Why Should an Attorney Care about Neuropsychological Effort Testing?
Use of effort testing in neuropsychology (also known as symptom validity testing or performance validity testing) is the current norm and expected standard of practice in neuropsychological evaluations. Effort tests that are included as part of the neuropsychological evaluation inform as to whether an examinee is providing an accurate measure of actual level of ability. If an individual is not giving full effort and effort testing reflects this, findings of deficit can often times not be interpreted as a measure of true ability. Thus, without administering effort testing, it is possible that a neuropsychological evaluation could overestimate the degree of an examinee’s impairment or problems.
It is important for the neuropsychologist to consider both effort within the cognitive functioning realm and effort within the realm of psychological symptoms, since findings in these areas are not always correlated.
Neuropsychological effort testing tells us about performance that is atypical compared to performance in neurologically and psychiatrically impaired populations. In some cases, if an examinee does not pass effort testing, it can be established that this would be a rare finding even in patients with severe dementia.
If you have retained a neuropsychologist who does not employ neuropsychological effort testing, it would be wise to understand why and to seek out an expert who does. The neuropsychologist who does not employ contemporary measures and methods of neuropsychological effort testing should face serious questions about the validity of the exam in court. The neuropsychologist should be able to articulate why s/he chose the measures s/he did, and to articulate what the implications of the effort test findings are for the validity of the exam. Effort testing is an absolute necessity within a litigation / IME context.
About the author. Dr. Messler is a board certified clinical neuropsychologist and licensed psychologist who has provided thousands of evaluations where the question of traumatic brain injury and symptom validity were raised. She has also served as expert consultant and witness. She believes it is critical to provide a scientifically defensible opinion, and to help the jury and court understand the implications of the neuropsychological aspects of cases before them.