Inter-rater Agreement in Multi-informant Reports of Psychosocial Functioning of Pediatric Brain and Solid Tumor Survivors

Abstract

Objectives: For pediatric cancer survivors in the post-treatment, school-reintegration period, integrating multi-informant reports and promoting a mutual clinician–family–school understanding of the child’s needs are critical for comprehensive care. This study evaluated patterns of agreement between child, parent, and teacher reports of psychosocial functioning in pediatric brain tumor survivors (PBTS) and non-CNS solid tumor survivors (PSTS). Participants and Methods: PBTS (n = 51) and PSTS (n = 34) age 7–14 who received tumor-directed therapy completed the study. Parents and teachers completed the CBCL/TRF and SSIS, and parents and children completed the PedsQL and PROMIS peer relationships. Intra-class correlation coefficients, % disagreements, t-tests, and correlations quantified inter-rater agreement. Results: Analysis yielded poor-to-moderate ICC levels across measures. Parent–teacher agreement was higher for reports of externalizing symptoms. Parents had higher ratings of child-internalizing problems, but lower ratings of overall social skills than teacher ratings. Parents had higher ratings of child emotional functioning and social skills compared to self-reports. Conclusions: Findings underscore the necessity for integrating multi-informant reports of psychosocial functioning in assessment for pediatric cancer survivors. Findings also highlight critical gaps in mutual parent–teacher–child understanding, indicating the need for increased collaboration in the post-treatment period.