Adaptive functioning of childhood brain tumor survivors following conformal radiation therapy

Adaptive functioning is not often examined in childhood brain tumor (BT) survivors, with the few existing investigations relying on examiner interviews. Parent questionnaires may provide similar information with decreased burden. The purpose of this study was: (1) to examine adaptive behaviors in BT survivors relative to healthy peer and cancer survivor groups, and (2) to explore the validity of a parent questionnaire in relation to an examiner administered interview. Participants (age 13.11 ± 2.98 years) were BT survivors treated with conformal radiation therapy (n = 50), healthy siblings of BT survivors (n = 39) and solid tumor (ST) survivors who did not receive CNS-directed therapy (n = 40). Parents completed the Adaptive Behavior Assessment System–2nd Edition (ABAS-II). For a subset of the BT cohort (n = 32), examiners interviewed the parents using the Vineland Adaptive Behavior Scales (VABS) within 12 months. Groups differed significantly on each of the ABAS-II indices and the general adaptive composite, with the BT group scoring lower than the sibling and ST groups across indices. Executive functioning, but not IQ, was associated with adaptive skills; no clear pattern of clinical and demographic predictors was established. VABS scores were correlated with ABAS-II scores on nearly all indices. BT survivors showed significantly lower adaptive functioning when compared to healthy and cancer controls. The ABAS-II proved sensitive to these behavioral limitations and was consistent with scores on the VABS. The use of a parent questionnaire to assess adaptive functioning enhances survivorship investigations by increasing flexibility of assessment and decreasing examiner burden.