PURPOSE: To evaluate the academic achievement of survivors of pediatric brain tumors relative to case-control classmates and determine the extent to which deficits are moderated by type of treatment, family socioeconomic status, parental education level, and quality of family environment. Survivors are known to be at risk of cognitive and academic impairments following treatment, however the degree of impairment varies and limited research examining the role of these factors and possible interactions between them exists.
METHODS: Brain tumor survivors, ages 5-18 and 1-5 years post treatment, were recruited from tumor registries at four pediatric hospitals in the US and Canada to participate in data collection in each child’s school and home. A case-control classmate matched for age, gender, and race was identified for each survivor. Measures included the Wide Range Achievement Test, parent demographic questionnaire, and Family Environment Scale. Medical data was obtained via chart review. Analyses include 164 pairs of brain tumor survivors and classmate controls.
RESULTS: Survivors demonstrated significantly lower achievement than controls in reading, spelling, and arithmetic, (p = .01). Deficits in academic achievement were found among children treated with Neurosurgery only as well as for those who received chemotherapy and/or radiation. Results suggested that the discrepancy in academic achievement between survivors and controls across all three academic domains may be heightened when survivors reside in home environments characterized by less support or more conflict. Possible interactions between family characteristics and treatment intensity were examined but not found to be significant.
CONCLUSIONS: This study supports frequently noted concerns about the potential impact of treatment for pediatric cancer on survivors’ quality of life. We also find evidence that survivors treated with neurosurgery only also experience academic difficulties and could benefit from support services and collaboration between medical and school systems. Finally, aspects of family environment may impact survivors’ achievement, which offers potential for the development of targeted interventions.