A nationwide, population‐based study of school grades, delayed graduation, and qualification for school years 10‐12, in children with brain tumors in Sweden

Abstract

BackgroundAs many as 95.7% of children diagnosed with a brain tumor will experience persistent late effects as adults. These include difficulties with general executive functions, lower IQ, and mental fatigue, which may negatively affect school performance.MethodsThrough the Swedish Childhood Cancer Registry, we identified 475 children born between 1988 and 1996, diagnosed with a brain tumor before their 15th birthday. School grades in “Swedish,” “mathematics,” and “English,” if their graduation was delayed, and qualification for school years 10‐12 were compared with 2197 matched controls. Furthermore, we checked for interaction effects between sex and age at diagnosis, and possible effects of tumor grade (high or low) as well as parents’ education.ResultsChildren treated for a brain tumor performed worse in the subjects compared to controls and also had delayed graduation to a greater extent. Fewer children treated for a brain tumor than controls qualified for school years 10‐12. Children treated at a young age, especially females, and children whose parents have low education seem to be at particular risk. Unexpectedly, there were no differences in outcomes between survivors with high‐ and low‐grade tumors.ConclusionsIt is important that schools provide regular pedagogical assessment and individualized support to meet the different needs of children treated for a brain tumor. Children treated for low‐grade tumors do not perform better than children treated for high‐grade tumors, despite the lighter treatment, and hence require the same attention and support.

Nationwide, population-based study of school grades in practical and aesthetic subjects of children treated for brain tumour

“…From Statistics Sweden we obtained information about grades, number of students with Swedish as their first or second language, and parents’ education (table 2). 6…”

“…However, PBTS may face different kinds of difficulties in school, as they typically suffer from cognitive late effects, such as difficulties with verbal memory, language and attention,2 IQ decline over time,3 psychosocial difficulties, as well as depression or anxiety disorders 4. Particularly, children treated at a younger age and female PBTS appear to be at risk of academic difficulties 5–7. PBTS may also have limitations in physical performance affecting everyday life 8…”

“…In this study, we focused on PBTS performance in the practical and aesthetic (PRAEST) subjects, home and consumer studies (equivalent to the subject home economics), physical education and health, art, crafts and music (table 1). Previous studies of PBTS’s school performance have mainly focused on theoretical subjects, such as mother tongue, mathematics and foreign language 5–7 9. These studies have shown a greater risk of lower school grades for PBTS compared with controls.…”

Lithium treatment reverses irradiation-induced changes in rodent neural progenitors and rescues cognition

“…Lithium is effective even when introduced long after the injury Cranial radiation therapy is a major cause of long-term complications in pediatric patients [1]. Here we chose to investigate female subjects due to their propensity to suffer more from postirradiation cognitive deficits [6,46,47], and given that lithium effects are not dependent on sex we argued that a successful lithium treatment in females is likely to aid male subjects to the same extent [48,49]. These complications include late-occurring cognitive impairments, and a negative impact on social competence [3,50].…”

“…Radiotherapy is known to cause debilitating cognitive alterations [3] leading to impaired processing speed, attention and working memory, leading to social isolation, further impinging on emotional and psychological well-being and ultimately leading to anxiety, and posttraumatic stress symptoms [4]. Declines in IQ and academic achievements have been observed during longitudinal follow-up and these impact the quality of life, academic performance, and overall daily activities [5,6].…”