title: Neurocognitive and behavioral outcomes in Latino childhood cancer survivors.
abstract: BACKGROUND
  Children with brain tumors and leukemia are at risk for neurocognitive and behavioral late effects due to central nervous system-directed therapies. Few studies have examined these outcomes in ethnic minority samples, despite speculation that socio-demographic factors may increase vulnerability for adverse neurobehavioral outcomes. We evaluated the neurocognitive and behavioral outcomes and their impact on the health-related quality of life in survivors of childhood cancer drawn from Latino families in the Los Angeles region.
  
  
  METHODS
  Using culturally-relevant recruitment strategies, 73 predominantly Spanish-speaking parents of pediatric brain tumor or leukemia survivors completed standardized questionnaires, including the Conners parent-report and the Bidimensional Acculturation Scales. Clinical and socio-demographic factors influencing the development of neurocognitive and behavioral dysfunction were examined.
  
  
  RESULTS
  Approximately 50% of the children placed at or above the "elevated" level for difficulties with attention, school-based learning, and peer relations. Younger age at diagnosis significantly predicted dysfunction in inattention, learning problems, and hyperactivity/impulsivity. Children whose parents were less adherent to the non-Hispanic white culture were more likely to have problems with peer relations and executive functioning. HRQL was significantly lower in survivors with neurocognitive and behavioral dysfunction relative to those with normal range scores on the Conners scale.
  
  
  CONCLUSIONS
  In addition to the child's age at diagnosis, acculturation appears to predict select neurocognitive and behavioral outcomes in this socio-demographically homogeneous sample of Latino families. Further research is needed to understand the interaction of ethnic and cultural factors with therapeutic exposures in determining the adverse neurobehavioral outcomes, so as to optimally design interventions.
authors.affiliation: Department of Population Sciences, City of Hope Medical Center & Beckman Research Institute, Duarte, CA, USA. spatel@coh.org
authors.forename: Sunita K
authors.initials: SK
authors.lastname: Patel
authors.forename: Tracy T Y
authors.initials: TT
authors.lastname: Lo
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Dennis
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms; D002648:Child; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology* / Q000628:therapy; D007858:Learning; D007859:Learning Disabilities / Q000453:epidemiology* / Q000628:therapy; D007938:Leukemia; D008297:Male; D011595:Psychomotor Agitation / Q000453:epidemiology* / Q000628:therapy; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Latino; childhood cancer; health disparities; late effects; neurocognitive