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

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.