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Published on: November 21, 2013
Analysis of handwriting of children during treatment for acute lymphoblastic leukemia
H A Reinders-Messelink1, M M Schoemaker, T A Snijders
1Children's Cancer Center, University Hospital Groningen, 9700 RB Groningen, The Netherlands. W.A.Kamps@bkk.azg.nl
Insights
Children undergoing acute lymphoblastic leukemia (ALL) treatment experience handwriting difficulties, particularly with increased drawing pressure due to vincristine
Area of Science:
- Pediatric Oncology
- Neuroscience
- Movement Science
Background:
- Children with acute lymphoblastic leukemia (ALL) frequently report handwriting difficulties.
- Handwriting impairment is a common, yet often overlooked, side effect in pediatric cancer patients.
Purpose of the Study:
- To prospectively investigate the impact of ALL treatment on the fine motor control required for handwriting.
- To analyze specific kinematic parameters of handwriting in children undergoing chemotherapy.
Main Methods:
- A computerized writing task was employed to assess handwriting movements in 11 children (aged 5-12) undergoing ALL treatment.
- Children were evaluated at key intervals relative to vincristine administration to capture treatment-related effects.
Main Results:
- Children with ALL exhibited slower drawing speeds and longer pause durations during handwriting tasks.
- A consistent finding was an increased drawing pressure, even when other difficulties were overcome.
Conclusions:
- The observed difficulties in handwriting, particularly increased drawing pressure, may represent an adaptive response to vincristine-induced peripheral neuropathy.
- This adaptation aims to enhance kinesthetic feedback, though the neurotoxic effects of other chemotherapy agents warrant consideration.
Background:
Children treated for acute lymphoblastic leukemia (ALL) often complain about handwriting problems.
Procedure:
Using a computerized writing task, we have prospectively studied the processes necessary for the production of handwriting movements in 11 children (5-12 years old) during treatment for ALL. Children were tested at time points closely related to the vincristine administration.
Results And Conclusions:
Children treated for ALL drew slower, with longer pause durations and increased drawing pressure. Children were able to overcome the problems, except for a consistently increased drawing pressure. This increased drawing pressure may be an attempt of the children to obtain sufficient kinesthetic information and thus can be seen as an adequate adaptation mechanism in case of peripheral neuropathy due to the neurotoxic effects of vincristine. However, neurotoxic effects of other cytostatic drugs cannot be excluded.
