Kristen R Hoskinson1,2, Kelly R Wolfe3, Keith Owen Yeates4,5, E Mark Mahone6,7, Kim M Cecil8, M Douglas Ris9,10. 1. Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 2. Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA. 3. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. 4. Department of Psychology, Alberta Children's Hospital Research Institute, Calgary, AB, Canada. 5. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. 6. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA. 7. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 8. Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 9. Psychology Service, Texas Children's Hospital, Houston, TX, USA. 10. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Abstract
BACKGROUND: Children are at risk for behavioral and adaptive difficulties following pediatric brain tumor. This study explored whether familial/demographic, developmental, diagnostic, or treatment-related variables best predict posttreatment behavioral and adaptive functioning. METHODS: Participants included 40 children (mean age = 12.76 years, SD = 4.01) posttreatment (mean time since diagnosis = 1.99 years, SD = 0.21) for pediatric brain tumor. Parents rated children's behavioral adjustment and adaptive functioning and provided demographic and developmental histories. Diagnostic and treatment-related information was abstracted from medical records. RESULTS: Ratings of adaptive and behavioral functioning approximately 2 years postdiagnosis were within the average range, although the percentage of children exceeding clinical cutoffs for impairment in adaptive skills exceeded expectation, particularly practical skills. Premorbid behavior problems and tumor size predicted posttreatment adaptive functioning. After accounting for adaptive functioning near diagnosis, premorbid behavior problems predicted declines in adaptive functioning 2 years postdiagnosis. After accounting for adjustment near diagnosis, no variables predicted declines in behavioral adjustment. CONCLUSIONS: Children may be vulnerable to reduced adaptive functioning following pediatric brain tumor treatment, especially in practical skills. Assessing prediagnosis functioning and diagnostic and treatment-related variables may improve our ability to predict those at greatest risk, although those factors may be less helpful in identifying children likely to develop behavioral difficulties. Screening of these factors in tertiary care and long-term follow-up settings may improve identification of those at greatest need for support services.
BACKGROUND:Children are at risk for behavioral and adaptive difficulties following pediatric brain tumor. This study explored whether familial/demographic, developmental, diagnostic, or treatment-related variables best predict posttreatment behavioral and adaptive functioning. METHODS:Participants included 40 children (mean age = 12.76 years, SD = 4.01) posttreatment (mean time since diagnosis = 1.99 years, SD = 0.21) for pediatric brain tumor. Parents rated children's behavioral adjustment and adaptive functioning and provided demographic and developmental histories. Diagnostic and treatment-related information was abstracted from medical records. RESULTS: Ratings of adaptive and behavioral functioning approximately 2 years postdiagnosis were within the average range, although the percentage of children exceeding clinical cutoffs for impairment in adaptive skills exceeded expectation, particularly practical skills. Premorbid behavior problems and tumor size predicted posttreatment adaptive functioning. After accounting for adaptive functioning near diagnosis, premorbid behavior problems predicted declines in adaptive functioning 2 years postdiagnosis. After accounting for adjustment near diagnosis, no variables predicted declines in behavioral adjustment. CONCLUSIONS:Children may be vulnerable to reduced adaptive functioning following pediatric brain tumor treatment, especially in practical skills. Assessing prediagnosis functioning and diagnostic and treatment-related variables may improve our ability to predict those at greatest risk, although those factors may be less helpful in identifying children likely to develop behavioral difficulties. Screening of these factors in tertiary care and long-term follow-up settings may improve identification of those at greatest need for support services.
Authors: Kimberly P Raghubar; Jessica Orobio; M Douglas Ris; Andrew M Heitzer; Alexandra Roth; Austin L Brown; M Fatih Okcu; Murali Chintagumpala; David R Grosshans; Arnold C Paulino; Anita Mahajan; Lisa S Kahalley Journal: Pediatr Blood Cancer Date: 2019-05-27 Impact factor: 3.167
Authors: Alexandra K Roth; M Douglas Ris; Jessica Orobio; Judy Xue; Anita Mahajan; Arnold C Paulino; David Grosshans; M Fatih Okcu; Murali Chintagumpala; Lisa S Kahalley Journal: Pediatr Blood Cancer Date: 2019-11-17 Impact factor: 3.167
Authors: Yuliang Wang; Anthony Pak Yin Liu; Tatia Mei-Chun Lee; Wilfred Hing Sang Wong; Daniel Yee Tak Fong; Lok Kan Leung; Matthew Ming Kong Shing; Dennis Tak-Loi Ku; Godfrey Chi-Fung Chan; Winnie Wan-Yee Tso Journal: Cancers (Basel) Date: 2022-07-04 Impact factor: 6.575