title: Effect of motivation on academic fluency performance in survivors of pediatric medulloblastoma.
abstract: It has been proposed previously that extrinsic motivation may enable survivors of childhood medulloblastoma to significantly improve aspects of neurocognitive performance. In healthy populations, enhanced motivation has been shown to promote academic fluency, a domain likely more relevant to the educational outcomes of pediatric medulloblastoma survivors than academic skill development. The present study investigates the effect of enhanced extrinsic motivation on fluent (i.e., accurate and efficient) academic performance in pediatric medulloblastoma survivors. Participants were 36 children, ages 7-18, who had completed treatment for medulloblastoma. Participants completed a neuropsychological battery that included administration of equivalent tasks on Forms A and B of the Woodcock-Johnson III Tests of Achievement. Half were randomly assigned to an incentive condition prior to the administration of Form B. Provision of a performance-based incentive resulted in statistically significant improvement, but not normalization of function, in performance on measures of academic fluency. No demographic, treatment-related, academic, neuropsychological, or self-perception variables predicted response to incentive. Findings suggest that academic performance of survivors may significantly improve under highly motivating conditions. In addition to implications for educational services, this finding raises the novel possibility that decreased motivation represents an inherent neuropsychological deficit in this population and provides a rationale for further investigation of factors affecting individual differences in motivational processes. Further, by examining effort in a context where effort is not inherently suspect, present findings also significantly contribute to the debate regarding the effects of effort and motivation on neuropsychological performance.
authors.affiliation: a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.|b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Alice Ann
authors.initials: AA
authors.lastname: Holland
authors.affiliation: b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Carroll W
authors.initials: CW
authors.lastname: Hughes
authors.affiliation: a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.|b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Lana
authors.initials: L
authors.lastname: Harder
authors.affiliation: c Department of Rehabilitation Science , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Silver
authors.affiliation: d Department of Neuro-Oncology , Children's Medical Center Dallas , Dallas , TX , USA.|e Department of Pediatrics , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Bowers
authors.affiliation: a Department of Psychology , Children's Medical Center Dallas , Dallas , TX , USA.|b Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Stavinoha
mesh_terms: D000124:Achievement; D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000523:psychology*; D009042:Motivation; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology*
keywords: Cancer; Child; Effort; Incentive; Motivation