Background Recent shifts from radiation to chemotherapy‐based treatment for acute lymphoblastic leukemia (ALL) have contributed to reduced long‐term morbidity. Despite this, ALL survivors remain at increased risk for long‐term cognitive impairments. Aim To identify demographic and treatment factors associated with school performance in pediatric survivors of ALL. Methods We collected standardized test scores for reading, math, and science obtained in a school setting from grades 3–11 in 63 ALL survivors (46.0% boys). Most participants were assessed across multiple grades (median number of grades n = 5, range 1–7), and 269 observations were considered in the analyses. Treatment exposures were extracted from medical records. Socio‐economic status was estimated using participation in free/reduced lunch programs at school. Mixed effects linear regression models were conducted to determine factors associated with school performance. Results ALL survivors' scores were comparable to state norms on reading, math, and science performances. On multivariable analysis, participation in free/reduced lunch programs was significantly associated with lower reading scores ( β = −12.52; 95% CI −22.26:−2.77, p = .01). Exposure to radiation during treatment was also associated with lower reading test scores ( β = −30.81, 95% CI −52.00:−9.62, p = .01). No significant associations between demographics and treatment parameters were observed for math and science test scores. Conclusions We utilized population‐based achievement tests conducted from grades 3–11 to characterize school performance in ALL survivors. Our results imply that survivors with low socio‐economic status and those exposed to radiation during treatment could benefit from early monitoring and intervention to maximize academic success.

Background: Molecular studies provide evidence that mutant huntingtin (mHTT) affects early cortical development; however, cortical development has not been evaluated in child and adolescent carriers of mHTT. Objective: To evaluate the impact of mHTT on the developmental trajectories of cortical thickness and surface area. Methods: Children and adolescents (6–18 years) participated in the KidsHD study. mHTT carrier status was determined for research purposes only to classify participants as gene expanded (GE) and gene non-expanded (GNE). Cortical features were extracted from 3T neuroimaging using FreeSurfer. Nonlinear mixed effects models were conducted to determine if age, group, and CAG repeat were associated with cortical morphometry. Results: Age-related changes in cortical morphometry were similar across groups. Expanded CAG repeat was not significantly associated with cortical features. Conclusion: While striatal development is markedly different in GE and GNE, developmental change of the cortex appears grossly normal among child and adolescent carrier of mHTT.

Introduction:We compared neuropsychiatric symptoms between child and adolescent huntingtin gene-mutation carriers and noncarriers. Given previous evidence of atypical striatal development in carriers, we also assessed the relationship between neuropsychiatric traits and striatal development.Methods: Participants between 6 and 18 years old were recruited from families affected by Huntington's disease and tested for the huntingtin gene expansion. Neuropsychiatric traits were assessed using the Pediatric Behavior Scale and the Behavior Rating Inventory of Executive Function. Striatal volumes were extracted from 3T neuro-anatomical images. Multivariable linear regression models were conducted to evaluate the impact of group (i.e., gene nonexpanded [GNE] or gene expanded [GE]), age, and trajectory of striatal growth on neuropsychiatric symptoms.Results: There were no group differences in any behavioral measure with the exception of depression/anxiety score, which was higher in the GNE group compared to the GE group (estimate = 4.58, t(129) = 2.52, FDR = 0.051). The growth trajectory of striatal volume predicted depression scores (estimate = 0.429, 95% CI 0.15:0.71, p = .0029), where a negative slope of striatal volume over time was associated with lower depression/anxiety. Conclusions:The current findings show that GE children may have lower depression/anxiety compared to their peers. Previously, we observed a unique pattern of early striatal hypertrophy and continued decrement in volume over time among GE children and adolescents. In contrast, GNE individuals largely show striatal volume growth.These findings suggest that the lower scores of depression and anxiety seen in GE children and adolescents may be associated with differential growth of the striatum.

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