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Published on: September 25, 2012
Developmental and adaptive functioning of very young children with solid tumors and brain tumors
Sequoya Fitzpatrick1,2, Lisa M Jacola1, Jennifer L Harman1
1Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Insights
Infants and toddlers with solid tumors show developmental delays similar to those with brain tumors. Early developmental assessment and intervention are crucial for these young cancer patients.
Area of Science:
- Pediatric Oncology
- Developmental Pediatrics
- Childhood Cancer Research
Background:
- Infancy and toddlerhood (0-36 months) are critical periods for rapid development.
- Children undergoing cancer treatment receive developmental assessments.
- Limited research compares developmental outcomes in infants/toddlers with brain tumors versus non-CNS solid tumors.
Purpose of the Study:
- To compare the developmental outcomes of infants and toddlers treated for brain tumors versus solid tumors.
- To identify potential developmental risks in young children with cancer.
Main Methods:
- Retrospective review of electronic health records for infants/toddlers (0-36 months) treated for brain tumors (n=36) or solid tumors (n=40).
- Developmental assessment data were analyzed using Z-scores compared to age expectations.
- Chi-square and multivariate analysis of variance were used to compare developmental outcomes between groups.
Main Results:
- The overall group of infants/toddlers demonstrated significantly less developed skills than age expectations.
- Infants/toddlers with solid tumors showed clinical deficits in most developmental domains at higher rates than expected.
- The rate of developmental impairment did not significantly differ between the brain tumor and solid tumor groups across most subtests.
Conclusions:
- Infants and toddlers with malignant solid tumors may be at increased risk for developmental delays.
- Developmental functioning in this population warrants longitudinal study to inform intervention strategies.
- Early developmental assessment, intervention services, and ongoing monitoring are recommended for young children with cancer.
Purpose:
Infancy/toddlerhood is a period of rapid development. All infants/toddlers (0-36 months-of-age) undergoing cancer-directed treatment at one hospital are offered developmental assessments and related services. Yet, literature comparing development of infants/toddlers with brain tumors to those with non-CNS solid tumors is sparse.
Design And Methods:
Developmental assessment data were abstracted from electronic health records of infants/toddlers undergoing treatment for a brain tumor (n = 36; mean age = 21.83 ± 9.96 months) or a solid tumor (n = 40; mean age = 17.35 ± 8.50). Z-scores compared obtained data with age expectations. Chi-square analyses assessed whether a greater proportion of participants scored within the clinical range than normative expectations. Multivariate analysis of variance and chi-square analyses compared developmental outcomes between groups.
Results:
Compared with age expectations, the overall group demonstrated significantly less well-developed skills. Infants/toddlers with solid tumors demonstrated clinical deficits at rates higher than expected for most domains; the rate of impairment for the solid tumor group did not differ significantly from that of the brain tumor group across most subtests.
Conclusions:
Like young patients with brain tumors, the developmental functioning of infants/toddlers with solid tumors should be studied across time to determine the trajectory of functioning for these young patients and to inform future developmental intervention studies.
Practice Implications:
Infants/toddlers with a malignant solid tumor may be at increased risk for delayed development. These very young patients would likely benefit from developmental assessment, early intervention services during and after treatment, and ongoing monitoring of development across time.
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