ArticlePublisher preview available

Psychometric Markers of Genuine and Feigned Neurodevelopmental Disorders in the Context of Applying for Academic Accommodations

June 2017
Psychological Injury and Law 10(5)

DOI:10.1007/s12207-017-9287-5

Authors:

Jessica Hurtubise

University of Windsor

Antonette Hazell

University of Windsor

Sanya Sagar

University of Windsor

Laszlo A Erdodi

University of Windsor

The article reviews systemic and context-specific challenges of psychoeducational assessment using two case studies: a 19-year-old woman with feigned attention-deficit/ hyperactivity disorder and a 50-year-old man with genuine dyslexia. These cases demonstrate that providing a thorough evaluation of performance validity is an essential component of determining eligibility for academic accommodations in both clinical and higher education settings. At the same time, discounting failure on certain performance validity tests may be necessary to protect against false positive errors. In addition , empirically based test selection and interpretation has the potential to enhance the clinical confidence during differential diagnosis. Examining the internal consistency of a given neurocognitive profile provides valuable clinical information to determine both the credibility of the overall presentation and applying established diagnostic criteria. Although clinical research has yet to identify definitive markers of non-credible neurocognitive profiles, a multivariate approach to performance validity assessment that combines empirically validated indicators and sound clinical judgment can improve detection rates while simultaneously protecting against false positive errors.

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Psychometric Markers of Genuine and Feigned

Neurodevelopmental Disorders in the Context of Applying

for Academic Accommodations

Jessica L. Hurtubise

&Antonette Scavone

&Sanya Sagar

&Laszlo A. Erdodi

Received: 15 May 2017 /Accepted: 16 May 2017 /Published online: 6 June 2017

#Springer Science+Business Media New York 2017

Abstract The article reviews systemic and context-specific

challenges of psychoeducational assessment using two case

studies: a 19-year-old woman with feigned attention-deficit/

hyperactivity disorder and a 50-year-old man with genuine

dyslexia. These cases demonstrate that providing a thorough

evaluation of performance validity is an essential component

of determining eligibility for academic accommodations in

both clinical and higher education settings. At the same time,

discounting failure on certain performance validity tests may

be necessary to protect against false positive errors. In addi-

tion, empirically based test selection and interpretation has the

potential to enhance the clinical confidence during differential

diagnosis. Examining the internal consistency of a given

neurocognitive profile provides valuable clinical information

to determine both the credibility of the overall presentation

and applying established diagnostic criteria. Although clinical

research has yet to identify definitive markers of non-credible

neurocognitive profiles, a multivariate approach to perfor-

mance validity assessment that combines empirically validat-

ed indicators and sound clinical judgment can improve detec-

tion rates while simultaneously protecting against false posi-

tive errors.

Keywords ADHD .Dyslexia .Feigning .Disability

evaluation .Performance validity assessment

Non-credible presentation in young adults applying for special

accommodations in higher education settings is a growing

concern (Harrison & Edwards, 2010). Having a documented

disability has a number of tangible benefits, including extend-

ed test taking time, flexible deadlines, and access to

psychostimulant medication (Barrett, Darredeau, Bordy, &

Pihl, 2005;Harrison&Edwards,2010). While allowing extra

time to complete a task may be a legitimate accommodation in

the skill development phase (Stretch & Osborne, 2005), it

alters the underlying construct measured by speeded testing

(Bridgeman, Cline, & Hessinger, 2004). As such, additional

test-taking time changes the meaning of the test scores and

provides an unfair advantage to individuals without a genuine

disability, violating the ethical principle of equal opportunity

in a highly competitive environment.

When considering special accommodations within an edu-

cational setting, neurodevelopmental disorders are of particu-

lar interest. Neurodevelopmental disorders, including atten-

tion-deficit/hyperactivity disorder (ADHD) and specific learn-

ing disabilities (LDs), have been associated with lower grad-

uation rates in high school (Kent et al., 2011) and university

(Weyandt & DuPaul, 2008). This interference of

neurodevelopmental disorders on success in educational set-

tings suggests that the base rates for these disorders should

gradually decline with higher levels of education. However,

the base rate of certain neurodevelopmental disorders is nota-

bly higher among individuals preparing for high-stake exam-

inations compared to the general population (Julian et al.,

2004). This provides indirect evidence that a proportion of

the diagnosed that serve as the basis of academic accommo-

dation during high-stake exams is likely based on non-

credible presentation.

Given the implications of diagnostic errors in determining

disability status in academic settings, it is important to distin-

guish between genuine and feigned disorders. In fact, both

classification errors are costly. False positives (giving a diag-

nosis to someone who is feigning a condition) undermine

*Laszlo A. Erdodi

lerdodi@gmail.com

University of Windsor, 168 Chrysler Hall South, 401 Sunset Ave.,

Windsor, ON N9B 3P4, Canada

Psychol. Inj. and Law (2017) 10:121–137

DOI 10.1007/s12207-017-9287-5

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

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Amy F T Arnsten

Many researchers consider dysfunction of the prefrontal cortex (PFC) a fundamental problem in Attention-Deficit/Hyperactivity Disorder (ADHD). The PFC is critical for guiding behavior using working memory (Goldman-Rakic, 1987; see Rapport, Chapter 12). Working memory is constantly updated; the PFC uses these representations to guide behavior effectively, freeing the organism from its dependence on the environment, inhibiting inappropriate responses or distractions and allowing us to plan and organize our behavior (Robbins, 1996). The PFC, particularly on the right side, is activated during both sustained and selective attention tasks (Coull et al., 1998).

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May 2017
RES DEV DISABIL

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