Abstract

Growing recognition and concerns of non-credible performance in pediatric populations have led clinicians to investigate the utility of performance and symptom validity tests (PVT/SVTs) among children and adolescents. Yet current research has indicated that a minority of clinicians routinely utilize a free-standing PVT in pediatric neuropsychological evaluations. The current article investigates the rationale for using PVT/SVTs, and the impact that failure of such exams have on other neurocognitive tests. A review of common adult PVTs and their appropriateness for use with specific pediatric clinical populations is presented, as well as empirical evidence for evaluating embedded validity indicators. The limited literature on SVTs with youth is also reviewed and provides additional insight into symptom exaggeration. There are various reasons children would provide noncredible performance, many of which are different from adults. A review of how the clinician should handle this behavior in pediatric evaluations is provided and what patient populations may present with a higher base rate of failure. Finally, various approaches are offered on how to explain these results to children and their caregivers.

摘要

对儿科人群不可靠表现的日益认识和担忧促使临床医生调查表现和症状有效性测试 (PVT/SVT) 在儿童和青少年中的效用。然而，目前的研究表明，少数临床医生在儿科神经心理学评估中经常使用独立的 PVT。当前文章调查了使用 PVT/SVT 的基本原理，以及此类考试失败对其他神经认知测试的影响。介绍了常见成人 PVT 及其适用于特定儿科临床人群的审查，以及评估嵌入式有效性指标的经验证据。还审查了有关青年 SVT 的有限文献，并提供了对症状夸大的额外见解。儿童提供不可信的表现有多种原因，其中许多原因与成人不同。提供了临床医生应如何处理儿科评估中的这种行为以及哪些患者群体可能出现更高的基本失败率的审查。最后，提供了关于如何向儿童及其照顾者解释这些结果的各种方法。