Article2024

Enhanced detection of suboptimal effort in psychoeducational assessments for dyslexia

Allyson G. Harrison · Nathaniel Davin · Beth Pollock

4 citations0/0 files storedThe Clinical Neuropsychologist

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Developmental and Educational Neuropsychology Psychological Testing and Assessment Deception detection and forensic psychology

Abstract

Objective: Although performance validity tests (PVTs) are routinely administered in neuropsychological evaluations, they are employed less frequently in assessments for specific learning disabilities such as dyslexia, likely due, at least in part, to the limited availability of PVTs to evaluate effort on measures of academic achievement. This is troubling, as previous research suggests that up to 24% of postsecondary students undergoing learning disability assessments produce noncredible test scores indicative of symptom exaggeration or low effort. This paper discusses normative data collected for the revised Dyslexia Assessment of Simulation or Honesty- Revised (DASH-R), a PVT developed specifically to identify symptom exaggeration or magnification during dyslexia testing. Method: We administered the DASH-R to three groups of students: honest responding controls (n = 48), students with documented dyslexia (n = 232), and students coached to simulate dyslexia (n = 42). Students were also administered measures of reading and processing speed. Results: DASH-R scores differentiated simulators from both honest responding controls and those with dyslexia. Further, ROC curve analysis showed that a composite feigning index score derived from the DASH-R could be used diagnostically to detect low effort; an optimal cut score of ≥4 on a seven-variable index yielded high specificity (≥98%) and good sensitivity (71%), with positive predictive accuracy of 86%. Creation of a 9-variable index that included errors on an additional reading test produced improved positive predictive accuracy to 96% while retaining excellent specificity (99%). Conclusions: The DASH-R appears to be a promising disability-specific measure for detecting feigned reading problems in young adults undergoing evaluations for dyslexia.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2011Neuropsychological Assessment 2009American Academy of Clinical Neuropsychology Consensus Conference Statement on the Neuropsychological Assessment of Effort, Response Bias, and Malingering 1994Validation of malingered amnesia measures with a large clinical sample.2003Detection of Malingering Using Atypical Performance Patterns on Standard Neuropsychological Tests 2021American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering 2020Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria 2007Symptom Exaggeration by College Adults in Attention-Deficit Hyperactivity Disorder and Learning Disorder Assessments

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2026The critical role for neuropsychologists in the assessment and diagnosis of learning disorders: a position paper from the National Academy of Neuropsychology position, education, and response committee

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