Rates of Effort Test Failure in Children With ADHD: An Exploratory Study

The present study assessed performance on symptom validity tests (SVTs) and various cognitive-processing measures to evaluate the impact of having attention-deficit hyperactivity disorder (ADHD) on SVT performance using a clinical sample of 73 children aged 7 to 18 years old who had a previous diagnosis of ADHD. Cognitive impairment associated with ADHD may lead these individuals to perform poorly on what are considered to be relatively easy but boring SVTs. Few clients in this sample returned a score pattern on the Word Memory Test, Medical Symptom Validity Test, or Nonverbal Medical Symptom Validity Test that would have classified them as having invested poor effort; the Computerized Assessment of Response Bias returned higher rates of failure. In the absence of a lifelong history of severe attention and impulse control problems, and especially where secondary gains exist for obtaining a diagnosis, clinicians should interpret low scores on these SVTs as indicating low effort or noncredible performance as opposed to failure due to the symptoms of ADHD.