title: Intellectual functioning and multi-dimensional attentional processes in long-term survivors of a central nervous system related pediatric malignancy.
abstract: OBJECTIVE
  Central nervous system (CNS) malignancies and/or their treatment in pediatric cancer survivors are known to be associated with deficits in neuropsychological functions. We report findings from a nation-wide study of childhood cancer survivors to investigate intelligence and attention/concentration from a multi-dimensional perspective in a diverse sample from this population.
  
  
  METHODS
  Four hundred forty-four pediatric cancer survivors between 6 and 17 years of age, who had suffered CNS involvement associated with their malignancy, were evaluated. All patients completed a measure of general intelligence. Attention was measured by a continuous performance test (CPT) and by parental report using a standardized psychological inventory.
  
  
  RESULTS
  Social economic status (SES) was a significant predictor of intellectual functioning and scores on independent measures of attention. After controlling for SES, cranial radiation therapy (CRT) was strongly predictive of impairments in intellectual functioning. Patients who had completed a transplant procedure did not have significant impairments in intellectual functioning when compared to other participants. CPT performance was most clearly influenced by a younger age at diagnosis and the presence of a supratentorial brain tumor. Reaction time was lower in patients who had received CRT. Gender did not correlate with CPT performance, but caregiver reports of deficits in attentional functioning were more prevalent in girls compared to boys.
  
  
  CONCLUSIONS
  These findings are important given the large, representative sample and multi-dimensional assessment of attentional functioning. The presence of a very strong SES effect on all dependent variables must be addressed in studies of this nature.
authors.affiliation: Austin Hatcher Foundation for Pediatric Cancer, Chattanooga, TN, USA. Electronic address: butlerr@hatcherfoundation.org.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Butler
authors.forename: Diane L
authors.initials: DL
authors.lastname: Fairclough
authors.forename: Ernest R
authors.initials: ER
authors.lastname: Katz
authors.forename: Anne E
authors.initials: AE
authors.lastname: Kazak
authors.forename: Robert B
authors.initials: RB
authors.lastname: Noll
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Thompson
authors.forename: Olle Jane Z
authors.initials: OJ
authors.lastname: Sahler
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001288:Attention; D001932:Brain Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000528:radiation effects; D012727:Sex Characteristics; D012923:Social Class; D017741:Survivors / Q000523:psychology*; D014888:Wechsler Scales
keywords: Attention; Intelligence; Pediatric cancer survivors; Socio-economic status