title: Neurocognitive Predictors of Academic Outcomes Among Childhood Leukemia Survivors.
abstract: BACKGROUND
  Acute lymphoblastic leukemia is the most common pediatric cancer, and survival approaches 90%. Acute lymphoblastic leukemia survivors are more likely than healthy peers or siblings to experience academic underachievement, yet little is known about neurocognitive predictors of academic outcomes.
  
  
  OBJECTIVE
  Objectives were to compare neurocognitive abilities to age-adjusted standardized norms, examine change over time in neurocognitive abilities, and establish neurocognitive predictors of academic outcomes.
  
  
  METHODS
  Seventy-one children were followed over the course of therapy. Cognitive abilities were assessed during induction when the child was in remission (baseline) and annually for 3 years (years 1, 2, and 3). Reading and mathematics abilities were assessed at year 3.
  
  
  RESULTS
  Fine motor dexterity was significantly below age-adjusted norms at all data points but showed improvement over time. Baseline visual-motor integration was within the reference range but significantly declined by year 3, and mean scores at years 2 and 3 were significantly below age-adjusted norms. Verbal short-term memory was significantly below age-adjusted norms at all assessments. Visual-motor integration predicted reading and mathematics abilities. Verbal short-term memory predicted reading abilities, and visual short-term memory predicted mathematics abilities.
  
  
  CONCLUSIONS
  Central nervous system-directed therapy is associated with specific neurocognitive problems. Visual-spatial skills and verbal and visual short-term memory predict academic outcomes.
  
  
  CONCLUSIONS
  Early assessment of visual-spatial perception and short-term memory can identify children at risk of academic problems. Children who are at risk of academic problems could benefit from a school-based individual educational program and/or educational intervention.
authors.affiliation: Author Affiliations: College of Nursing, University of Arizona, Tucson, Arizona (Drs Moore, Insel, and Pasvogel and Ms Koerner); Baylor College of Medicine, Houston, Texas (Drs Lupo and Harris and Mss Adkins and Taylor); and Duke School of Nursing, Durham, North Carolina (Dr Hockenberry).
authors.forename: Ida M Ki
authors.initials: IM
authors.lastname: Moore
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Lupo
authors.forename: Kathleen
authors.initials: K
authors.lastname: Insel
authors.forename: Lynnette L
authors.initials: LL
authors.lastname: Harris
authors.forename: Alice
authors.initials: A
authors.lastname: Pasvogel
authors.forename: Kari M
authors.initials: KM
authors.lastname: Koerner
authors.forename: Kristin B
authors.initials: KB
authors.lastname: Adkins
authors.forename: Olga A
authors.initials: OA
authors.lastname: Taylor
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Hockenberry
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000401:mortality / Q000523:psychology; D011932:Reading; D017741:Survivors / Q000523:psychology*