Cognitive and problem solving training in children with cancer: a pilot project.

BACKGROUND: Neurocognitive sequelae are among the most debilitating late effects experienced by survivors of childhood cancer, with far reaching consequences for educational, social, and adaptive development. Empirically validated interventions to address such disease and treatment related psychosocial morbidities are needed. PROCEDURE: We conducted a pilot study to evaluate participants' acceptance and impact of a 15-session, clinic-based training program to teach compensatory learning and problem-solving skills in survivors with cognitive deficits. The intervention program consisted of 5 core components designed to improve daily problem solving, attention and memory, and academic performance.
RESULTS: A sample of 12 survivors completed the program. Virtually all objective performance scores showed gains from preintervention to postintervention in the expected positive direction, although only 2 of the gains were statistically significant. Parent responses indicated they perceived the skills taught to be useful, to have improved the child's problem-solving ability and learning skills, to have provided concrete and practical interventions for the home, and to have increased parental knowledge. Similarly, the children rated the overall program high, and reported satisfaction with learning more about their relative cognitive strengths and weaknesses and practical problem solving for academic difficulties.
CONCLUSIONS: Although the majority of enrolled families completed at least 70% of the training sessions, the overall low participation rate from eligible families raise concern about widespread acceptance of such programs in the oncology clinic. The limitations of the study design and recommendations for future research are discussed.