Cognitive-Executive Processes and Social Adjustment in Survivors of Pediatric Acute Lymphoblastic Leukemia
Date
2024-02-14
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Abstract
Background: Survivors of pediatric acute lymphoblastic leukemia (ALL) have historically faced serious neurological and social difficulties as a consequence of their treatment with cranial radiation therapy (CRT). However, such difficulties are poorly understood among survivors treated with modern chemotherapy-only protocols. This study aimed to investigate cognitive-executive functioning and social adjustment, as well as factors relating to these outcomes, in this new wave of survivors as compared to survivors of pediatric non-central nervous system (CNS) solid tumours and healthy children. Methods: This cross-sectional study assessed survivors aged 8-17 and their caregivers at least two years after finishing treatment. Survivors of pediatric ALL (n=25) and non-CNS solid tumours (n=18) were recruited to the current study, and healthy children (n=33) were included from a previous study. Cognitive-executive outcome measures included the Wechsler Intelligence Scale for Children Fifth Edition (WISC-V) Working Memory Index (WMI) and Processing Speed Index (PSI), and social adjustment was measured through the Adaptive Behaviors Assessment System Third Edition (ABAS-3) Social Adaptive Domain. Group comparisons were made using Analysis of Variance (ANOVA) tests, and hierarchical regression analyses were conducted to explore potential predictors of these outcomes. Results: Survivors of pediatric ALL scored significantly worse than healthy children on the WMI (ANOVA post hoc p<.001) and a subscale of the Social Adaptive Domain (ANOVA post hoc p=.002). Survivors of pediatric non-CNS solid tumours scored significantly worse than healthy children on the WMI (ANOVA post hoc p=.028) and PSI (ANOVA post hoc p<.001). No significant differences were observed between the two survivor groups. WMI and PSI scores did not significantly predict Social Adaptive Domain scores. Conclusions: These findings highlight difficulties faced by both survivors of pediatric ALL and non-CNS solid tumours which have the potential to cause substantial, ongoing negative impacts on their lives. Future research should investigate the underlying causes of these difficulties in order to inform screening and intervention protocols aimed at improving these children’s quality of life.
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Pediatrics, Psychosocial, Oncology, Cognition, Executive Processes, Acute Lymphoblastic Leukemia, Leukemia, Solid Tumours, Social Adjustment, Late Effects
Citation
McDonald, K. A. (2024). Cognitive-executive processes and social adjustment in survivors of pediatric acute lymphoblastic leukemia (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.