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Developing preschool surveillance tools for adaptive functioning: lessons for neuro-oncology.

Michael E Msall¹

¹Section of Developmental and Behavioral Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA. mmsall@peds.bsd.uchicago.edu

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society

|May 18, 2010

Summary

Increased survival in pediatric brain tumor patients necessitates understanding treatment impacts on development. This review proposes a framework for assessing neurodevelopmental and adaptive skills in young survivors to improve long-term outcomes.

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Published on: December 14, 2012

Area of Science:

Neuro-oncology
Pediatric neurodevelopment
Childhood central nervous system (CNS) malignancies

Background:

Pediatric brain tumor survival rates have significantly improved.
Long-term outcomes require understanding treatment effects on development, learning, and adaptive behaviors.
The developing nervous system is vulnerable to tumors, complications, and therapies.

Purpose of the Study:

To review conceptualizations of CNS adaptive functioning in young children with brain tumors.
To utilize the International Classification of Functioning (ICF) model for describing neurodisability outcomes.
To highlight an integrated surveillance strategy for motor, communication, and adaptive skills.

Main Methods:

Review of conceptual frameworks for CNS adaptive functioning.
Application of the International Classification of Functioning (ICF) model.
Proposal of an integrated surveillance strategy linked to neuropsychological assessments.

Main Results:

The developing nervous system's vulnerability to tumors and treatments impacts development, learning, and adaptive status.
Young children are particularly susceptible to therapy side effects, affecting communication, coordination, and social skills.
Chemotherapy's long-term effects on neural populations and connectivity can impair memory, learning, and executive function.

Conclusions:

A framework for conceptualizing CNS adaptive functioning is essential for optimizing pediatric brain tumor survivor outcomes.
Integrated surveillance of motor, communicative, and adaptive skills is crucial.
This approach aids in evaluating management impact and reducing neurobehavioral morbidities.