Search

Background Acute lymphoblastic leukemia (ALL) and brain tumor (BT) survivors are at risk for post-treatment IQ declines. The extent to which lower scores represent global cognitive decline versus domain-specific impairment remains unclear. This study examined discrepancies between processing speed and estimated IQ (EIQ) scores and identified clinical characteristics associated with score discrepancies in a sample of pediatric cancer survivors. Procedure Survivors (50 ALL, 50 BT) ages 12–17 years completed cognitive testing. The Wechsler Abbreviated Scale of Intelligence provided an untimed measure of general reasoning ability (EIQ). The age-appropriate Wechsler Intelligence Scale provided a Processing Speed Index (PSI) score. Scores were examined and compared. Results Survivors' PSI scores were lower than their EIQ scores (BT t(45) = 6.3, p

Objective This randomized controlled trial tested the efficacy of parent-based behavioral counseling for reducing secondhand smoke exposure (SHSe) among children with cancer. It also examined predictors of smoking and SHSe outcomes.

Objectives To describe the psychological needs of adolescent survivors of acute lymphoblastic leukemia (ALL) or brain tumor (BT), we examined the following: (i) the occurrence of cognitive, behavioral, and emotional concerns identified during a comprehensive psychological evaluation and (ii) the frequency of referrals for psychological follow-up services to address identified concerns. Methods Psychological concerns were identified on measures according to predetermined criteria for 100 adolescent survivors. Referrals for psychological follow-up services were made for concerns previously unidentified in formal assessment or not adequately addressed by current services. Results Most survivors (82%) exhibited at least one concern across domains: behavioral (76%), cognitive (47%), and emotional (19%). Behavioral concerns emerged most often on scales associated with executive dysfunction, inattention, learning, and peer difficulties. Cranial radiation therapy was associated with cognitive concerns, χ2(1, N = 100) = 5.63, p

This randomized controlled trial tested the efficacy of parent-based behavioral counseling for reducing secondhand smoke exposure (SHSe) among children with cancer. It also examined predictors of smoking and SHSe outcomes.Participants were 135 parents or guardians of nonsmoking children with cancer,18 years, at least 30 days postdiagnosis, and living with at least one adult smoker. Parents were randomized to either a standard care control group or an intervention consisting of six counseling sessions delivered over 3 months. Parent-reported smoking and child SHSe levels were obtained at baseline, 3, 6, 9, and 12 months. Children provided urine samples for cotinine analyses.Reductions in parent-reported smoking and exposure were observed in both the intervention and control conditions. There was a significantly greater reduction in parent-reported smoking and child SHSe at 3 months for the intervention group compared with the control group. Child SHSe was significantly lower at 12 months relative to baseline in both groups. Children's cotinine levels did not show significant change over time in either group. Exposure outcomes were influenced by the number of smokers at home, smoking status of the parent participating in the trial, and the child's environment (home versus hospital) the day before the assessment.Children's SHSe can be reduced by advising parents to protect their child from SHSe, combined with routine reporting of their child's exposure and cotinine testing, when delivered in the context of the pediatric cancer setting. More intensive interventions may be required to achieve greater reductions in SHSe.

Exposure to environmental tobacco smoke (ETS) poses serious health risks for children with cancer. Parental smoke is a primary source of exposure for these children. Parent smoking behaviors and parent-reported ETS exposure among children treated for cancer were examined in this study. In addition, reports of ETS exposure among children with cancer who currently smoked or who had smoked in the past were compared to those of children with cancer who never smoked. Written questionnaires about smoking behaviors and ETS exposure were administered to 47 smoking parents of youngsters diagnosed with cancer, 10–18 years of age (57.4% male, 78.7% Caucasian). Child reports of smoking status were also obtained. Results indicated that children with cancer are exposed to ETS from a number of sources and settings, as reported by their parents. Current or previous child smokers had greater ETS exposure than non-smoking children. Older children and Caucasian children also had greater ETS exposure. Level of ETS exposure did not differ based on the child's treatment status. Interventions that teach parents to protect their youngster from ETS exposure have potential for reducing adverse health outcomes in this vulnerable population. Copyright © 2003 John Wiley & Sons, Ltd.