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Updated: Dec 21, 2025
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Self-reported and parent proxy reported functional impairment among pediatric cancer survivors and controls
Sarah J Erickson1, Sarah Hile2, Nicole Kubinec3
1Department of Psychology, Logan Hall, University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA. erickson@unm.edu.
Insights
Pediatric cancer survivors report higher functional impairment than parents perceive. Self-reported functional impairment (FI) is a valuable tool for assessing children's daily functioning and neurocognitive deficits.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Child Psychology
Background:
- Limited research exists on functional impairment in pediatric cancer survivors due to reliance on parent proxy reports.
- Pediatric cancer treatment's impact on children's daily functioning and neurocognitive abilities requires further investigation.
Purpose of the Study:
- To examine a novel measure of self-reported functional impairment (FI) in pediatric cancer survivors.
- To explore the relationship between self-reported and parent-reported FI in survivors compared to controls.
- To investigate the association between functional impairment and neurocognitive functioning.
Main Methods:
- A cross-sectional study recruited 26 pediatric cancer survivors (off-treatment average 6.35 years) and 53 controls.
- Participants completed measures of functional impairment (FI), intellectual assessment (RIST), and executive functions (NIH Examiner).
- Parents also reported on their children's functional impairment.
Main Results:
- Survivors and controls reported similar overall functional impairment.
- Self-reported FI was higher than parent-reported FI across all participants, though correlated.
- Parent-reported FI significantly predicted self-reported FI, and executive function deficits were linked to increased impairment.
Conclusions:
- Self-reported functional impairment (FI) is a viable outcome measure, adding validity to parent reports.
- Pediatric cancer survivors report higher FI than parents perceive, indicating clinical utility.
- Screening pediatric cancer survivors for self-reported functional difficulties is recommended.
Background:
A unique and limiting component in the research on functional impairment among children has been the exclusive use of parent proxy reports about child functioning; and there is limited information regarding the impact of pediatric cancer treatment on children's day-to-day functioning and how this is related to neurocognitive functioning. The objective of the current study was to examine a novel measure of self-reported functional impairment, and explore the relationship between self-reported and parent-reported child functional impairment in pediatric cancer survivors compared to controls.
Methods:
A cross-sectional cohort of survivors (n = 26) and controls (n = 53) were recruited. Survivors were off treatment an average of 6.35 years (SD = 5.38; range 1-15 years) and demonstrated an average "medium" Central Nervous System treatment intensity score. Participants completed measures of functional impairment (FI), intellectual assessment (RIST) and executive functions (NIH Examiner), while parents reported on children's functional impairment.
Results:
Survivors were similar to controls in functional impairment. Regardless of group membership, self-reported FI was higher than parent-reported FI, although they were correlated and parent report of FI significantly predicted self-reported FI. Across groups, increased impairment was associated with four of seven Examiner scores.
Conclusions:
Research regarding self-reported functional impairment of cancer survivors and its association with parent-reported functional impairment and neurocognitive deficits has been limited. Our results suggest that self-reported FI appears to be a reasonable and viable outcome measure that corresponds with and adds incremental validity to parent reported FI. While low treatment intensity may confer relative sparing of functional impairment among survivors, children report higher FI levels than parents, suggesting that FI can be of clinical utility. In conclusion, pediatric cancer survivors should be screened for self-reported functional difficulties.
