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Using archival data from 2463 psychoeducational assessments of postsecondary students we investigated whether failure on either symptom or performance validity tests (SVTs or PVTs) was associated with score differences on various cognitive, achievement, or executive functioning performance measures or on symptom report measures related to mental health or attention complaints. In total, 14.6% of students failed one or more PVT, 33.6% failed one or more SVT, and 41.6% failed at least one validity test. Individuals who failed SVTs tended to have the highest levels of self-reported symptoms relative to other groups but did not score worse on performance-based psychological tests. Those who failed PVTs scored worse on performance-based tests relative to other groups. Failure on at least one PVT and one SVT resulted in both performance and self-reported symptoms suggestive of greater impairment compared with those who passed all validity measures. Findings also highlight the need for domain-specific SVTs; failing ADHD SVTs was associated only with extreme reports of ADHD and executive functioning symptoms while failing mental health SVTs related only to extreme reports of mental health complaints. Results support using at least one PVT and one SVT in psychoeducational assessments to aid in diagnostic certainty, given the frequency of non-credible presentation in this population of postsecondary students.

Information processing speed is commonly measured in intelligence and neuropsychological testing, and the scores from speed measures are considered in diagnostic and management recommendations for students with academic learning problems. However, this score usage often depends on assumptions about strong relationships between cognitive speed and the ability to perform actual academic tasks under time pressure. The primary purpose of the present study was to test the strength of these relationships empirically. In the present study, children with prior learning disability diagnoses (146 girls and 301 boys, ages 10-14 years old) completed diagnostic batteries that included measures of cognitive speed as well as timed academic skills. The relationships between the two types of measures were often modest (median r  = 0.25), and the gap between processing speed and timed academic scores was typically approximately 1 standard deviation. The pattern of relationships suggested that superficial similarity in stimuli and task demands affected the strength of associations. These results suggest that timed academic skills cannot be reliably estimated based on processing speed scores, and there will often be significant gaps between the two. Therefore, making diagnostic judgments (e.g., learning disability diagnoses) or management recommendations (e.g., for extended time testing accommodations) should be based on more direct measures of relevant academic skills.

It is now widely understood that ADHD can be feigned easily and convincingly. Despite this, almost no methods exist to assist clinicians in identifying when such behavior occurs. Recently, new validity indicators specific to feigned ADHD were reported for the Personality Assessment Inventory (PAI). Derived from a logistic regression, these algorithms are said to have excellent specificity and good sensitivity in identifying feigned ADHD. However, these authors compared those with genuine ADHD only to nonclinical undergraduate students (asked to respond honestly or asked to simulate ADHD); no criterion group of definite malingerers was included. We therefore investigated these new validity indicators with 331 postsecondary students who underwent assessment for possible ADHD and compared scores of those who were eventually diagnosed with ADHD ( n   =   111) to those who were not [Clinical controls (66), Definite malingerers (36); No diagnosis (117)]. The two proposed PAI algorithms were found to have poor positive predictive value (.19 and .17). Self-report validity measures from the Connors' Adult Attention Rating Scale, and the Negative Impression Management scale on the PAI returned more positive results. Overall, more research is needed to better identify noncredible ADHD presentation, as the PAI-based methods proposed by Aita et al. appear inadequate as symptom validity measures.

An increasing number of individuals are requesting disability accommodations on high-stakes licensing examinations, and neuropsychological evaluation reports are a frequent component of disability documentation. This study reviewed 103 requests for accommodations based on a learning disability (LD), submitted to the National Board of Osteopathic Medical Examiners between 2013 and 2016 for accommodation on the licensure exams for osteopathic physicians. Depending on criteria employed, anywhere from 84 to 97% of applicants failed to meet recognized criteria for a LD diagnosis, with the vast majority demonstrating academic functioning that was average or better relative to most other individuals in the general population. Thus, although given a disability diagnosis, the majority lacked evidence of substantial impairment that would require accommodations under the Americans with Disabilities Act. Additionally, no significant differences were found between the academic achievement or fluency scores of those requesting 50% as compared to 100% extra time. Finally, many evaluators employed grade-based assessment measures to demonstrate academic impairment, even when candidates' functioning using age-based comparisons was unimpaired. Recommendations for future research and practice based on these and other findings are discussed.

Measuring performance validity in Attention Deficit Hyperactivity Disorder (ADHD) assessments is essential, with multiple studies identifying how easily young adults can feign symptoms on self-report measures. Few methods, however, exist to identify such feigning when it occurs. While some clinicians include computerized tests of attention (e.g., Test of Variables of Attention [TOVA]) when assessing for possible ADHD, it is unclear how symptom exaggerators perform, and whether the TOVA Symptom Exaggeration Index (SEI) adequately identifies performance-based exaggeration when it occurs. Using archival data from a university-based ADHD screening clinic we investigated the performance of 245 late adolescents/emerging adults. Three groups were created: (1) Good effort but not ADHD ( n  = 183); (2) Good effort and diagnosed ADHD ( n  = 13); and (3) suspect effort ( n  = 49), based on final diagnosis and performance on an existing validity measure. Results showed clearly that those with suspect effort performed more poorly than the other two groups on all but second-half commission errors on the TOVA. Similar to Nicholls et al., the suspect effort group showed significantly subaverage (i.e., greater than two standard deviations below the mean) scores in Omission errors; in this replication, however, this was true for both the first and second half of the test. Response time variability was similarly exaggerated, with the suspect effort group again returning extreme scores in both halves of the test. Suspect effort students were indistinguishable from those with genuine ADHD when looking solely at self-reported symptoms; however, embedded symptom validity measures on an ADHD rating scale discriminated well between groups. Overall, results support the use of the TOVA as an embedded performance validity measure in the assessment of late adolescents/emerging adults and support previous findings that symptom report alone cannot distinguish credible from noncredible ADHD presentation.