Investigators have found that providing early developmental resources may help reduce the adverse effects of brain tumors and cancer therapy on the academic achievement of young pediatric cancer survivors, according to a recent study published by Somekh et al in the Journal of the National Cancer Institute.
Background
Pediatric patients who survive brain tumors often experience effects from both the cancer and its treatment long after the completion of therapy. Previous studies have focused mainly on school-aged pediatric patients.
“Even in very young children, we found academic readiness was starting to lag behind healthy children their age,” stressed senior study author Heather Conklin, PhD, Chief of the Section of Neuropsychology and a member of the Department of Psychology and Behavioral Sciences at the St. Jude Children’s Research Hospital. “They were gradually falling behind their same-age peers in academic fundamentals such as learning their letters, numbers, and colors,” she continued.
Study Methods and Results
In the recent study, the investigators examined academic readiness after brain tumor treatment in a group of 70 infantile patients and pediatric patients younger than age 3.
The investigators found that the patients who had been treated for brain tumors were less prepared for school—represented by lower academic readiness scores—than their peers. The gap persisted once the cancer survivors entered formal schooling.
At 6 months after diagnosis and annually for 5 years, “we found an increasing gap between these young patients treated for brain tumors and their typically developing peers because their academic readiness skills were not developing as fast. Early academic readiness was predictive of long-term reading and math outcomes. The effect isn’t temporary. These children don’t just catch up naturally,” Dr. Conklin detailed.
Despite making observations in the academic shortcomings of these pediatric patients as they aged, they were present early and had predictive power. Since the difference in academic readiness appeared to arise early after treatment, intervening prior to the start of schooling—as opposed to in elementary school, when most conventional interventions are initiated—may improve outcomes.
“We now know that we don’t need to wait until patients are struggling with math and reading; we can intervene earlier. We showed that the variability we’re seeing early on predicts longer-term academic skills, which highly suggests earlier interventions will be beneficial and make a real difference,” Dr. Conklin emphasized.
In order to succeed, the investigators noted that early interventions should be informed by the factors that increase vulnerability to or protect against the academic readiness gap. They evaluated factors such as treatment type and demographics and found just one characteristic that was significant.
“The only clinical or demographic factor we found that predicted academic readiness was socioeconomic status. Being from a family of higher socioeconomic status had a protective effect on children’s academic readiness,” Dr. Conklin indicated.
Conclusions
The finding that higher socioeconomic status was partially protective suggested that investing in resources to replace lost early enrichment experiences may mitigate the readiness gap. By increasing access to those replacement opportunities, more pediatric patients could be protected.
“We know that being away from their home environment, caregivers, daycare, play dates, parks, and early intervention services during these critical developmental years is probably having a negative impact on very young patients,” Dr. Conklin underscored. “Our results suggest that families can make play meaningful, and by making little changes in how they interact with their child, with the support of their medical team and receiving appropriate resources, they may be able to make a difference in their child’s cognitive and academic outcomes,” she concluded.
Disclosure: The research in this study was supported by grants from the National Cancer Institute and the American Lebanese Syrian Associated Charities. For full disclosures of the study authors, visit academic.oup.com.
