Communication and Language Profiles of Children Treated for Posterior Fossa Brain Tumors

Cognitive and language deficits are frequently reported sequelae of posterior fossa brain tumors (PFBT). Typically, delayed onset impedes prompt assessment and early intervention. This has devastating implications for quality of life. This study aimed to describe the language profiles of children treated for posterior fossa brain tumors referred to outpatient speech pathology, and to identify early indicators and predictive factors of late effects on language profiles of children treated for posterior fossa brain tumors.

A retrospective file audit and cohort study was conducted using medical records, speech pathology, and neuropsychology assessment data of 21 patients (≤18 years) diagnosed and treated for a primary PFBT between 2008 and 2021. Standard scores were extracted and categorized into language and neuropsychological domains. General and mixed effects linear models were used to investigate changes in assessment outcomes over time and the influence of child-, tumor-, and treatment-related variables.

Of 117 children diagnosed with a PFBT during the study period, 21 met the inclusion criteria. Narrative and pragmatics were the weakest language domains at the first timepoint post-treatment across the cohort. Statistically insignificant declines in assessment performance were noted across all language domains. Significant associations were identified between larger tumor size (p = 0.018) and tumor resection (p = 0.041) with a decline in semantic performance.

The lack of overt language deficits at the first timepoint post-treatment, with trends toward increasing deficits over time, highlights the need for ongoing assessment. Evaluation of narrative and pragmatic skills should be prioritized. Prospective studies with larger sample sizes are recommended.