Performance on the Test of Memory Malingering (TOMM) among a large clinic-referred pediatric sample

Abstract

Growing concerns with suboptimal effort in pediatric populations have led clinicians to investigate the utility of symptom validity tests (SVT) among children and adolescents. Performance on the Test of Memory Malingering (TOMM) was analyzed among a clinical sample of individuals ranging in age from 5 through 16 years. The 101 patients were referred for a variety of learning, developmental, psychiatric, and neurological concerns. All children were administered the TOMM as part of a clinical neuropsychological evaluation. Within the sample, 4 patients did not meet the adult cutoff criteria for passing the TOMM. Three of the 4 patients also demonstrated suboptimal effort on another SVT. Results revealed statistically significant correlations between TOMM performance and age, intelligence, and memory. Despite these correlations, 97 out of the 101 performed at or above the adult cutoff score. The findings suggest that children perform similarly to adults on the TOMM and that the TOMM is appropriate for use with pediatric clinical populations as young as 5 years.

Traumatic Brain Injury Across the Lifespan: A Neuropsychological Tutorial for Attorneys

“…Recent research has indicated that children as young as 5 years of age can pass the Test of Memory Malingering (TOMM; Tombaugh 1996) at levels at par with adults (Constantinou and McCaffrey 2003;Donders 2005b;Kirk et al 2009). It should be noted that the TOMM is ideal for younger children because it is a picture recognition test and requires no word reading.…”

Motivated to do well: An examination of the relationships between motivation, effort, and cognitive performance in schizophrenia

“…Nonetheless, PVTs are essential in the interpretation of neuropsychological test data so as to understand whether participants are providing sufficient effort during testing (Sharland and Gfeller, 2007;McCarter et al, 2009;Fox, 2011). PVTs have also been increasingly used for the assessment of effort in nonlitigation settings, including in children, adolescents, healthy university students, and in neurological disorders (Merten et al, 2007;Locke et al, 2008;Axelrod and Schutte, 2011;Kirk et al, 2011;Brooks et al, 2012;Wisdom et al, 2012).…”

Utility of the Test of Memory Malingering (TOMM) in Children Ages 4–7 Years with and without ADHD

“…The practice of using the TOMM in pediatric samples has largely maintained the same adult published cut-off scores on Trial 2 or Retention in order to determine whether the results suggest non-credible performance (Tombaugh, 1996). As with adults, the Retention trial is used only if the child does not pass Trial 2, although in many studies, the Retention is administered regardless of Trial 2 performance to clarify performance patterns across the trials (Blaskewitz, Merten, & Kathmann, 2008; Kirk, et al, 2011; Loughan & Perna, 2014; Rienstra, Spaan, & Schmand, 2010). …”

“…In a mixed clinical sample of children ages 5–16 years (approximately half of whom were diagnosed with ADHD), Kirk et al (2011) reported that 96% of the participants earned an acceptable score on TOMM Trial 2 and Retention, and none of those with ADHD were among the 4% with non-credible performance. Similarly, Loughran and Perna (2014) reported that 93% of the children with ADHD in their sample achieved an acceptable score.…”

“…There is some evidence to suggest that this transition may occur among children younger than age 5 years (Berk, 1997); although, there may also be other developmental factors aside from memory skills (e.g., attentional control, language comprehension, behavioral maturity, motor persistence) that set the lower age threshold for validity of performance validity tests such as the TOMM. Results of studies examining the association between age and TOMM performance have been mixed, with some showing no association with age (Constantinou & McCaffrey, 2003; MacAllister et al, 2009), and others identifying a positive relationship with age (Donders, 2005; Kirk et al, 2011). While younger school-aged children typically achieve lower overall mean scores in these studies, the proportion of children in the youngest age range (6–10 years) that achieved acceptable performance was still quite high: 87% (MacAllister et al, 2009), 91% (Donders, 2005), and 100% (Kirk et al, 2011).…”