The Medical Symptom Validity Test Measures Effort Not Ability in Children: A Comparison Between Mild TBI and Fetal Alcohol Spectrum Disorder Samples
Bibliographic record
Abstract
Inadequate effort during neuropsychological examination results in inaccurate representations of an individual's true abilities and difficulties. As such, performance validity tests (PVTs) are strongly recommended as standard practice during adult-based evaluations. One concern with using PVTs with children is that failure reflects immature cognitive ability rather than non-credible effort. The current study examined performance on the Medical Symptom Validity Test (MSVT) in two large pediatric clinical samples with strikingly different neuropsychological profiles: (1) mild traumatic brain injury (mTBI; n = 510) and (2) fetal alcohol spectrum disorder (FASD; n = 120). Despite higher IQ scores and reading ability, the mTBI group performed significantly worse than the FASD group on all effort indices. Sixteen percent of the mTBI group failed the MSVT, whereas only 5% of the FASD group did. Our findings support the idea that the MSVT measures effort, not ability, in most cases and help to justify incorporating PVTs into pediatric neuropsychological batteries.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.004 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".