BackgroundAlthough pediatric brain tumor survivors are at high risk for a variety of psychosocial and neurocognitive late effects, there are few evidence‐based interventions to address their needs. The purpose of this study was to test the efficacy of an online problem‐solving intervention on improving the quality of life and executive dysfunction among adolescent and young adult brain tumor survivors.ProcedureA Survivor's Journey was adapted from a similar intervention for survivors of traumatic brain injuries, and involved self‐guided web modules providing training in problem‐solving as a tool for coping with everyday challenges, as well as weekly teleconferences with a trained therapist. Survivors (n = 19) between the ages of 13 and 25, and their caregivers, completed standardized measures of their emotional and behavioral functioning, executive functioning, and quality of life before and after the 12‐ to 16‐week intervention.ResultsParticipation in the intervention led to significant improvements in self‐reported overall (Mpre = 62.03, SDpre = 17.67, Mpost = 71.97, SDpost = 16.75; d = 0.58, P = 0.01) and physical quality of life (Mpre = 63.13, SDpre = 21.88, Mpost = 75.00, SDpost = 21.33; d = 0.55, P < 0.01) as well as parent‐reported emotional quality of life (Mpre = 65.00, SDpre = 28.72, Mpost = 76.15, SDpost = 23.47; d = 0.43, P = 0.03). Greater improvement was noted in those who were diagnosed before the age of seven and those with average or above average estimated IQs. Current age did not moderate outcomes.ConclusionsOnline problem‐solving therapy may be efficacious in improving pediatric brain tumor survivors’ quality of life; however, further research with a comparison group is needed. Online interventions such as Survivor's Journey may decrease barriers to evidence‐based psychosocial care for brain tumor survivors.

To describe the preliminary feasibility and acceptability of a web-based, problem-solving intervention for adolescent and young adult pediatric brain tumor survivors. Methods: With feedback from survivors and stakeholders, we created "A Survivor's Journey" by modifying an existing problem-solving intervention for traumatic brain injury. Survivors (ages 13-25) were recruited from a pediatric survivorship clinic and were eligible if they had self or caregiver-reported psychosocial difficulties. A Survivor's Journey has four core sessions (i.e., introduction, problem-solving, positive thinking, memory) and up to seven supplemental sessions. Each session involved web content and videoconferencing with a doctoral-level therapist. We analyzed postintervention data related to feasibility (i.e., enrollment and completion rates), as well as survivor's ratings of satisfaction and usability of the intervention. Results: Nineteen survivors (M age ϭ 17.57), half of eligible participants, agreed to

Although effect sizes were modest, these findings suggest that previously-reported correlations between sleep duration and academic performance reflect true cause-effect relationships. Findings add to the growing evidence that the chronically shortened sleep experienced by many adolescents on school nights adversely impacts their functioning and health.

Objective: To investigate the effects of methylphenidate on long-term executive and neuropsychological functioning in children with attention problems following TBI, as well as the relationship between methylphenidate associated changes in lab-based neuropsychological measures of attentional control, processing speed, and executive functioning and parent- or self-report measures of everyday executive functioning. Method: 26 children aged 6–17 years, who were hospitalized for moderate-to-severe blunt head trauma 6 or more months previously, were recruited from a large children’s hospital medical center. Participants were randomized into a double-masked, placebo-controlled cross-over clinical trial. Participants completed a comprehensive neuropsychological battery and parent- and self-report ratings of everyday executive functioning at baseline, and at 4 weeks and 8 weeks following upward titration of medication to an optimal dose or while administered a placebo. Results: Methylphenidate was associated with significant improvements in processing speed, sustained attention, and both lab-based and everyday executive functioning. Significant treatment-by-period interactions were found on a task of sustained attention. Participants who were randomized to the methylphenidate condition for the first treatment period demonstrated random or erratic responding, with slower and more variable response times when given placebo during the second period. Conclusion: Results indicate that methylphenidate treatment is associated with positive outcomes in processing speed, sustained attention, and both lab-based and everyday measures of executive functioning compared to placebo group. Additionally, results suggest sustained attention worsens when discontinuing medication. (JINS, 2019, 25, 740–749)