Neurocognitive Interventions for Children and Adolescents Surviving Cancer
1 Oregon Health Science University, Portland, Oregon, and 2 St. Jude Children’s Research Hospital, Memphis, Tennessee
All correspondence should be sent to Robert W. Butler, Division of Pediatric Hematology/Oncology, Oregon Health & Science University, MC: CDRCP, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239. E-mail: butlerr{at}ohsu.edu.
Background It is well recognized that many cures for childhood leukemia and brain tumors entail some relatively permanent neurocognitive and psychological costs to the patient and family. As cure rates have improved over the past three decades, increasing efforts have been directed toward reducing treatment-related late effects. Objective The particular focus of this review will be on interventions for the neuropsychological late effects associated with the treatment of acute lymphoblastic leukemia (ALL) and malignant brain tumors. Summary We will first briefly review current approaches to the medical treatment of ALL and brain tumors to provide an appreciation of potential sources of brain injury. We will then summarize the existing literature on types of neuropsychological deficits found among survivors, with special attention to variables that place some children at greater risk. Then, there will be a discussion of approaches to intervention for these deficits–specifically, cognitive remediation, pharmacology, and ecological alterations in the classroom. Finally, we will present directions for future research in the field.
Key words: pediatric brain injury; rehabilitation; childhood cancer.
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