Predicting changes in adaptive functioning and behavioral adjustment following treatment for a pediatric brain tumor: A report from the Brain Radiation Investigative Study Consortium.
Children are at risk for behavioral and adaptive difficulties following pediatric brain tumor. This study explored whether familial/demographic, developmental, diagnostic, or treatment-related variables best predict posttreatment behavioral and adaptive functioning.



Participants included 40 children (mean age = 12.76 years, SD = 4.01) posttreatment (mean time since diagnosis = 1.99 years, SD = 0.21) for pediatric brain tumor. Parents rated children's behavioral adjustment and adaptive functioning and provided demographic and developmental histories. Diagnostic and treatment-related information was abstracted from medical records.



Ratings of adaptive and behavioral functioning approximately 2 years postdiagnosis were within the average range, although the percentage of children exceeding clinical cutoffs for impairment in adaptive skills exceeded expectation, particularly practical skills. Premorbid behavior problems and tumor size predicted posttreatment adaptive functioning. After accounting for adaptive functioning near diagnosis, premorbid behavior problems predicted declines in adaptive functioning 2 years postdiagnosis. After accounting for adjustment near diagnosis, no variables predicted declines in behavioral adjustment.



Children may be vulnerable to reduced adaptive functioning following pediatric brain tumor treatment, especially in practical skills. Assessing prediagnosis functioning and diagnostic and treatment-related variables may improve our ability to predict those at greatest risk, although those factors may be less helpful in identifying children likely to develop behavioral difficulties. Screening of these factors in tertiary care and long-term follow-up settings may improve identification of those at greatest need for support services.
Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.|Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA.
Kristen R
0000-0003-4044-9753
KR
Hoskinson
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Kelly R
KR
Wolfe
Department of Psychology, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Keith Owen
KO
Yeates
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.|Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
E Mark
EM
Mahone
Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Kim M
KM
Cecil
Psychology Service, Texas Children's Hospital, Houston, TX, USA.|Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
M Douglas
MD
Ris
D000223:Adaptation, Psychological / Q000528:radiation effects*; D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000532:radiotherapy*; D002648:Child; D002652:Child Behavior / Q000528:radiation effects*; D002653:Child Behavior Disorders / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D011597:Psychomotor Performance / Q000528:radiation effects*; D012917:Social Adjustment
adaptive functioning; brain tumor; cancer; oncology; pediatric; psychosocial adjustment