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Psychosocial and behavioral functioning among pediatric brain tumor survivors

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Abstract

Objective: To describe the psychosocial and behavioral functioning, as described by patient, parent and teacher, of a cohort of adolescents who have been previously treated for a brain tumor.

Methods: A cohort of 32 patients, 12–18 years old, were evaluated between 1 and 5 years post-treatment for brain tumor during the patient's regularly scheduled follow-up clinic appointment at the Dana-Farber Cancer Institute. The Self-Report questionnaire and the Parent-Report of the Behavioral Assessment System for Children (BASC) were administered to the patient and to one of the patient's parents, respectively. In addition, the BASC Teacher-Report was completed by the patient's teacher. Descriptive statistics were generated; binomial distribution analyses were carried out to assess whether the proportion of individuals with impaired performance on each measure exceeded normative expectations.

Results: Comparison of the proportion of patients with elevated scores to normative expectations indicated no excess of elevated scores on any of the BASC scales of the Self-Report. However, parents endorsed items in the areas of attention problems and leadership; teachers endorsed items concerning learning problems; and both parents and teachers endorsed items indicative of somatization behaviors.

Conclusions: Parent and teacher feedback indicate some level of psychosocial and behavioral morbidity for adolescents treated for a brain tumor; this finding contrasts with adolescent Self-Report indicating no difficulties in behavioral and psychosocial functioning. The extent to which these vulnerabilities impact quality of life and the discrepancy between reporters should be assessed in follow-up studies with a larger cohort of patients.

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References

  1. Smith MA, Freidlin B, Ries LA, Simon R:Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90: 1269–1277, 1998

    Google Scholar 

  2. Carpentieri SC, Waber DP, Scott RM, Goumnerova LC, Kieran MW, Cohen LE, Kim F, Billett AL, Tarbell NJ, Pomeroy SL: Memory deficits among children with craniopharyngiomas. Neurosurgery 49: 1053–1057, 2001

    Google Scholar 

  3. Mulhern RK, Reddick WE, Palmer SL, Glass JO, Elkin TD, Kun LE, Taylor J, Langston J, Gajjar A: Neurocognitive deficits in medulloblastoma survivors and white matter loss. Ann Neurol 46: 834–841, 1999

    Google Scholar 

  4. Cavazzutti V, Winston K, Baker R, Welch K: Psychological changes following surgery for tumors in the temporal lobe. J Neurosurg 53: 618–626, 1980

    Google Scholar 

  5. Jannoun L, Bloom HJG: Long-term psychological effects in children treated for intracranial tumors. Int J Radiat Oncol Biol Phys 18: 747–753, 1990

    Google Scholar 

  6. Packer RJ, Goldwein J, Nicholson HS, Vezina LG, Allen JC, Ris MD, Muraszko K, Rorke LB, Wara WM, Cohen BH, Boyett JM: Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: a Children's Cancer Group Study. J Clin Oncol 17: 2127–2136, 1999

    Google Scholar 

  7. Riva D, Giorgi C: The neurodevelopmental price of survival in children with malignant brain tumors. Child Nerv Syst 16: 751–754, 2000

    Google Scholar 

  8. Siffert J, Allen JC: Late effects of therapy of thalamic and hypothalamic tumors in childhood: vascular, neurobehavioral and neoplastic. Pediatr Neurosurg 33: 105–111, 2000

    Google Scholar 

  9. Ris MD, Noll RB: Long-term neurobehavioral outcome in pediatric brain-tumor patients: review and methodological critique. J Clin Exp Neuropsychol 16: 21–42, 1994

    Google Scholar 

  10. Forman NK, Faestel PM, Pearson J, Disabato J, Poole M, Wilkening G, Arenson EB, Greffe B, Thorne R: Health status in 52 long-term survivors of pediatric brain tumors. J Neuro-Oncol 41: 47–53, 1999

    Google Scholar 

  11. Carroll N, Neal LA: Diencephalic tumours presenting as behavioural problems in the workplace. Occup Med 47: 52–54, 1997

    Google Scholar 

  12. Clopper RR, Meyer WJ, Udverhelyi GB, Money J, Aarabi B, Mulvihill JJ, Piasio M: Postsurgical IQ and behavioral data on 20 patients with a history of childhood craniopharyngioma. Psychoneuroendocrinology 2: 235–372, 1977

    Google Scholar 

  13. Danoff BF, Cowchock FS, Marquette C: Assessment of the long-term effects of primary radiation therapy for brain tumors in children. Cancer 49: 1580–1586, 1982

    Google Scholar 

  14. LeBaron S, Zeltzer PM, Seltzer LK, Scott S, Marlin AE: Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma. Cancer 62: 1215–1222, 1988

    Google Scholar 

  15. Mulhern RK, Carpentieri SC, Shema S, Stone P, Fairclough D: Factors associated with social and behavioral problems among children recently diagnosed with brain tumor. J Pediatr Psychol 18: 339–350, 1993

    Google Scholar 

  16. Packer RJ, Sposto R, Atkins TE: Quality of life in children with primitive neuroectodermal tumor (medulloblastoma) of the posterior fossa. Pediatr Neurosci 13: 169–175, 1988

    Google Scholar 

  17. Greenberg HS, Kazak AE, Meadows AT: Psychological functioning in 8-16 year old cancer survivors and their parents. J Pediatr 114: 488–493, 1989

    Google Scholar 

  18. Mulhern RK, Horowitz ME, Ochs J, Friedman AG: Assessment of quality of life among pediatric patients with cancer. Psychol Assess 1: 130–138, 1989

    Google Scholar 

  19. Kun LE, Mulhern RK, Crisco JJ: Quality of life in children treated for brain tumors: intellectual, emotional and academic function. J Neurosurg 58: 1–6, 1983

    Google Scholar 

  20. Lannering B, Marky I, Lundberg A, Olssom E: Long-term sequelae after pediatric brain tumors: their effect on disability and quality of life. Med Pediatr Oncol 18: 304–310, 1990

    Google Scholar 

  21. Mulhern RK, Kovnar EH, Kun LE, Crisco JJ, Williams JM: Psychologic and neurologic function following treatment for childhood temporal lobe astrocytoma. J Child Neurol 3: 47–52, 1988

    Google Scholar 

  22. Carpentieri SC, Mulhern RK, Douglas S, Hanna S, Fairclough D: Behavioral resiliency among children surviving brain tumors: a longitudinal study. J Clin Child Psychol 22: 236–246, 1993

    Google Scholar 

  23. Sollee NP, Kindlon DJ: Lateralized brain injury and behavior problems in children. J Abnorm Child Psychol 15: 479–490, 1987

    Google Scholar 

  24. Kupst MJ, Shulman JL: Long-term coping with pediatric leukemia: a six year follow-up study. J Pediatr Psychol 13: 7–22, 1988

    Google Scholar 

  25. Canning EH, Kelleher K: Performance of screening tools for mental health problems in chronically ill children. Arch Pediatr Adolesc Med 148: 272–278, 1994

    Google Scholar 

  26. Harris ES, Canning RD, Kelleher KJ: A comparison of measures of adjustment, symptoms, and impairment among children with chronic medical conditions. J Am Acad Child Adolesc Psychiatry 35: 1025–1032, 1996

    Google Scholar 

  27. Perrin EC, Stein REK, Drotar D: Cautions in using the Child Behavior Checklist: observations based on research about children with a chronic illness. J Pediatr Psychol 16: 411–421, 1991

    Google Scholar 

  28. Reynolds CR, Kemphaus RW: Behavior Assessment System for Children (BASC). AGS Inc., Minn, 1992, pp 1–310

  29. Shelby MD, Nagle RJ, Barnett-Queen LL, Quattlebaum PD, Wuori DF: Parental reports of psychosocial adjustment and social competence in child survivors of Acute Lymphocytic Leukemia. Child Health Care 27: 113–129, 1998

    Google Scholar 

  30. Flanagan R: A review of the Behavior Assessment System for Children (BASC): assessment consistent with the requirements of the Individuals with Disabilities Education Act (IDEA). J School Psychol 33: 177–186, 1995

    Google Scholar 

  31. Doyle A, Ostrander R, Skare S, Crosby RD, August GJ: Convergent and criterion-related validity of the Behavior Assessment System for Children-Parent Rating Scale. J Clin Child Psychol 26: 276–284, 1977

    Google Scholar 

  32. Merenda PF: BASC: Behavior Assessment System for Children. Meas Eval Counsel Develop 28: 229–232, 1996

    Google Scholar 

  33. Sandoval J, Echandia A: Behavior assessment system for children. J School Psychol 32: 419–425, 1995

    Google Scholar 

  34. Eapen V, Revesz T, Mpofu C, Daradkeh T: Self-perception profile in children with cancer: self vs. parent report. Psychol Rep 84: 427–432, 1999

    Google Scholar 

  35. Levi RB, Drotar D: Health-related quality of life in childhood cancer: discrepancy in parent-child reports. Int J Cancer (Suppl 12): 58–64, 1999

  36. Radcliffe J, Bennett D, Kazak AE, Foley B, Phillips PC: Adjustment in childhood brain tumor survival: child, mother, and teacher report. J Pediatr Psychol 21: 529–539, 1996

    Google Scholar 

  37. Fuemmeler BF, Mullins, LL, Marx BP: Posttraumatic stress and general distress among parents of children surviving a brain tumor. Child Health Care 30: 169–182, 2001

    Google Scholar 

  38. Mulhern RK, Fairclough DL, Smith B, Douglas SM: Maternal depression, assessment methods, and physical symptoms affect estimates of depressive symptomatology among children with cancer. J Pediatr Psychol 17: 313–326, 1992

    Google Scholar 

  39. Schwean VL, Burt K, Saklofske DH: Correlates of motherand teacher-ratings of hyperactivity-impulsivity and inattention in children with ADHD. Can J School Psychol 15: 43–62, 1999

    Google Scholar 

  40. Fossen A, Abrahamsen TG, Storm-Mathisen I: Psychological outcome in children treated for brain tumor. Pediatr Hematol Oncol 15: 479–488, 1988

    Google Scholar 

  41. Noll RB, Ris MD, Davies WH, Bukowski WM, Koontz K: Social interactions between children with cancer or sickle cell disease and their peers: teacher ratings. J Dev Behav Pediatr 13: 187–193, 1992

    Google Scholar 

  42. Vance YH, Eiser C: The school experience of the child with cancer. Child Care Health Dev 28: 5–19, 2002

    Google Scholar 

  43. Vannatta K, Gartstein MA, Short A, Noll RB: A controlled study of peer relationships of children surviving brain tumors: teacher, peer, and self ratings. J Pediatr Psychol 23: 279–287, 1998

    Google Scholar 

  44. Carpentieri SC, Mulhern RK: Patterns of memory dysfunction among children surviving temporal lobe tumors. Arch Clin Neuropsychol 8: 345–357, 1993

    Google Scholar 

  45. Kimmings E, Kleinlugtebeld AT, Casey A, Hayward RD: Medulloblastoma: factors influencing the educational potential of surviving children. Br J Neurosurg 9: 611–617, 1995

    Google Scholar 

  46. Meyer EA, Kieran MW: Psychological adjustment of 'surgery-only' pediatric neuro-oncology patients: a retrospective analysis. Psychooncology 11: 74–79, 2002

    Google Scholar 

  47. Hockenberry-Eaton M, Manteuffei B, Bottomley S: Development of two instruments examining stress and adjustment in children with cancer. J Pediatr Oncol Nurs 14: 178–185, 1997

    Google Scholar 

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Carpentieri, S.C., Meyer, E.A., Delaney, B.L. et al. Psychosocial and behavioral functioning among pediatric brain tumor survivors. J Neurooncol 63, 279–287 (2003). https://doi.org/10.1023/A:1024203323830

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