Objective: Credibility research shows adults often find children more believable than adults. We examined whether these findings translate to neuropsychological contexts, specifically as related to performance validity. This topic is underexplored in the neuropsychology literature (MacAllister et al., 2009). We anticipated that neuropsychologists would more likely find pediatric examinees effortful relative to adults.
Participants and Method: Participants were NAN and AACN listserv members who completed the study via Qualtrics. Participants were randomized to vignette conditions describing either a pediatric (age 9) or adult (age 23) assessment scenario. Vignettes were otherwise identical and indicated the examinee performed below recommended cut-offs on the TOMM and VSVT Hard Items.
Participants indicated whether the examinee’s performance was invalid, valid, or that they were unsure, as well as their level of confidence (slightly, moderately, very, or extremely). A composite outcome variable was constructed by multiplying participants' perceived performance validity by their level of confidence.
Results: An initial 94 participants began the study. A final sample of N = 44 were included in analyses after excluding due to failed manipulation checks, incomplete surveys, and not reporting at least slight familiarity with both pediatric and adult validity literatures. Participants were approximately 45 years old on average, 71% women, and 98% White. The majority (66%) held a PhD and have been practicing for approximately 15 years.
An independent sample t-test indicated a significant difference between conditions on validity/confidence composite scores, t(42) = 2.05, p = .047, Cohen's d = 0.65. Participants were significantly more likely to find the pediatric examinee’s performance valid and were more confident in their opinions relative to the adult examinee. This was a medium-to-large effect size.
Conclusions: This novel yet concerning finding suggests that neuropsychological standards of care can vary according to examinee age. Results remind neuropsychologists of the importance of objective normative data and stress the need for continued research in this area.