Language outcomes subsequent to treatment of brainstem tumour in childhood

Abstract

While the occurrence and management of brainstem tumours in children would not traditionally indicate potential direct structural impact on classical language centres, recent theories have implicated some involvement of the brainstem in a functional language and cognitive neural loop between the cerebellum and the cerebral hemispheres. Thus, the present paper explored the impact of treatment for brainstem tumour on the general and high-level language abilities of six children treated for brainstem tumour, in addition to phonological awareness skills. Group analysis revealed that children treated for brainstem tumour demonstrated intact language and phonological awareness abilities in comparison to an age-and gender-matched control group. Individual analysis revealed only one of six children treated for brainstem tumour revealed evidence of language disturbances, with an additional child demonstrating an isolated mildly reduced score on one phonological awareness task. Language deficits identified in a child treated with a combination of both radiotherapy and chemotherapy were noted in the high-level language area of lexical generation. Findings highlighted that no overt language disturbances were evident in children treated for brainstem tumour. However, further analysis into higher-level language skills in the present study indicated that both general and high-level language abilities require long-term monitoring in this population.

Communication and swallowing outcomes of children diagnosed with childhood brain tumor or leukemia: A systematic review

“…A number of studies on language outcomes included between‐group comparisons with a typically developing control group and found no statistically significant differences between groups on some or all measures 25,26,28,69,74,75,77–79,83–85 . However, the ability to interpret group‐level comparisons was often limited due to small sample sizes for the CBTL group (≤17).…”

“…However, the ability to interpret group‐level comparisons was often limited due to small sample sizes for the CBTL group (≤17). The majority of these studies also included an individual‐level analysis and descriptively reported language outcomes, revealing difficulties in some, but not all, children with CBTL 25,26,28,69,74,75,77–79,83 …”

“…82 A number of studies on language outcomes included betweengroup comparisons with a typically developing control group and found no statistically significant differences between groups on some or all measures. 25,26,28,69,74,75,[77][78][79][83][84][85] However, the ability to interpret group-level comparisons was often limited due to small sample sizes for the CBTL group (≤17). The majority of these studies also included an individual-level analysis and descriptively reported language outcomes, revealing difficulties in some, but not all, children with CBTL.…”

“…The majority of these studies also included an individual-level analysis and descriptively reported language outcomes, revealing difficulties in some, but not all, children with CBTL. 25,26,28,69,74,75,[77][78][79]83 A pattern of persistent communication difficulty in children diagnosed with posterior fossa brain tumors was apparent. This difficulty was characterized by an acute period of mutism that resolved to dysarthria and/or language difficulties.…”

“…Communication difficulties reported in children diagnosed with childhood brain tumor or leukemia (CBTL) include problems with producing clear speech and understanding and using spoken and/or written language 19–29 . Communication skills that are yet to develop are most vulnerable, with evidence of children failing to acquire skills at expected rates after cancer treatment 15,16 .…”