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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurobehavioral outcomes and associated risk factors in pediatric brain tumor survivors
Yuliang Wang1, Wing Lam Chan1, Fei Li2
1Department of Paediatrics & Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
Insights
Pediatric brain tumor survivors face higher risks of ADHD and ASD. Improving sleep quality is vital for reducing neurobehavioral challenges and enhancing their well-being.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Child Psychology
Background:
- Improving survival rates for pediatric brain tumors necessitates understanding long-term neurobehavioral outcomes.
- Neurobehavioral issues significantly impact children's quality of life and overall well-being.
Purpose of the Study:
- To investigate the prevalence of ADHD, ASD, and emotional/behavioral difficulties in pediatric brain tumor survivors (PBTS).
- To identify risk and protective factors influencing the mental well-being of PBTS.
Main Methods:
- Retrospective cohort study of 274 PBTS from a territory-wide registry.
- Cross-sectional follow-up survey assessing mental well-being in 107 PBTS.
- Evaluation of emotional/behavioral difficulties, quality of life, parental stress, and sleep, benchmarked against community cohorts.
Main Results:
- Prevalence of ADHD (10.6%) and ASD (6.9%) in PBTS significantly exceeds general population rates.
- PBTS exhibit more emotional/behavioral symptoms, higher parental stress, and poorer quality of life.
- Younger age at diagnosis, seizure history, supratentorial tumors, and radiotherapy were associated with increased difficulties; better sleep correlated with fewer symptoms.
Conclusions:
- PBTS have an elevated risk for ADHD and ASD, facing greater vulnerability in peer relationships and mental health.
- Sleep improvement strategies may be crucial for mitigating neurobehavioral challenges in PBTS.
- Routine neurobehavioral and sleep assessments are essential for comprehensive survivorship care and improved well-being.
Purpose:
Survival rates for children with brain tumors improve, highlighting the importance of understanding the long-term neurobehavioral outcomes because of its impact on children's well-being and quality of life. This study investigated the prevalence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and emotional/behavioral difficulties in pediatric brain tumor survivors (PBTS), and identified the risks and protective factors on mental well-being.
Methods:
A territory-wide retrospective cohort included 274 PBTS registered in the Hong Kong Paediatric Haematology and Oncology Study Group Registry. In addition, a cross-sectional follow-up survey on mental well-being was completed by 107 PBTS during survivorship follow-up. Emotional/behavioral difficulties, health-related quality of life, parental stress, and sleep variables were assessed by the survey and benchmarked against previously published Hong Kong-based reference/community cohorts.
Results:
Among 274 PBTS, 10.6% had ADHD and 6.9% had ASD, which are significantly higher than the general pediatric population prevalence. They had more emotional/behavioral symptoms, higher parental stress, and poorer quality of life. Younger age at diagnosis, seizure history, and supratentorial tumors were linked to more difficulties. Radiotherapy was associated with reduced quality of life. Better sleep correlated with fewer ADHD and emotional symptoms.
Conclusion:
PBTS had increased risk of ADHD and ASD, and are more vulnerable to peer-relationship difficulties, poorer mental health, and quality of life. Improving sleep could be key to reducing neurobehavioral challenges. Implementing routine neurobehavioral monitoring, including sleep assessments, is crucial for enhancing survivorship care and overall well-being.
