Parent-reported executive functioning in young children treated for cancer

Abstract

It is well known that children treated for cancer are at risk for cognitive and functional impairments. Such research is largely based on studies of late effects in school-aged or older children. However, far less is known about executive function weaknesses in preschool-aged children treated for cancer. Thus, the aim of this study was to examine executive functioning in a clinically referred sample of young oncology patients, and its association with broader domains of functioning. Data from 61 young children with cancer, who were referred for clinical cognitive evaluations, were abstracted and included in this study. Patients were 5.00 years of age (SD = 0.72) at assessment, 54.1% male, and two-thirds (63.9%) had been treated for brain tumors. Most executive functions were significantly discrepant from the mean, with 47.5% of preschoolers having parent-reported working memory concerns within the clinically significant range. There were no differences in executive functioning based on diagnosis or treatment status. Parent-reported executive functioning was strongly correlated with global intelligence and adaptive functioning, with some indices also associated with nonverbal problem solving and pre-academic skills. Ultimately, results indicate the presence of emerging weaknesses in executive functioning in young children with cancer, and add to a growing body of literature highlighting the potential cognitive and behavioral risks associated with a cancer diagnosis in early childhood.

Processing efficiency in pediatric cancer survivors: A review and operationalization for outcomes research and clinical utility

“…For example, impairment in cognitive flexibility (Brinkman et al., 2012 ), organization (Caron et al., 2009 ), and abstract reasoning (Hollen et al., 2013 ) are all cited as broader weaknesses in “executive functioning” in this population, but each of these studies report a different pattern of performance across these higher‐order cognitive skills. The most consistent evidence for executive functioning deficits among pediatric cancer survivors appears to be from parent‐ or self‐ report ratings rather than lab‐based measures (Alderson & Mullins, 2011 ; Harman et al., 2019 ; Patel et al., 2013 ), and these studies typically report primary deficits in working memory skills that translate to broader difficulties with activities of daily living and functional independence.…”

Researching the Experiences of Children with Cancer: Considerations for Practice

“…Epidemiology, psychology, biology, and genetics are just a few areas researching the unique experiences of children with cancer [35]. Other areas of study for this population include parenting concerns [36], cognitive and neuropsychological functioning [37], and patient experiences within and outside of the hospital [38]. Both social science and clinical research traditions acknowledge the challenges in striking a balance between protecting the vulnerabilities of young research participants and respecting their autonomy [5,33].…”

Occupational Therapy: An Essential Component of Support for Young Children With Cancer

“…Prolonged periods of hospitalization, illness, and cancer-related precautions restrict the ability of young children with cancer to access age-appropriate environments, activities, and social experiences during treatment. Indeed, across various diagnoses, infants treated for cancer are at increased risk for delays in fine and gross motor skills, daily living skills, cognitive development, and communication (Bornstein et al, 2012; Harman, Molnar, et al, 2018; Kenney et al, 2020; Quigg et al, 2013; Willard et al, 2014). In addition, infants and toddlers with cancer are at risk for problems with behavior and social emotional development (Cox et al, 2018; Jurbergs et al, 2019).…”