Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor

Abstract

CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07–5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children’s motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS’s total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children’s motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis’ tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

Health-related quality of life in AYA cancer survivors who underwent HSCT compared with healthy peers

“…Possible interventions could focus on two directions: the first could be the implementing of motor skills functioning on children with cancer both during the treatment phase, when the therapies impacted negatively on their motor performance (Taverna et al., ), and also when they were off therapies, adopting a specific rehabilitative programme and paediatric occupational therapy to reduce their fatigue.…”

Who Benefits from An Intervention Program on Foundational Skills for Handwriting Addressed to Kindergarten Children and First Graders?

“…Studies on the effectiveness of handwriting intervention programs found improvements in fine motor and visual-motor skills in children receiving direct occupational therapy lasting seven or more months [33][34][35][36]. Nevertheless, research has suggested that even short-term interventions targeting fine motor performances in children of lower elementary school ages can lead to significant changes in individuals with or without disabilities [37][38][39][40][41][42]. Furthermore, short-term interventions can be more easily managed and would offer the possibility to be included also in the educational curriculum to improve handwriting foundational skills in preschool children.…”

The Impact of Hematologic Cancer and Its Treatment on Physical Activity Level and Quality of Life Among Children in Mainland China

“…32 Two studies indicated that the correlation coefficients between the side effects of cancer treatment and physical activity and between physical activity and quality of life for children with hematologic cancer were -0.33 and 0.66, respectively. 33,34 With reference to the guideline proposed by Cohen, the aforementioned correlation coefficients were arranged from small to large effect sizes (r), and the necessary sample size of this study was calculated using the smallest effect size. 35 An effect size at a 5% significance level (p <0.5) and a power of 0.8 was used to predict the difference between the hematologic cancer group and the healthy group.…”