Objective: The goal of this case study is to provide support for the use of multiple measures of performance validity in neuropsychological evaluations of pediatric populations, as is generally done in adult neuropsychological examination. Method: This case study examines the neuropsychological profile of an adolescent female who sustained a concussion two months prior to testing. Presenting complaints at the time of evaluation included sleep problems and headaches. Comorbid diagnoses of dyslexia and attention deficit/hyperactivity disorder (ADHD) were reported. A standard neurocognitive test battery was administered, as were measures of performance validity [(e.g., Reliable Digit Span; Medical Symptom Validity Test (MSVT); Test of Memory Malingering (TOMM)]. A self-report rating of behavioral functioning also was completed. Results: Performance on neuropsychological measures showed variability. The patient initially failed the MSVT and performed poorly on the WISC-IV Digit Span, but passed the TOMM. The MSVT was re-administered and modified (patient read words out loud); however, the patient failed a second time. Conclusion: These findings suggest that the use of a single measure of performance validity in pediatric neuropsychological testing, especially in evaluation of adolescent concussion may be insufficient. This study also offers strong support for the use of the MSVT in evaluation of adolescent concussion cases, as has been previously published (Kirkwood, Yeates, Randolph, and Kirk). In this case, neuropsychological interpretation would have been flawed had one only used the TOMM. Future research should focus on the underlying factors that impact variable effort during.