title: Hearing loss, quality of life, and academic problems in long-term neuroblastoma survivors: a report from the Children's Oncology Group.
abstract: OBJECTIVE
  Among a cohort of long-term neuroblastoma survivors, our aims were to (1) assess the association between treatment intensity and parent-reported hearing loss in the child, (2) evaluate the strength of the association between hearing loss and parent-reported academic and psychosocial difficulties in the child, and (3) examine the association between parent-reported academic and psychosocial difficulties in the child and the child's self-reported quality of life.
  
  
  METHODS
  Through a mailed survey that included the Pediatric Quality of Life Inventory 4.0 and an outcomes questionnaire for parents, we evaluated 137 children (aged 8-17 years) who were previously enrolled in 1 of 2 Children's Cancer Group neuroblastoma clinical studies.
  
  
  RESULTS
  Childhood survivors of neuroblastoma who had prevalent hearing loss, as reported by their parents, had at least twice the risk of an identified problem with reading skills, math skills, and/or attention and a similarly higher risk of a general learning disability and/or special educational needs than did neuroblastoma survivors without hearing loss. Consistent with this finding, hearing loss was associated with a 10-point-lower mean score in the school-functioning scale of the Pediatric Quality of Life Inventory 4.0. We also observed a clear pattern of poorer self-reported quality-of-life scores among children with parent-reported academic and psychosocial problems compared with those without such problems, particularly with school functioning, even after controlling for reported hearing loss.
  
  
  CONCLUSIONS
  We found evidence that long-term neuroblastoma survivors, especially those with hearing loss, are at elevated risk for academic learning problems and psychosocial difficulties. We also found strong concordance between parent-reported learning problems in the child and indications of distress in the child's self-reported quality of life.
authors.affiliation: Department of Pediatrics, University of Michigan, 300 N Ingalls St, Room 6E02, Ann Arbor, MI 48109, USA. jamegurn@umich.edu
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Jean M
authors.initials: JM
authors.lastname: Tersak
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Wendy
authors.initials: W
authors.lastname: Landier
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Matthay
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology / Q000523:psychology*; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors