Cognitive and Psychosocial Development in Young Children with Brain Tumors: Observations from a Clinical Sample

Survivors of pediatric brain tumor (BT) are known to be at risk for developing cognitive and psychosocial late effects. Young age at treatment (≤6 years) is typically considered to put patients at increased risk. However, there is limited research specifically exploring functioning in these young patients. Cognitive and psychosocial data were retrospectively abstracted from medical charts for 79 young patients (54.4% male) treated for BT with a variety of treatment modalities (e.g., surgery, radiation therapy, chemotherapy). Children were clinically assessed at 4.52 years of age (range = 1.48–5.98) and most were off-therapy (74.4%). Mean performances on developmental (68.3 ± 10.02), cognitive (88.09 ± 18.38), and pre-academic (86.84 ± 19.75) measures were all below average. Parent report of adaptive functioning was also below average (82.10 ± 16.21), but psychosocial functioning was generally within normal limits. Most patients had impaired functioning (scores <10th percentile) in at least one domain assessed. Exploratory analyses revealed that many patients (27.3–60.6%) exhibited a significant discrepancy between domains of cognitive functioning (e.g., verbal and spatial). Young children treated for BT experienced high rates of impairment in cognitive, pre-academic, and adaptive domains. Future work is needed to focus on serial longitudinal assessment of these young patients, as well as dedicated intervention and prevention efforts

Caregiver perceptions of importance of COVID-19 preventative health guidelines and difficulty following guidelines are associated with child adherence rates

Objective: To describe child adherence to four preventative-health guidelines during the COVID-19 pandemic and investigate caregiver-level correlates of adherence. Method: Two hundred thirty-six caregivers (75% female) of children ages 6–12 years (Mage = 8 years; 53% male) living in the United States rated child adherence to four preventative-health guidelines between 10/16/2020 and 11/14/2020. Caregivers also rated perceived importance of each guideline in limiting virus spread and perceived difficulty in obtaining child compliance. Results: Child adherence was highest for mask-wearing (median [Mdn] = 96%) and hand hygiene (Mdn = 95%). Adherence to social distancing guidelines was lower. Mdn adherence for social distancing with family outside the household was 80%, and Mdn adherence for social distancing with friends was 72%. Furthermore, for each of the four guidelines, fewer than half the sample reported 100% adherence (range = 20%–43%). Adherence was positively associated with caregiver perceptions of importance of a given behavior in limiting virus spread (rs = .38–.62) and negatively associated with perceived difficulty in gaining child compliance (rs = –.37––.25). Discussion: Current results indicated parents perceive child adherence to social distancing more challenging than child adherence to mask wearing or hand hygiene. Lower caregiver perceptions of importance of the behavior and greater perceived difficulty in gaining child compliance were associated with lower adherence to all tasks. Brief targeted interventions (e.g., motivational interviewing, parent behavior management training) may be well suited to enhance caregivers’ perceptions of value of the behavior, while also addressing behavioral challenges that interfere with child adherence