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Acute leukemia. Learning disabilities following CNS irradiation
K Fogarty1, V Volonino, J Caul
1Section of Pediatric Oncology, St. Louis University School of Medicine, Cardinal Glennon Children's Hospital, Missouri.
Clinical Pediatrics
|November 1, 1988
Summary
Children treated for acute leukemia with cranial irradiation often develop learning disorders, including math and reading disabilities. Many do not receive needed educational support, suggesting delayed detection of neurodevelopmental issues.
Area of Science:
- Pediatric Oncology
- Neurodevelopmental Disorders
- Radiation Oncology
Background:
- Cranial irradiation is a common treatment for acute leukemia in children.
- Long-term neurodevelopmental effects of cranial irradiation are a significant concern.
- Previous assessments may have underestimated the incidence of learning disorders post-treatment.
Purpose of the Study:
- To evaluate learning disorders in elementary school children previously treated with cranial irradiation for acute leukemia.
- To determine the prevalence of specific psychoeducational diagnoses.
- To assess the adequacy of current special educational services.
Main Methods:
- Psychometric and educational tests were administered to 13 children.
- Participants had received cranial irradiation (1,800–4,800 rads) a mean of 6.3 years prior.
- Results were analyzed using a graduated regressed standard score procedure.
Main Results:
- 15% were diagnosed with mental retardation.
- 15% had learning disabilities in reading and mathematics.
- 39% exhibited learning disabilities in mathematics.
- Overall, 69% received a specific psychoeducational diagnosis.
- Only 3 of the 9 diagnosed children received special educational services.
Conclusions:
- A high incidence of learning disorders, particularly in mathematics, was observed in children treated with cranial irradiation.
- Current psychoeducational assessments may not fully capture the extent of neurodevelopmental deficits.
- There is a critical need for improved identification and support services for these children.