Those assessing mental disability as a result of a brain injury need to rule out the possibility that the injured person may be feigning mental impairment for financial gain.

Several tests may be used to determine whether or not a person is faking memory impairment, however, the Test of Memory Malingering (TOMM) is considered the most reliable.

TOMM Visual Memory Recognition Test

The TOMM is designed to detect individuals who deliberately choose wrong answers in order to appear more cognitively impaired than is actually the case. The 50-question TOMM visual memory recognition test is administered in two learning trials, in which examinees are shown 50 line drawings for 3 seconds each. Each trial is followed by a forced-choice recognition trial, with feedback provided for every response. Patients who are making a good effort are expected to score at least 45 correct on Trial 2.

Performance on Trial 2 is very high for non-malingerers regardless of age, neurological dysfunction, or psychological symptom. The material on the TOMM is designed to be so easy that well-motivated individuals with brain damage can perform in the normal range. However, a large number of intellectually disabled (formerly called retarded) individuals have been falsely identified with the TOMM as not putting forth maximum effort when they are actually trying their best.

Despite some limitations, its simple design, ease of use, and relatively short administration time make the TOMM test ideal to use in measuring feigned cognitive impairment.