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Executive skills are critical cognitive skills for everyday functioning in children; accurate measurement using validated tools is thus important. The purpose of this study was to examine concurrent validity between the MEMRY Executive/Working Memory scale and the BRIEF2. Participants included a large pediatric clinical sample who completed parent ( n  = 567), teacher ( n  = 148), and self-report ( n  = 88) scales. All correlations were significant between the MEMRY Executive/Working Memory and the BRIEF2 Global Executive Composite, Cognitive Regulation Index, and Working Memory scale (all r's > .80). Classification agreement metrics ranged from fair to excellent. This study provides evidence of strong concurrent validity of the MEMRY Executive/Working Memory scale as a brief, useful tool for assessing executive functioning using parent, teacher, and self-report versions.

Abbreviated memory batteries play a role in some clinical and research assessments, but their validity and accuracy need to be well supported. The purpose of this study was to examine the accuracy of the ChAMP Screening Index for detecting memory impairment. The sample included N  = 804 youths (ages 5-21 years) with medical and neurological diagnoses who were presented for a clinical neuropsychological assessment. All completed the full Child and Adolescent Memory Profile and had valid data. The ChAMP Screening Index contains the first two subtests of the battery (Lists and Objects) and takes about 10 min to administer (full ChAMP is about 35 min). Analyses to examine the accuracy of the ChAMP Screening Index with both the Total Memory Index and Delayed Memory Index included Intraclass correlations, Cohen's Kappa coefficients, receiver operating characteristics, and classification metrics (e.g., sensitivity, specificity, positive predictive values [PPV], and negative predictive values [NPV]). Very strong correlations, minimal mean difference scores, substantial agreement on kappa coefficients, and outstanding receiver operating characteristics all support the Screening Index accuracy. A cutoff score on the Screening Index of 70 provides a good balance between a high PPV (.91) and a high NPV (.96) for the Total Memory Index. When detecting impairment on the Delayed Memory Index, a Screening Index cutoff score of 65 provides a balance between a high PPV (.92) and a high NPV (.94). This study supports the accuracy, validity, and utility of the 10-min ChAMP Screening Index in those clinical and research situations where a brief evaluation of memory is desired.

Objective: It is essential to interpret performance validity tests (PVTs) that are well-established and have strong psychometrics. This study evaluated the Child and Adolescent Memory Profile (ChAMP) Validity Indicator (VI) using a pediatric sample with traumatic brain injury (TBI)., Method: A cross-sectional sample of N = 110 youth (mean age = 15.1 years, standard deviation [SD] = 2.4 range = 8-18) on average 32.7 weeks (SD = 40.9) post TBI (71.8% mild/concussion; 3.6% complicated mild; 24.6% moderate-to-severe) were administered the ChAMP and two stand-alone PVTs. Criterion for valid performance was scores above cutoffs on both PVTs; criterion for invalid performance was scores below cutoffs on both PVTs. Classification statistics were used to evaluate the existing ChAMP VI and establish a new VI cutoff score if needed., Results: There were no significant differences in demographics or time since injury between those deemed valid (n = 96) or invalid (n = 14), but all ChAMP scores were significantly lower in those deemed invalid. The original ChAMP VI cutoff score was highly specific (no false positives) but also highly insensitive (sensitivity [SN] = .07, specificity [SP] = 1.0). Based on area under the curve (AUC) analysis (0.94), a new cutoff score was established using the sum of scaled scores (VI-SS). A ChAMP VI-SS score of 32 or lower achieved strong SN (86%) and SP (92%). Using a 15% base rate, positive predictive value was 64% and negative predictive value was 97%., Conclusions: The originally proposed ChAMP VI has insufficient SN in pediatric TBI. However, this study yields a promising new ChAMP VI-SS, with classification metrics that exceed any other current embedded PVT in pediatrics., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Objectives: Empirically informed neuropsychological opinion is critical for determining whether cognitive deficits and symptoms are legitimate, particularly in settings where there are significant external incentives for successful malingering. The Slick, Sherman, and Iversion (1999) criteria for malingered neurocognitive dysfunction (MND) are considered a major milestone in the field's operationalization of neurocognitive malingering and have strongly influenced the development of malingering detection methods, including serving as the criterion of malingering in the validation of several performance validity tests (PVTs) and symptom validity tests (SVTs) (Slick, D.J., Sherman, E.M.S., & Iverson, G. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13(4), 545-561). However, the MND criteria are long overdue for revision to address advances in malingering research and to address limitations identified by experts in the field., Method: The MND criteria were critically reviewed, updated with reference to research on malingering, and expanded to address other forms of malingering pertinent to neuropsychological evaluation such as exaggeration of self-reported somatic and psychiatric symptoms., Results: The new proposed criteria simplify diagnostic categories, expand and clarify external incentives, more clearly define the role of compelling inconsistencies, address issues concerning PVTs and SVTs (i.e., number administered, false positives, and redundancy), better define the role of SVTs and of marked discrepancies indicative of malingering, and most importantly, clearly define exclusionary criteria based on the last two decades of research on malingering in neuropsychology. Lastly, the new criteria provide specifiers to better describe clinical presentations for use in neuropsychological assessment., Conclusions: The proposed multidimensional malingering criteria that define cognitive, somatic, and psychiatric malingering for use in neuropsychological assessment are presented., (© The Author(s) 2020. Published by Oxford University Press.)

Performance validity tests (PVT) should be used when assessing youth with mild traumatic brain injury (MTBI). The goal of this study was to derive a new cutscore for determining invalid performance on the Memory Validity Profile (MVP) in youth with MTBI. Children and adolescents ( N  = 92; mean age =14.8 years, SD  = 2.3, range =8-18) on average six months ( SD  = 3.6) post-MTBI were administered the MVP as part of their assessment. Two validated PVTs [Test of Memory Malingering (TOMM) and Medical Symptom Validity Test (MSVT)] were administered and used to group the sample into valid ( n  = 73, neither TOMM/MSVT failed) and invalid ( n  = 19, both TOMM/MSVT failed). New cutscores for the MVP to determine invalid performance in this sample were established using failure on both TOMM/MSVT as the criterion. MVP performance correlated significantly with failure on TOMM/MSVT. Youth with invalid performance had significantly lower MVP total scores and area under the curve was .80, suggesting good separation of groups. A cutscore of 31 or less on the MVP provided sensitivity of 63% for detecting invalid performance with 93% specificity. This study yields a promising new cutscore for the MVP that has good sensitivity and strong specificity for detecting invalid performance in youth with MTBI.

Despite its popularity in the neuropsychological evaluation of children, the utility of the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) has not yet been investigated in children with epilepsy. Eighty clinically referred children and adolescents with epilepsy were administered the WISC-V as part of a comprehensive assessment and scores were compared to matched controls from the WISC-V standardization sample. T tests compared WISC-V indices and subtests between patients and controls and Chi-square analyses compared the rates of low scores. Correlational analyses assessed the relationships between epilepsy severity variables (e.g., age of onset, duration of epilepsy, number of antiepileptic drugs, seizure frequency). All WISC-V composites and subtests were significantly lower in patients versus controls and the rate of low scores was higher in patients than controls for all composites and subtests with the exception of Figure Weights. The Working Memory Index and Processing Speed Index were most sensitive to impairment, while the Verbal Comprehension Index and Fluid Reasoning Index were least sensitive. Of the epilepsy severity variables, age of seizure onset and number of antiepileptic drugs were strong predictors of deficits, whereas seizure frequency was the weakest predictor. Importantly, no significant differences were seen in children with right hemisphere epilepsy versus left on the five WISC-V composites, though a trend was seen towards a lower Visual-Spatial Index in those with right-sided focal seizures.

Computerized cognitive batteries, such as CNS Vital Signs (CNSVS), can provide valuable information in clinical and research settings. However, psychometric properties, especially in children and adolescents, remain relatively understudied. The aim of this study was to investigate the factor structure of CNSVS in children and adolescents with neurological diagnoses. Participants with neurological diagnoses ( N = 280) age 7-19 years were assessed as part of their clinical care at a tertiary hospital. All participants received the full CNSVS computerized cognitive battery, which contains seven subtests designed to measure attention, executive functioning, psychomotor speed, and memory. Principal components analyses were used to examine factor structure. Scores from CNSVS subtests loaded onto a three-component solution and accounted for 46% of the variance. The three components were deemed to best represent (1) speed, (2) memory, and (3) inhibition, with subtest scores loading differently than the original 11 primary and secondary domain scores would have suggested. Although the CNSVS program generates numerous primary and secondary domain scores, a three-component solution represents a more parsimonious approach to interpreting performance on the CNSVS in youth with neurological diagnoses. Confirmation of this factor solution in other samples is warranted.

Background: Development of an embedded performance validity test (PVT) is desired for visual memory tests. The goal of this study was to derive an embedded PVT for the Child and Adolescent Memory Profile (ChAMP) Objects visual memory subtest in youth with mild traumatic brain injury (MTBI)., Methods: Children and adolescents (N = 91; mean age = 14.9 years, SD = 2.2, range = 8-18) on average 25.2 weeks (SD = 15.4) post-MTBI were administered ChAMP Objects. Two stand-alone PVTs (Test of Memory Malingering and Medical Symptom Validity Test) were administered, which allowed for grouping into valid (zero failed stand-alone PVTs) and invalid (both stand-alone PVTs failed). Cutoff scores for invalid performance on ChAMP Objects and Objects Delayed were established using failure on two PVTs as the criterion., Results: One in five youth (n = 19) failed both PVTs. Invalid performance was not associated with demographics or time since injury, but was significantly correlated with both ChAMP Objects (r = .53, p<.001) and Objects Delayed (r = -.63, p<.001). Area under the curve suggested adequate discrimination by Objects (.87) and excellent discrimination by Objects Delayed (.91). A cutoff scaled score of 5 or less on ChAMP Objects provided sensitivity of 58% for detecting invalid performance with 96% sensitivity. A cutoff scaled score of 5 or less on ChAMP Objects Delayed achieved sensitivity of 63% and specificity of 96%. Interpreting the two embedded PVTs simultaneously improved sensitivity to 79% with 93% specificity., Conclusion: This study yields promising new embedded PVTs for the ChAMP Objects subtest with strong sensitivity and specificity for detecting invalid performance in youth with MTBI., (© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Determining the validity of obtained data is an inherent part of a neuropsychological assessment. The purpose of this study was investigate the failure rate of the Memory Validity Profile (MVP) in a large clinical sample of children and adolescents with neurological diagnoses. Data were obtained from 261 consecutive patients (mean age = 12.0, SD = 3.9, range = 5-19) who were referred for a neuropsychological assessment in a tertiary care pediatric hospital and were administered the MVP. In this sample, 4.6% of youth failed the MVP. Mean administration time for the MVP was 7.4 min, although time to complete was not associated with failure rates. Failure rates were held relatively consistent at approximately 5% across age ranges, diagnoses, and psychomotor processing speed abilities. Having very low, below normal, or above normal intellectual abilities did not alter failure rate on the MVP. However, those with intellectual disability (i.e., IQ<70) had a higher fail rate at 12% on MVP Total Score, but only 6% on the MVP Visual portion. Failure rates on the MVP were associated with lower scores on memory tests. This study provides support for using the MVP in children as young as 5 years with neurological diagnoses.

Objective: Little is known about the validity of computerized cognitive batteries, such as CNS Vital Signs (CNSVS), in pediatric patients. The purpose of this study was to examine convergent and divergent validity of the CNSVS in a clinical pediatric sample with neurological diagnoses., Method: Participants included 123 pediatric patients assessed in a tertiary care setting as part of clinical care. CNSVS (Memory, Psychomotor Speed, Reaction Time, Complex Attention, and Cognitive Flexibility domains, and a Neurocognition Index) and paper-and-pencil neuropsychological measures assessing learning, memory, processing speed, reaction time, attention, and executive functioning were administered., Results: Most correlations between CNSVS domain scores and neuropsychological measures assessing similar constructs were medium in strength. With the exception of stronger correlations between psychomotor speed tests, correlations between tests of similar constructs were not significantly higher than those between dissimilar constructs., Conclusions: These results provide support for validity of the CNSVS battery, but also caution that many abilities are inter-correlated., (© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)