This study aimed to explore the possibility of using the Figure Weights subtest of the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) as an embedded validity test (EVT).

We conducted a retrospective cohort study of patients seen in the Johns Hopkins All Children’s Hospital (JHACH) Neuropsychology program between 2015 and 2019. Patient age ranged from 6-15 years (median age 11 years). All patients were administered the WISC-V as a portion of their neuropsychological evaluation. The sample included 75 patients who were generally male (63%), White (77%), English dominant (97%), and right-handed (81%).

Effort determination based on RDS identified more patients as having invalid effort. Clinicians identified only 7% of patients with invalid effort; whereas, 16% of patients with invalid effort were identified using the WISC-V RDS. Although patients having valid effort generally performed better on all WISC-V subtests, no significant differences between groups were found. Over 90% of patients were able to get items 1-10 correct on the WISC-V Figure Weights subtest regardless of their effort determination. WISC-V Figure Weights item analysis showed participants in the invalid group sometimes answered more difficult questions correctly while failing easier items which supports inconsistent effort. Further statistical analyses, including discriminant validity tests, were unable to be completed given the study was underpowered due to significant disparity between effort groups.

This study shows support for WISC-V Figure Weights subtest items 1-10 as an embedded EVT given these items were sufficiently easy to pass regardless of whether participant gave valid or invalid effort. As this is an exploratory study, results will need to be replicated in other pediatric samples. Additionally, the discriminant ability of the WISC-V Figure Weights subtest EVT will need to be further investigated.