Flaro & Boone, 2009 Henry, 2005 Kirkwood, Kirk, Blaha, & Wilson, 2010 Lu & Boone, 2002 McCaffrey & Lynch, 2009). In comparison to the vast literature focused on noncredible neuropsychological performance in adults, the pediatric literature is relatively sparse. Indeed, classification statistics produced in this pediatric sample compare favorably with those produced in many real-world adult patients.ĭigit span, Reliable digit span, Wechsler intelligence scale for children, Symptom validity testing, Response bias, Postconcussion, Mild traumatic brain injury Introduction Although only moderately sensitive, Digit Span scores are likely to have good utility in identifying noncredible performance in relatively high-functioning older children and adolescents. For Reliable Digit Span, the optimal cut-score was ≤6, with sensitivity of 51% and specificity of 92%. For age-corrected scaled scores, a score of ≤5 resulted in the optimal cut-score, yielding sensitivity of 51% and specificity of 96%. Fourteen percent of the participants failed both the Medical Symptom Validity Test and Test of Memory Malingering, which was used as the criterion for noncredible effort. The sample consisted of 274 clinically referred mild traumatic brain injury patients aged 8 through 16 years. The present study examined the classification value of several scores derived from the WISC-IV Digit Span subtest. Although several recent studies have demonstrated the appropriateness of using stand-alone symptom validity tests with younger populations, a near absence of pediatric work has investigated embedded validity indicators. Far less work has focused on methods appropriate for children. In adult populations, research on methodologies to identify negative response bias has grown exponentially in the last two decades.
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