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Parental report of everyday cognitive abilities among children treated for acute lymphoblastic leukemia
K S Williams1, J Ochs, J M Williams
1MaGee Rehabilitation Hospital, Philadelphia, Pennsylvania.
Insights
Parents rated children with leukemia as having worse cognitive functioning than controls, especially in academics. Learning disabled children performed worse overall. Academic deprivation impacted leukemic children
Area of Science:
- Neuropsychology
- Pediatric Oncology
Background:
- Central nervous system (CNS) prophylaxis is crucial for treating leukemia in children.
- Cognitive deficits can arise from leukemia treatments, impacting academic performance.
Purpose of the Study:
- To compare the everyday cognitive functioning of children with leukemia undergoing different CNS prophylaxis treatments.
- To evaluate the impact of academic deprivation on cognitive ratings in leukemic children.
Main Methods:
- Parental ratings of cognitive functioning were collected for children with leukemia, normal controls, and learning disabled (LD) children.
- Leukemic children received one of two CNS prophylaxis regimens.
- Statistical comparisons were made between the groups.
Main Results:
- Leukemic children were rated significantly lower than controls in academic skills.
- Learning disabled children showed the poorest cognitive functioning across all areas.
- CNS prophylaxis type did not significantly differentiate parent ratings.
- Leukemic children missed more school, contributing to academic skill deficits.
Conclusions:
- Academic deprivation significantly affects the perceived cognitive functioning of leukemic children.
- Future studies on CNS prophylaxis should control for academic deprivation.
- Reintegration programs should address cognitive and academic challenges faced by these children.
Abstract:
Compared ratings of everyday cognitive functioning made by parents of leukemic children to ratings made by parents of normal control and learning disabled (LD) children. The leukemic children had been randomly assigned to one of two CNS prophylaxis treatments, one including cranial irradiation and intrathecal methotrexate and another including only intrathecal methotrexate and intermediate dose infusions of methotrexate. Leukemic children were rated significantly worse than controls in areas related to schooling and academic skills. The type of CNS prophylaxis was not discriminated by parent ratings. LD children were rated as significantly worse than either of the two groups in all areas of cognitive functioning. Leukemic and LD children were both rated as having poor academic skills. Leukemic children missed significantly more school than control and LD children, and their poor ratings on academic skills were partially attributed to academic deprivation. These results suggest that studies should control for academic deprivation when evaluating the neuropsychological outcome of CNS prophylactic treatment and that reintegration and normalization programs should be designed to address the intellectual problems resulting from missed academic experiences.