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Tonning Olsson I, Lundgren J, Hjorth L, Munck Af Rosenschöld P, Hammar Å, Perrin S. Neurocognitive development after pediatric brain tumor - a longitudinal, retrospective cohort study. Child Neuropsychol 2024; 30:22-44. [PMID: 36744788 DOI: 10.1080/09297049.2023.2172149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 01/18/2023] [Indexed: 02/07/2023]
Abstract
Survivors of Pediatric Brain Tumors (PBTs) treated with cranial radiation therapy (CRT) often experience a decline in neurocognitive test scores. Less is known about the neurocognitive development of non-irradiated survivors of PBTs. The aim of this study was to statistically model neurocognitive development after PBT in both irradiated and non-irradiated survivors and to find clinical variables associated with the rate of decline in neurocognitive scores. A total of 151 survivors were included in the study. Inclusion criteria: Diagnosis of PBT between 2001 and 2013 or earlier diagnosis of PBT and turning 18 years of age between 2006 and 2013. Exclusion criteria: Death within a year from diagnosis, neurocutaneous syndromes, severe intellectual disability. Clinical neurocognitive data were collected retrospectively from medical records. Multilevel linear modeling was used to evaluate the rate of decline in neurocognitive measures and factors associated with the same. A decline was found in most measures for both irradiated and non-irradiated survivors. Ventriculo-peritoneal (VP) shunting and treatment with whole-brain radiation therapy (WBRT) were associated with a faster decline in neurocognitive scores. Male sex and supratentorial lateral tumor were associated with lower scores. Verbal learning measures were either stable or improving. Survivors of PBTs show a pattern of decline in neurocognitive scores irrespective of treatment received, which suggests the need for routine screening for neurocognitive rehabilitation. However, survivors treated with WBRT and/or a VP shunt declined at a faster rate and appear to be at the highest risk of negative neurocognitive outcomes and to have the greatest need for neurocognitive rehabilitation.
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Affiliation(s)
- Ingrid Tonning Olsson
- Department of Psychology, Lund University, Lund, Sweden
- Department of Paediatrics, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Johan Lundgren
- Department of Paediatrics, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Lars Hjorth
- Department of Paediatrics, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Per Munck Af Rosenschöld
- Medical Radiation Physics, Lund University, Lund, Sweden
- Radiation Physics, Dept of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Åsa Hammar
- Department of Psychology, Lund University, Lund, Sweden
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
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Papini C, Willard VW, Gajjar A, Merchant TE, Srivastava D, Armstrong GT, Hudson MM, Krull KR, Brinkman TM. Social cognition and adjustment in adult survivors of pediatric central nervous system tumors. Cancer 2023; 129:3064-3075. [PMID: 37329245 PMCID: PMC10528486 DOI: 10.1002/cncr.34889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Survivors of pediatric central nervous system (CNS) tumors are at risk for neurocognitive and social difficulties throughout childhood. This study characterized social cognition (perception and reasoning from social cues) and adjustment in adulthood. METHODS A total of 81 adult survivors of pediatric CNS tumors (51% female; mean [SD] age, 28.0 [5.8] years), were recruited across four groups: (1) no radiation therapy (RT) [n = 21], (2) infratentorial (IT) tumors + focal RT [n = 20], (3) IT tumors + craniospinal irradiation [n = 20], and (4) supratentorial tumors + focal RT [n = 20]. Prevalence of social cognitive and adjustment impairments was compared to test norms. Multivariable models examined clinical and neurocognitive predictors of social cognition and its impact on functional outcomes. RESULTS Survivors demonstrated elevated risk of severe social cognitive impairments (social perception Morbidity Ratio [95% CI] 5.70 [3.46-9.20]), but self-reported few social adjustment problems. Survivors of IT tumors treated with craniospinal irradiation performed nearly 1 SD worse than survivors treated without RT on multiple measures of social cognition (e.g., social perception: β = -0.89, p = .004). Impaired executive functioning and nonverbal reasoning were associated with worse social cognitive performance (e.g., social perception: β = -0.75, p < .001; β = -0.84, p < .001, respectively). Better social perception was associated with higher odds of attaining full-time employment (odds ratio, 1.52 [1.17-1.97]) and at least some college education (odds ratio, 1.39 [1.11-1.74]). CONCLUSIONS Adult survivors of CNS tumors are at elevated risk of severely impaired social cognition, but do not perceive social adjustment difficulties. Better understanding of potential mechanisms underlying social cognitive deficits may inform intervention targets to promote better functional outcomes for at-risk survivors.
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Affiliation(s)
- Chiara Papini
- Department of Psychology and Biobehavioral Sciences, St.
Jude Children’s Research Hospital, Memphis, TN, USA
| | - Victoria W. Willard
- Department of Psychology and Biobehavioral Sciences, St.
Jude Children’s Research Hospital, Memphis, TN, USA
| | - Amar Gajjar
- Department of Pediatric Medicine, St. Jude
Children’s Research Hospital, Memphis, TN, USA
| | - Thomas E. Merchant
- Department of Radiation Oncology, St. Jude
Children’s Research Hospital, Memphis, TN, USA
| | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children’s
Research Hospital, Memphis, TN, USA
| | - Gregory T. Armstrong
- Department of Oncology, St. Jude Children’s Research
Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN, USA
| | - Melissa M. Hudson
- Department of Oncology, St. Jude Children’s Research
Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN, USA
| | - Kevin R. Krull
- Department of Psychology and Biobehavioral Sciences, St.
Jude Children’s Research Hospital, Memphis, TN, USA
| | - Tara M. Brinkman
- Department of Psychology and Biobehavioral Sciences, St.
Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN, USA
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Strauser DR, Shen S, Brehmer CE, Fine E, Liptak C. Barriers to employment for young adult central nervous system tumor survivors: The role of career readiness and core self-evaluations. JOURNAL OF VOCATIONAL REHABILITATION 2023. [DOI: 10.3233/jvr-230008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: Although the majority of childhood cancer survivors make successful transitions to adulthood, research suggests that a significant group experiences ongoing medical concerns, such as psychological distress, that significantly impact the achievement of crucial social roles including employment. OBJECTIVE: The purpose of this study was to examine the relationship between career decision making, core self-evaluations, and perceived internal and external barriers to employment in a sample of young adult central nervous system tumor survivors. METHOD: A sample of 110 young adult survivors of pediatric central nervous system tumors was surveyed. Mediation analysis with structural equational modeling was used to correlate a number of different measures (Career Decision Making [CTI], Perceived Employment Barriers [PEB], and Core-Self Evaluations [CSE]). RESULTS: The presence of both significant direct and indirect effects of career decision making on perceived employment barriers implied that there was a partial mediating effect of core self-evaluations on the association between career readiness and employment barriers. CONCLUSION: Career decision-making is a robust construct that can be applied to young adult central nervous system tumor survivors in effort to gain more insight into the vocational psychological factors that impact career development and employment in this group. Core self-evaluations was found to be a mediator between career decision making and perceived career barriers.
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Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | - Sa Shen
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Elizabeth Fine
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
| | - Cori Liptak
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
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Strauser DR, Rumrill SP, Rumrill PD, Greco CE, Wagner S. The Work Experience Survey: An on-the-job needs assessment tool to promote successful career outcomes for young adult central nervous system cancer survivors. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-191070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | | | - Phillip D. Rumrill
- University of Kentucky, Human Development Institute and Rehabilitation Counseling Program, Lexington, KY, USA
| | | | - Stacia Wagner
- Children’s Brain Tumor Foundation, New York, NY, USA
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5
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Desjardins L, Solomon A, Janzen L, Bartels U, Schulte F, Chung J, Cataudella D, Downie A, Barrera M. Executive functions and social skills in pediatric brain tumor survivors. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 9:83-91. [PMID: 30501139 DOI: 10.1080/21622965.2018.1522589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Pediatric brain tumor survivors (PBTSs) may experience impairment in executive functions and social competence, but their interrelation is not well understood. This study aimed to address the specificity of this relationship. PBTSs (n = 91) were on average 11.21 years old, 5 years from diagnosis, and 48.4% female. One parent and PBTS completed the Social Skills Rating System (subscales: Cooperation, Assertiveness, Empathy, Self-Control, and Total), and parents also completed the Behavior Rating Inventory of Executive Function (General Executive Composite [GEC], Metacognition [MI], and Behavioral Regulation [BRI] indices) and the (Withdrawal scale). Based on proxy reports, more PBTSs had deficits in Cooperation, Assertiveness and Responsibility skills relative to normative data. MI was more consistently associated with parent reported social skills deficits than BRI. PBTSs reported fewer deficits in social skills relative to normative data across all scales; none of the correlations between PBTSs reported social skills and executive functions were significant. Time since diagnosis and proxy reported lower total social skills predicted greater withdrawal. These findings highlight the importance of assessing differential perspectives of PBTSs social competence, and that metacognitive strategies may bear particular importance for the social skills of PBTSs.
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Affiliation(s)
- Leandra Desjardins
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Aden Solomon
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Laura Janzen
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Ute Bartels
- Department of Neuro-Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Fiona Schulte
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | - Andrea Downie
- Department of Psychology, London Health Sciences Centre, London, Canada
| | - Maru Barrera
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
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Strauser DR, Chan F, Fine E, Iwanaga K, Greco C, Liptak C. Development of the perceived barriers scale: a new instrument identifying barriers to career development and employment for young adult survivors of pediatric CNS tumors. J Cancer Surviv 2018; 13:1-9. [PMID: 30357721 DOI: 10.1007/s11764-018-0722-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the significant employment disparities for survivors of pediatric brain tumors, there is increased need to conduct vocational and career research with this group. The purpose of the present study was to construct an instrument, the Perceived Barriers Scale, that is psychometrically sound and has both clinical and research application related to career and employment issues of pediatric brain tumor survivors. METHOD The participants consisted of 110 young adult central nervous system survivors of childhood cancer aged between 18 and 30 years old (M = 23.05, SD = 3.36) who were identified by the DFCI Pediatric Brain Tumor Clinic. The 12-item Perceived Barriers Scale was developed from a comprehensive literature review, clinical interviews conducted with survivors of pediatric brain tumors, and feedback from multidisciplinary providers. Exploratory factor analysis and correlations were completed to examine the initial psychometric properties of the scale. RESULTS Exploratory factors analysis identified two factors that accounted for 57.92% with the two factors labeled as internal barriers and external barriers. All factors loaded significantly onto their respective factors (.48 to .88). The results of the correlational analysis found significant relationships between both internal barrier and external barrier subscales and CSE and WHODAS-2 providing initial support for the construct validity of the Perceived Barriers Scale. CONCLUSIONS Overall, the study findings indicate good psychometrics with the brevity of the scale increasing potential application and utilization in both research and clinical settings. IMPLICATIONS FOR CANCER SURVIVORS Identification of employment barriers for brain tumor survivors provides opportunity for more targeted vocational intervention.
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Affiliation(s)
- David R Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA. .,Work and Disability Lab, Department of Kinesiology And Community Health, 213A Huff Hall, 1206 South Fourth Street, Champaign, IL, 61820, USA.
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Elizabeth Fine
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
| | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Cori Liptak
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
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Szentes A, Erős N, Kekecs Z, Jakab Z, Török S, Schuler D, Hauser P, Garami M. Cognitive deficits and psychopathological symptoms among children with medulloblastoma. Eur J Cancer Care (Engl) 2018; 27:e12912. [DOI: 10.1111/ecc.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 12/31/2022]
Affiliation(s)
| | - Nikoletta Erős
- 2 Department of Pediatrics; Semmelweis University; Budapest Hungary
| | - Zoltán Kekecs
- Department of Psychology; Lund University; Lund Sweden
| | - Zsuzsanna Jakab
- 2 Department of Pediatrics; Semmelweis University; Budapest Hungary
| | - Szabolcs Török
- Institute of Mental Health; Semmelweis University; Budapest Hungary
| | - Dezső Schuler
- 2 Department of Pediatrics; Semmelweis University; Budapest Hungary
| | - Péter Hauser
- 2 Department of Pediatrics; Semmelweis University; Budapest Hungary
| | - Miklós Garami
- 2 Department of Pediatrics; Semmelweis University; Budapest Hungary
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8
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Abstract
Neuroscientific evidence indicates that human social functioning is supported by a distributed network of frontal and temporal brain regions that undergoes significant development during childhood and adolescence. Clinical studies of individuals with early brain insults (EBI) to frontotemporal regions suggest that such lesions may interfere with the maturation of sociocognitive skills and lead to increased sociobehavioural problems. However, little attention has focussed on the direct assessment of sociocognitive skills, such as moral reasoning, following focal EBI. In the present study, the performance of 15 patients with focal EBI (8–16 years) was compared to that of 15 demographically matched controls on basic neuropsychological measures (IQ and executive functions), sociocognitive tasks (moral reasoning, moral decision-making and empathy) and parent reports of sociobehavioural problems and social adaptive skills. Patients with focal EBI had significantly lower levels of moral reasoning maturity, moral decision-making, and empathy than their matched controls, but did not differ on more general measures of cognition. Their parents also reported increased sociobehavioural problems. These findings suggest that focal EBI to frontotemporal regions can result in reduced sociocognitive capacities, more specifically moral reasoning, and increased vulnerability to sociobehavioural problems.
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Wilford J, Buchbinder D, Fortier MA, Osann K, Shen V, Torno L, Sender LS, Parsons SK, Wenzel L. "She Was a Little Social Butterfly": A Qualitative Analysis of Parent Perception of Social Functioning in Adolescent and Young Adult Brain Tumor Survivors. J Pediatr Oncol Nurs 2017; 34:239-249. [PMID: 28615001 DOI: 10.1177/1043454216688660] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Psychosocial sequelae of diagnosis and treatment for childhood brain tumor survivors are significant, yet little is known about their impact on adolescent and young adult (AYA) brain tumor survivors. Interviews were conducted with parents of AYA brain tumor survivors with a focus on social functioning. Semistructured interviews were conducted with English- and Spanish-speaking parents of AYA brain tumor survivors ≥10 years of age who were >2 years postdiagnosis, and analyzed using emergent themes theoretically integrated with a social neuroscience model of social competence. Twenty parents representing 19 survivors with a survivor mean age 15.7 ± 3.3 years and 10.1 ± 4.8 years postdiagnosis were interviewed. Several themes relevant to the social neuroscience social competence model emerged. First, parents' perceptions of their children's impaired social functioning corroborated the model, particularly with regard to poor social adjustment, social withdrawal, impaired social information processing, and developmentally inappropriate peer communication. Second, ongoing physical and emotional sequelae of central nervous system insults were seen by parents as adversely affecting social functioning among survivors. Third, a disrupted family environment and ongoing parent psychosocial distress were experienced as salient features of daily life. We document that the aforementioned framework is useful for understanding the social impact of diagnosis and treatment on AYA brain tumor survivorship. Moreover, the framework highlights areas of intervention that may enhance social functioning for AYA brain tumor survivors.
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Liptak C, Brinkman T, Bronson A, Delaney B, Chordas C, Brand S, Patenaude AF, Muriel AC, Manley P. A social program for adolescent and young adult survivors of pediatric brain tumors: The power of a shared medical experience. J Psychosoc Oncol 2016; 34:493-511. [DOI: 10.1080/07347332.2016.1225146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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de Ruiter MA, Grootenhuis MA, van Mourik R, Maurice-Stam H, Breteler MHM, Gidding C, Beek LR, Granzen B, van Vuurden DG, Schouten-van Meeteren AYN, Oosterlaan J. Timed performance weaknesses on computerized tasks in pediatric brain tumor survivors: A comparison with sibling controls. Child Neuropsychol 2015; 23:208-227. [DOI: 10.1080/09297049.2015.1108395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hocking MC, McCurdy M, Turner E, Kazak AE, Noll RB, Phillips P, Barakat LP. Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology. Pediatr Blood Cancer 2015; 62:375-84. [PMID: 25382825 PMCID: PMC4304946 DOI: 10.1002/pbc.25300] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/16/2014] [Indexed: 12/21/2022]
Abstract
Pediatric brain tumor (BT) survivors are at risk for psychosocial late effects across many domains of functioning, including neurocognitive and social. The literature on the social competence of pediatric BT survivors is still developing and future research is needed that integrates developmental and cognitive neuroscience research methodologies to identify predictors of survivor social adjustment and interventions to ameliorate problems. This review discusses the current literature on survivor social functioning through a model of social competence in childhood brain disorder and suggests future directions based on this model. Interventions pursuing change in survivor social adjustment should consider targeting social ecological factors.
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Affiliation(s)
| | - Mark McCurdy
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Elise Turner
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, Nemours Children’s Health System
- Department of Pediatrics, Sidney Kimmel School of Medicine at Thomas Jefferson University
| | | | - Peter Phillips
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
| | - Lamia P. Barakat
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
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Salley CG, Hewitt LL, Patenaude AF, Vasey MW, Yeates KO, Gerhardt CA, Vannatta K. Temperament and social behavior in pediatric brain tumor survivors and comparison peers. J Pediatr Psychol 2014; 40:297-308. [PMID: 25287068 DOI: 10.1093/jpepsy/jsu083] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the role of temperament (i.e., surgency/positive affect, negative affect, and effortful control) in the social behavior of pediatric brain tumor survivors and comparison classmates. METHODS Parent-, peer-, and self-report data were collected for 75 children after treatment for a brain tumor, and 67 comparison classmates. Tests of mediation and moderated mediation were run to examine whether effortful control accounted for group differences in social behavior and whether this indirect effect was moderated by surgency/positive or negative affectivity. RESULTS Peers described survivors as lower in Leadership-popularity and higher in Sensitivity-isolation and victimization than comparison classmates. Parent and self-report of surgency/positive affect revealed survivors were lower on this dimension. Survivors were rated by parents as demonstrating less effortful control. Effortful control did not consistently account for group differences in social behavior. There was limited evidence of moderated mediation. CONCLUSIONS Research on the implications of potential changes in temperament following treatment is warranted.
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Affiliation(s)
- Christina G Salley
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Larissa L Hewitt
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Andrea F Patenaude
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Michael W Vasey
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Keith O Yeates
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Cynthia A Gerhardt
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Kathryn Vannatta
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Department of Psychology, Department of Pediatrics, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
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14
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Abstract
OBJECTIVE To assess self-perceptions of social behavior among children treated for a brain tumor and comparison children. To investigate group differences in the accuracy of children's self-perceptions as measured by discrepancies between self and peer reports of social behavior and to understand if these phenomena differ by gender. METHOD Self and peer reports of social behavior were obtained in the classrooms of 116 children who were treated for an intracranial tumor. Social behaviors were assessed using the Revised Class Play, which generates indices for 5 behavioral subscales: Leadership-popularity, Prosocial, Aggressive-disruptive, Sensitive-isolated, and Victimization. A child matched for gender, race, and age was selected from each survivor's classroom to serve as a comparison. Abbreviated IQ scores were obtained in participants' homes. RESULTS Relative to comparison children, those who had undergone treatment for a brain tumor overestimated their level of Leadership-popularity and underestimated levels of Sensitive-isolated behaviors and Victimization by peers. Female survivors were more likely than male survivors to underestimate Sensitive-isolated behaviors and Victimization. CONCLUSION Following treatment for a brain tumor, children (particularly girls) may be more likely than healthy children to underestimate peer relationship difficulties. These discrepancies should be considered when obtaining self-report from survivors and developing interventions to improve social functioning.
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Tonning Olsson I, Perrin S, Lundgren J, Hjorth L, Johanson A. Access to neuropsychologic services after pediatric brain tumor. Pediatr Neurol 2013; 49:420-3. [PMID: 24095573 DOI: 10.1016/j.pediatrneurol.2013.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/05/2013] [Accepted: 07/06/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Increasing survival rates for children with brain tumors creates a greater need for neuropsychologic follow-up and intervention. The aim of this study was to evaluate rates of referral by medical doctors to neuropsychologic services and patient and treatment factors that differentiated referred and nonreferred patients. METHODS Data were retrieved from medical records of all pediatric brain tumor patients in southern Sweden diagnosed between 1993 and 2004 who survived more than 1 year (n = 132). Characteristics of the patients, the cancer, and treatment received were then compared for patients who were and were not referred for neuropsychologic examination during that period. RESULTS Sixty-four (48%) of the pediatric brain tumor patients were referred for neuropsychologic evaluation. These patients had significantly larger tumors, more recurrences of cancer, and increased intracranial pressure at diagnosis when compared with the nonreferred group (n = 68). However, most of the patients in the nonreferred group either had significant risk factors for cognitive impairment or were reporting impairments that would suggest a referral was warranted. CONCLUSIONS Given the high rates of cognitive impairment in children with brain tumors, referral to neuropsychologic services should be considered in all survivors. In addition to improving long-term adjustment, systematic referral can provide data on cognitive impairments, making it possible to evaluate different cancer treatment protocols not only in terms of survival but also in terms of quality of survival. Greater efforts are needed to disseminate and raise awareness about published guidelines on the long-term care of pediatric brain tumor patients.
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Affiliation(s)
- Ingrid Tonning Olsson
- Department of Psychology, Lund University, Lund, Sweden; Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
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Willard VW, Hardy KK, Allen TM, Hwang EI, Gururangan S, Hostetter SA, Bonner MJ. Sluggish cognitive tempo in survivors of pediatric brain tumors. J Neurooncol 2013; 114:71-8. [DOI: 10.1007/s11060-013-1149-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 05/06/2013] [Indexed: 11/24/2022]
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17
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de Ruiter MA, van Mourik R, Schouten-van Meeteren AYN, Grootenhuis MA, Oosterlaan J. Neurocognitive consequences of a paediatric brain tumour and its treatment: a meta-analysis. Dev Med Child Neurol 2013; 55:408-17. [PMID: 23157447 DOI: 10.1111/dmcn.12020] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIM This meta-analysis provides a systematic review of studies into intellectual and attentional functioning of paediatric brain tumour survivors (PBTS) as assessed by two widely used measures: the Wechsler Intelligence Scale for Children (3rd edition; WISC-III) and the Conners' Continuous Performance Test (CPT). METHOD Studies were located that reported on performance of PBTS (age range 6-16y). Meta-analytic effect sizes were calculated for Full-scale IQ, Performance IQ, and Verbal IQ as measured by the WISC-III, and mean hit reaction time, errors of omission, and errors of commission as measured by the CPT. Exploratory analyses investigated the possible impacts of treatment mode, tumour location, age at diagnosis, and time since diagnosis on intelligence. RESULTS Twenty-nine studies were included: 22 reported on the WISC-III in 710 PBTS and seven on CPT results in 372 PBTS. PBTS performed below average (p(s) <0.001) on Full-scale IQ (Cohen's d=-0.79), Performance IQ (d=-0.90), and Verbal IQ (d=-0.54). PBTS committed more errors of omission than the norm (d=0.82, p<0.001); no differences were found for mean hit reaction time and errors of commission. Cranial radiotherapy, chemotherapy, and longer time since diagnosis were associated with lower WISC-III scores (p(s) <0.05). INTERPRETATION PBTS have seriously impaired intellectual functioning and attentiveness. Being treated with cranial radiotherapy and/or chemotherapy as well as longer time since diagnosis leads to worse intellectual functioning.
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Affiliation(s)
- Marieke A de Ruiter
- Pediatric Psychosocial Department, Emma Children's Hospital Academic Medical Center, Amsterdam, The Netherlands.
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18
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de Ruiter MA, Schouten-Van Meeteren AYN, van Mourik R, Janssen TWP, Greidanus JEM, Oosterlaan J, Grootenhuis MA. Neurofeedback to improve neurocognitive functioning of children treated for a brain tumor: design of a randomized controlled double-blind trial. BMC Cancer 2012; 12:581. [PMID: 23217162 PMCID: PMC3530427 DOI: 10.1186/1471-2407-12-581] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 11/22/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neurotoxicity caused by treatment for a brain tumor is a major cause of neurocognitive decline in survivors. Studies have shown that neurofeedback may enhance neurocognitive functioning. This paper describes the protocol of the PRISMA study, a randomized controlled trial to investigate the efficacy of neurofeedback to improve neurocognitive functioning in children treated for a brain tumor. METHODS/DESIGN Efficacy of neurofeedback will be compared to placebo training in a randomized controlled double-blind trial. A total of 70 brain tumor survivors in the age range of 8 to 18 years will be recruited. Inclusion also requires caregiver-reported neurocognitive problems and being off treatment for more than two years. A group of 35 healthy siblings will be included as the control group. On the basis of a qEEG patients will be assigned to one of three treatment protocols. Thereafter patients will be randomized to receive either neurofeedback training (n=35) or placebo training (n=35). Neurocognitive tests, and questionnaires administered to the patient, caregivers, and teacher, will be used to evaluate pre- and post-intervention functioning, as well as at 6-month follow-up. Siblings will be administered the same tests and questionnaires once. DISCUSSION If neurofeedback proves to be effective for pediatric brain tumor survivors, this can be a valuable addition to the scarce interventions available to improve neurocognitive and psychosocial functioning. TRIAL REGISTRATION ClinicalTrials.gov NCT00961922.
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Affiliation(s)
- Marieke A de Ruiter
- Psychosocial Department, Emma Children's Hospital AMC, room A3-241, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
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19
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Brinkman TM, Palmer SL, Chen S, Zhang H, Evankovich K, Swain MA, Bonner MJ, Janzen L, Knight S, Armstrong CL, Boyle R, Gajjar A. Parent-reported social outcomes after treatment for pediatric embryonal tumors: a prospective longitudinal study. J Clin Oncol 2012; 30:4134-40. [PMID: 23071220 DOI: 10.1200/jco.2011.40.6702] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine longitudinal parent-reported social outcomes for children treated for pediatric embryonal brain tumors. PATIENTS AND METHODS Patients (N=220) were enrolled onto a multisite clinical treatment protocol. Parents completed the Child Behavior Checklist/6-18 at the time of their child's diagnosis and yearly thereafter. A generalized linear mixed effects model regression approach was used to examine longitudinal changes in parent ratings of social competence, social problems, and withdrawn/depressed behaviors with demographic and treatment factors as covariates. RESULTS During the 5-year period following diagnosis and treatment, few patients were reported to have clinically elevated scores on measures of social functioning. Mean scores differed significantly from population norms, yet remained within the average range. Several factors associated with unfavorable patterns of change in social functioning were identified. Patients with high-risk treatment status had a greater increase in parent-reported social problems (P=.001) and withdrawn/depressed behaviors (P=.01) over time compared with average-risk patients. Patients with posterior fossa syndrome had greater parent-reported social problems over time (P=.03). Female patients showed higher withdrawn/depressed scores over time compared with male patients (P<.001). Patient intelligence, age at diagnosis, and parent education level also contributed to parent report of social functioning. CONCLUSION Results of this study largely suggest positive social adjustment several years after diagnosis and treatment of a pediatric embryonal tumor. However, several factors, including treatment risk status and posterior fossa syndrome, may be important precursors of long-term social outcomes. Future research is needed to elucidate the trajectory of social functioning as these patients transition into adulthood.
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Affiliation(s)
- Tara M Brinkman
- St Jude Children's Research Hospital, Department of Epidemiology and Cancer Control, 262 Danny Thomas Place, MS 735, Memphis, TN 38105, USA.
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Wolfe KR, Walsh KS, Reynolds NC, Mitchell F, Reddy AT, Paltin I, Madan-Swain A. Executive functions and social skills in survivors of pediatric brain tumor. Child Neuropsychol 2012; 19:370-84. [PMID: 22420326 DOI: 10.1080/09297049.2012.669470] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed.
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Affiliation(s)
- Kelly R Wolfe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
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21
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Porter MA, Dodd H, Cairns D. Psychopathological and behavior impairments in Williams-Beuren syndrome: the influence of gender, chronological age, and cognition. Child Neuropsychol 2012; 15:359-74. [PMID: 19125360 DOI: 10.1080/09297040802577881] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to explore psychopathological and behavior impairments in Williams-Beuren syndrome (WBS) by focusing on individual differences rather than group tendencies. Parent/Guardian ratings on the Child Behavior Checklist were analyzed in order to examine the influence of gender, chronological age, and cognitive abilities on psychopathological impairment within WBS. In line with predictions, and consistent with cognitive heterogeneity in WBS, psychopathological and behavioral abnormalities were variable, with gender and specific cognitive abilities making significant and independent contributions to this variance. For gender, females were significantly more likely than males with WBS to display difficulties with externalizing problems. For specific cognitive abilities, those cognitive functions characteristic of the classic WBS cognitive profile (a strength in verbal skills and a weakness in spatial skills) related to significantly greater internalizing difficulties. Future studies should explore underlying genetic and neurological differences in individuals with WBS in order to help explain the variability in psychopathological and cognitive functions.
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Affiliation(s)
- Melanie A Porter
- Psychology Department, Macquarie University, Sydney, Australia. melanie.porter@psy mq.edu.au
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22
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Robinson KE, Kuttesch JF, Champion JE, Andreotti CF, Hipp DW, Bettis A, Barnwell A, Compas BE. A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatr Blood Cancer 2010; 55:525-31. [PMID: 20658625 DOI: 10.1002/pbc.22568] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Deficits in neurocognitive functioning are an important area of late effects in survivors of pediatric brain tumors, but a quantitative analysis of the magnitude of these deficits has yet to be conducted. PROCEDURE The purpose of the current article is to provide a comprehensive meta-analysis of the literature on long-term neurocognitive effects found in these survivors. RESULTS Results indicated significant deficits in both narrow and broad indices of neurocognitive functioning, and the overall magnitude of the effects across all domains ranged from small to large in magnitude (g = -0.45 to -1.43) with a large mean overall effect size of g = -0.91. CONCLUSIONS These findings underscore the importance of monitoring the neurocognitive late effects in survivors of pediatric brain tumors, and the need for more consistent consideration of demographic, diagnostic, and treatment-related variables in future research to allow for examination of factors that may moderate these deficits.
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Affiliation(s)
- Kristen E Robinson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennesse 37203, USA.
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Schulte F, Bartels U, Bouffet E, Janzen L, Hamilton J, Barrera M. Body weight, social competence, and cognitive functioning in survivors of childhood brain tumors. Pediatr Blood Cancer 2010; 55:532-9. [PMID: 20658626 DOI: 10.1002/pbc.22543] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of the following article was to examine: (a) body mass index (BMI) in survivors of childhood brain tumors; (b) the association of BMI with social competence and cognitive functioning; and (c) congruency in reporting of survivors' social competence by the survivors, parents, and teachers. PROCEDURE Fifty-four survivors of childhood brain tumors (32 males) 8-18 years participated. BMI-for-age percentiles and BMI Z-scores (SDS) were calculated and survivors were categorized as underweight, normal, overweight, or obese, using established criteria. Informants completed measures of social competence and internalizing behaviors. Survivors also completed a test of self-perception and cognitive functioning (IQ). RESULTS Survivors were more underweight (15% vs. 4%), and less overweight (17% vs. 31%) than population norms (chi(2) = 38.62, P < 0.001). Parents perceived lower social competence in survivors that were underweight, had lower verbal IQ, and higher internalizing behaviors (P < 0.05). A significant interaction between BMI-for-age and IQ on self-perception of close friendships suggested that survivors with lower weight and lower IQ perceived having fewer close friendships (P < 0.05). Congruency among the three informants was moderate. CONCLUSIONS Survivors of childhood brain tumors are at increased risk for underweight. Underweight status is related to lower parent reported social competence and survivors' self-perception of fewer close friendships in the presence of low IQ.
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Affiliation(s)
- Fiona Schulte
- Hematology/Oncology/Transplant Program Department of Oncology, Alberta Children's Hospital, Calgary, Alberta, Canada.
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Social competence in childhood brain tumor survivors: a comprehensive review. Support Care Cancer 2010; 18:1499-513. [DOI: 10.1007/s00520-010-0963-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 07/20/2010] [Indexed: 10/19/2022]
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Lim AN, Lange BJ, King AA. Rehabilitation for survivors of pediatric brain tumors: our work has just begun. FUTURE NEUROLOGY 2010. [DOI: 10.2217/fnl.09.65] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
CNS tumors are the second most common childhood cancer, and survival rates for children with these tumors have increased over the last few decades. Children are often treated with a combination of neurosurgery, chemotherapy and cranial radiation. Both the tumors and these therapies can lead to cognitive challenges, decreased social participation or coping, and physical dysfunction, which can impede a child’s ability to complete daily activities and participate in his or her environment. This review describes these late effects in the framework of the International Classification of Functioning, Disability and Health, and discusses the few studies that have attempted to improve children’s functioning in their environment beyond just survival.
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Affiliation(s)
- Audrey N Lim
- Program of Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA
| | - Beverly J Lange
- University of Pennsylvania Department of Pediatrics & The Children’s Hospital of Philadelphia, PA, USA
| | - Allison A King
- Washington University School of Medicine, 660 South Euclid, Campus Box 8505, St Louis, MO 3110, USA
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Willard VW, Hardy KK, Bonner MJ. Gender differences in facial expression recognition in survivors of pediatric brain tumors. Psychooncology 2009; 18:893-7. [PMID: 19061181 DOI: 10.1002/pon.1502] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the relation between gender, history of cranial radiation therapy (CRT) and facial expression recognition (FER) skill in survivors of pediatric brain tumors. METHODS Fifty-three survivors (27 females) completed a measure of FER and an intelligence test. RESULTS There was a significant interaction between gender and CRT on ability to interpret low-intensity facial expressions, such that females who had not had CRT made fewer errors than either females who had CRT or males. CONCLUSION A history of CRT has a notable effect on FER skill in females: girls who received CRT performed significantly more poorly than girls who did not.
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Affiliation(s)
- Victoria W Willard
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA.
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27
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Barrera M, Schulte F. A group social skills intervention program for survivors of childhood brain tumors. J Pediatr Psychol 2009; 34:1108-18. [PMID: 19321717 DOI: 10.1093/jpepsy/jsp018] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the feasibility and preliminary outcomes of a social skills group intervention program for child brain tumor survivors. METHODS Participants were 32 survivors (14 females) aged 8-18 years. Medulloblastoma (28%) was the main diagnosis. The intervention consisted of eight 2-hr weekly sessions focused on social skills including friendship making and assertion. Survivors and parents completed measures of social skills, quality of life, behavior and depression, at baseline, pre- and post-intervention, and 6 months later. RESULTS Feasibility analyses revealed promising acceptability, retention, recruitment, and treatment fidelity. Significant improvement was found after intervention based on parents' reports of self-control [F(1,27) = 5.97, p <.05], social skills [F(1,28) = 5.70, p <.05], and quality of life [F(1,15) = 17.98, p <.01]. CONCLUSIONS The intervention is feasible and outcomes based on parental reports provide preliminary support for the efficacy of the program.
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Affiliation(s)
- M Barrera
- Department of Psychology, The Hospital for Sick Children, University of Toronto.
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28
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Bonner MJ, Hardy KK, Willard VW, Gururangan S. Additional Evidence of a Nonverbal Learning Disability in Survivors of Pediatric Brain Tumors. CHILDRENS HEALTH CARE 2009. [DOI: 10.1080/02739610802615849] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bonner MJ, Hardy KK, Willard VW, Anthony KK, Hood M, Gururangan S. Social functioning and facial expression recognition in survivors of pediatric brain tumors. J Pediatr Psychol 2008; 33:1142-52. [PMID: 18390896 DOI: 10.1093/jpepsy/jsn035] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To assess social functioning and facial expression recognition skill in survivors of pediatric brain tumors (BT) as compared to children with juvenile rheumatoid arthritis (JRA). METHODS The social functioning of 51 survivors of BT and 31 children with JRA was assessed using a facial expression recognition task, questionnaire ratings of social functioning, and an IQ screener. RESULTS After controlling for estimated IQ, survivors of BT made significantly more errors interpreting adult facial expressions as compared to children with JRA. Additionally, history of therapy and diagnosis age predicted performance on the child portion of the facial recognition task. Finally, survivors of BT demonstrated significantly impaired social functioning across multiple measures when compared to children with JRA. CONCLUSIONS Survivors of pediatric BT showed significant deficits in social functioning as compared to an illness comparison group. Errors in facial expression recognition represent another method for evaluating deficits that contribute to social outcomes.
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Affiliation(s)
- Melanie J Bonner
- Department of Psychiatry, Duke University Medical Center, DUMC Box 3527, Durham, NC 27710, USA.
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O'Toole K, Borden KA, Miller C. Long-term psychosocial and adaptive outcomes in children with arteriovenous malformations. Rehabil Psychol 2006. [DOI: 10.1037/0090-5550.51.1.60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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