A Comparison of the degree of effort involved in the TOMM and the ACS word choice test using a dual-task paradigm

Lucienne Isabel Barhon*, Jennifer Batchelor, Susanne Meares, Eugene Chekaluk, E. Arthur Shores

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Citations (Scopus)


The aims of the current study were to: (a) examine the predictive validity and efficacy of the Advanced Clinical Solutions Word Choice Test (WCT) as a measure of effort relative to the Test of Memory Malingering (TOMM); (b) investigate whether performing a dual (distraction) task would undermine performance on either test; (c) assess the effect of coaching on the diagnostic accuracy of both the WCT and the TOMM; and (d) establish an optimal cut score for the WCT. The current study used a simulation design based on an analogue design in which normal participants were instructed to either apply full effort or simulate a brain injury on the tasks without being detected. Participants included 93 undergraduate university students who were randomly assigned to 1 of 4 conditions: (a) distraction, (b) uncoached traumatic brain injury (TBI) simulators, (c) coached TBI simulators, or (d) full effort. The results demonstrated that the WCT and the TOMM were effective in detecting simulated cognitive impairment. Both tests were resistant to the effects of distraction and were equally effective in detecting coached and uncoached simulators. A cut score of 42 on the WCT was found to provide optimal specificity and sensitivity on the test.

Original languageEnglish
Pages (from-to)114-123
Number of pages10
JournalApplied Neuropsychology:Adult
Issue number2
Publication statusPublished - 4 Mar 2015



  • neuropsychology
  • symptom validity testing
  • tests

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