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The Investigation Of Embedded Effort Measures Using The Children’S Memory Scale (Cms)

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Title:
The Investigation Of Embedded Effort Measures Using The Children’S Memory Scale (Cms)
Series Title:
19th Annual Undergraduate Research Symposium
Creator:
Hernandez, Brianna
Language:
English
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Undetermined

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Subjects / Keywords:
Center for Undergraduate Research
Center for Undergraduate Research
Genre:
Conference papers and proceedings
Poster

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Abstract:
Effort testing is an essential component of pediatric neuropsychological assessments to validate test results. They are a necessary measure to ensure the patient’s performance is reflective of their potential ability. Previous research has been largely limited to adult populations, with an absence of effort research in children. Studies in adults indicate the usefulness of multiple measures of effort throughout assessment. Embedded measures can improve effort testing. This study aimed to investigate novel, embedded effort measures using a recognition task on the CMS, and to compare the usefulness of the new effort measures to an established embedded effort measure, the Reliable Digit Span (RDS). The CMS Word Pairs 2 Delayed Recognition (CMS WP-DR) was analyzed for clinical use as an embedded measure of effort. ( en )
General Note:
Research authors: Brianna Hernandez, Shelley Heaton, Ph.D. - University of Florida
General Note:
McNair Scholars
General Note:
Faculty Mentor: Effort testing is an essential component of pediatric neuropsychological assessments to validate test results. They are a necessary measure to ensure the patient’s performance is reflective of their potential ability. Previous research has been largely limited to adult populations, with an absence of effort research in children. Studies in adults indicate the usefulness of multiple measures of effort throughout assessment. Embedded measures can improve effort testing. This study aimed to investigate novel, embedded effort measures using a recognition task on the CMS, and to compare the usefulness of the new effort measures to an established embedded effort measure, the Reliable Digit Span (RDS). The CMS Word Pairs 2 Delayed Recognition (CMS WP-DR) was analyzed for clinical use as an embedded measure of effort. - Center for Undergraduate Research, McNair Scholars

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Source Institution:
University of Florida
Rights Management:
Copyright Brianna Hernandez. Permission granted to University of Florida to digitize and display this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.

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! Assessing effort throughout pediatric neuropsychological assessment is a critical indicator of test validity ( Perna Loughan Hertza & Segraves 2014). Failure of effort tests is a good indicator that the patient is providing suboptimal effort that does not match their ability ( Perna et al., 2014). Embedded measures are time efficient and cost effective, ranging across multiple neurocognitive domains (Brooks, Sherman, & Iverson, 2014). Recognition tasks are better indicators of good or poor effort than recall tasks on memory scales (Bernard et al., 1993; Sullivan et al.,2002). Background Participants Results Conclusions Participants: N= 77 youth Participants represent a mixed-clinical sample of children who completed comprehensive neuropsychological assessments in Dr. Heaton's Pediatric Neuropsychology Clinic Ages 6-16 ( M =10.88, SD =3.11) 60.5% non-Hispanic/Latino; 18.4% Hispanic/ Latino CMS WP-DR items 9 and 21 (older only) may have clinical utility as an embedded measure of effort in pediatric populations. Future examination of the utility of items 9 and 21 should include larger pediatric samples. Future research examining the clinical utility of items 9 and 21 as an embedded effort measure should include additional confirmatory effort measures (e.g., TOMM, MVP). A combination of item recognition may be the most useful embedded effort measure. Measures & Method The Investigation of Embedded Effort Measures Using the Children's Memory Scale (CMS) Brianna Hernandez, Elise Turner, M.S., & Shelley C. Heaton, Ph.D. Department of Clinical and Health Psychology, University of Florida Results Construct Measure Scale Established Effort Measure Weschler Intelligence Scale for Children (WISC-V) Reliable Digit Span (RDS) RDS Cutoffs 6 and below: invalid 7 and above: valid Potential Effort Measures Children's Memory Scale (CMS) Word Pairs 2 Delayed Recognition Subtest (WP-DR) Total raw score Individual item recognition Consistency in recognition of repeated word pairs References The CMS WP-DR total raw score was not useful in discriminating between poor and adequate effort ( AUC younger =0.49, p=0.94, AUC older =0.18, p=0.45 Table 2. AUC results for younger (ages 5-8) and older (ages 9-16) participants. Consistency in recognition of the repeated items on CMS WP-DR was associated with RDS performance for six word pairs, !=0.21-0.28, p<0.05 RDS performance was significantly associated with five items on the CMS WP-DR, !=0.31-0.61, p<0.05 (see Table 1). Item 9 (monkey-stove) for all youth and item 21 for older children appeared the most robust in discriminating effort similarly to the RDS, =0.43-0.61, both p<0.01. Brooks, B.L., Sherman, E. M. S., & Iverson, G.L. (2014). Embedded validity indicators on CNS vital signs in youth with neurological diagnoses. Archives of Clinical Neuropsychology, 29 (5), 422-431. Bernard, L. C., Houston, W., & Natoli L. (1993). Malingering on neuropsychological memory tests: potential objective indicators. Journal of Clinical Psychology 49 45-53. Perna R., Loughan A.R., Hertza J. & Segraves K. (2014). The value of embedded measures in detecting suboptimal effort in children: an investigation into the WISC-IV digit span and CMS verbal memory subtests. Applied Neuropsychology, 3 45-51. Sullivan, K., Deffenti C., & Keane, B. (2002). Malingering on the RAVLT: part II. detection strategies. Archives of Clinical Neuropsychology 17, 223-233. Race White/ Caucasian Black/African American American Indian/Alaska Native Mixed Race Other Unspecified Data Analysis Plan: RDS was calculated by summing the number of digits in the last trial with a perfect score on WISC-V Digit Span Forward and Backward. Receiver operating characteristic (ROC) area under the curve (AUC) analyses were used to determine optimal classification statistics and cut-off scores for CMS WP-DR total raw scores. Chi-square tests of independence were used to determine associations between RDS performance, and CMS WP-DR (1) individual item recognition and (2) consistency in recognition of repeated word pairs. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity were calculated for significant items on the chisquare tests. Item PPV NPV Sensitiv ity Specific ity Meltrough** 20.83% 100% 100% 73.60% Air-free* 16.17% 98.11% 80% 72.22% Footballpencil* 12.50% 100% 100% 71.62% Monkeystove**` 16.17% 100% 100% 72.60% Applecloud* 33.33% 96.23% 80% 76.12% Table 1. Significant chi square test of independence results for CMS WP-DR Individual Item Recognition Gender Male Female Study Objectives To investigated novel, embedded effort measures using a recognition task on the Children's Memory Scale (CMS). To compare the usefulness of the new effort measures to an established embedded effort measure, Reliable Digit Span (RDS). *p<0.05, **p<0.01 Age Range Area Std. Error Signifi cance Younger 0.488 0.157 0.938 Older 0.182 0.137 0.020