The Making Change Test: Initial validation of a novel digitized performance validity test for tele-neuropsychology.

Objective: The Making Change Test (MCT) is a brief, digitized freestanding performance validity test (PVT) designed for tele-neuropsychology (TeleNP). The objective of this study was to report the initial validation of the MCT in a mixed neuropsychiatric sample referred for neuropsychological evaluation using a known-groups design.

Method: The sample consisted of 136 adult outpatients who underwent a neuropsychological evaluation. Patients were classified as valid (n = 115) or invalid (n = 21) based on several established PVTs. Two validity indicators were calculated and assessed, including an Accuracy Response-Score and an Abbreviated Index. The Accuracy Response-Score incorporated both response time and errors. The Abbreviated Index aggregated response time and errors across the most sensitive test items in terms of predicting performance validity status.

Results: Correlational analyses indicated that the MCT Accuracy Response-Score and Abbreviated Index were more similar to non-memory-based PVTs than memory-based PVTs. Both the MCT Accuracy Response-Score and Abbreviated Index indicated acceptable classification accuracy (area under the curve of .77). The optimal cut score for the MCT Accuracy Response-Score (≥24) yielded a sensitivity of .38 and specificity of .90. The optimal cut score associated with the Abbreviated Index yielded slightly better operating characteristics, with a sensitivity of .50 and specificity of .90.

Conclusions: Initial findings provide support for the criterion and construct validity of the MCT and suggest a promising TeleNP future for this performance validity tool. However, additional support is necessary before the MCT can be used clinically.