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Suboptimal effort affects the reliability and validity of clinical data. Effort measures of a sample of French Canadian schoolchildren who had undergone a psycho-educational assessment were compared with eight other schoolchildren samples presumed to have exerted good effort, using the Medical Symptom Validity Test (MSVT) and the Reliable Digit Span (RDS). The study focused, more specifically, on the MSVT effort measures, Immediate Recognition (IR), Delayed Recognition (DR) and Consistency (CNS) because they are relatively insensitive to impairments. Overall, the majority of children, with and without impairment passed the MSVT effort measures with a fail rate of 13.1% for MSVT and 36.1% for RDS. The correlation between failure of each measure was only moderately significant. The failure rate on the MSVT dropped to 6.1% after removal of participants who read below a grade three level and the correlation between failure on the RDS and failure on MSVT became insignificant. This is consistent with the literature documenting the use of MSVT and WMT with adults, with and without impairments, and supports the assertion that insufficient effort is likely the only explanation for failure on MSVT when the participants have the required reading level [8]. Green suggested considering evidence of a Genuine Memory Impairment Profile (GMIP) in failing protocols (i.e., when the average of IR, DR, and CNS exceeds the average of PA and FR by at least 20 points). In this study, all but one child who failed MSVT demonstrated a GMIP profile.

Effort-testing In Children Undergoing PsychoEducational Assessment Using The Medical Symptom Validity Test