Academic Readiness among Young Children Treated for Brain Tumors: A Multisite, Prospective, Longitudinal Trial

学业成绩 社会经济地位 人口 纵向研究 心理干预 学术技能 心理学 发展心理学 医学 临床心理学 医学教育 病理 精神科 环境卫生
作者
Melanie R Somekh,Jason M. Ashford,Michelle A. Swain,Lana Harder,Bonnie Carlson-Green,Joanna Wallace,Ryan Kaner,Catherine A. Billups,Arzu Onar‐Thomas,Jeanelle S. Ali,Jennifer L. Harman,Thomas E. Merchant,Amar Gajjar,Heather M. Conklin
出处
期刊:Journal of the National Cancer Institute [Oxford University Press]
标识
DOI:10.1093/jnci/djae194
摘要

Abstract BACKGROUND Young children treated for central nervous system (CNS) malignancies are at high risk for difficulties with academic functioning due to increased vulnerability of the developing brain and missed early developmental opportunities. Extant literature examining academics in this population is limited. We investigated academic readiness, its clinical and demographic predictors, and its relationship with distal academic outcomes among patients treated for CNS tumors during early childhood. METHODS Seventy patients with newly diagnosed CNS tumors were treated on a prospective, longitudinal, multisite study with chemotherapy, with or without photon or proton irradiation. Patients underwent assessments of academic skills at baseline, six months, one year, and then annually for five years. Assessments measured academic readiness and academic achievement in reading and math. RESULTS Mixed linear models revealed slowed development of academic readiness skills over time. Socioeconomic status (SES) was predictive of academic readiness at all time points. Other demographic (eg, age at treatment) and clinical (eg, shunt status, treatment exposure) variables were not predictive of academic readiness. Distal reading difficulties were proportionally greater than normative expectations while math difficulties did not differ. Academic readiness was predictive of distal academic outcomes in reading and math. CONCLUSIONS Treatment for CNS malignancies in early childhood appears to slow development of academic readiness skills, with SES predictive of risk. Academic readiness skills were predictive of subsequent academic achievement. A disproportionate number of long-term survivors performed below age-based expectations in reading. These findings suggest the need for monitoring and interventions targeting early academic skills in this population.
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