Upton P, Eiser C
CR-UK Child and Family Research Unit, University of Sheffield, Western Bank, Sheffield S10 2TP, UK.
Child Care Health Dev. 2006 Jan;32(1):9-17. doi: 10.1111/j.1365-2214.2006.00569.x.
Children surviving a brain tumour face major difficulties including learning problems, lengthy school absences and psychosocial problems, all of which can impact on school functioning. Our aims were to provide information for parents and teachers about the skills and resources of this group. Specifically, we aimed to: describe the special educational needs of these children; document the impact of diagnosis and treatment on school attendance; compare parent and teacher assessments of social, emotional and behavioural difficulties.
Forty families agreed to participate (response rate = 58.82%). The children (19 males and 21 females) were aged from 6 to 16 years and had completed treatment at least 2 years previously (range = 2 years-12 years 5 months). Questionnaires (Strengths and Difficulties and school experience) were completed by mothers and teachers.
Survivors were experiencing a wide range of physical, learning and interpersonal difficulties, according to parent and teacher reports. Almost half the children (n = 19) had ongoing neurological problems that were significant enough to require special help at school. Literacy and numeracy were the most common learning difficulties. Parents also rated brain tumour survivors as having more behavioural and emotional problems than would be expected from population norms. For example, survivors were rated as having more Total Difficulties (t = 6.86, P < 0.001), Emotional Symptoms (t = 8.82, P < 0.001), Hyperactivity (t = 2.25, P = 0.03), Peer Relationship Problems (t = 7.58, P < 0.001) and poorer Pro-social Behaviour (t = -3.34, P = 0.002) than would be expected from population norms. These problems were also seen to be having a significant impact on the child's functioning (t = 3.95, P < 0.001). Teachers rated these problems as less serious than parents.
These children experience significant problems in school some time after diagnosis and when they are considered medically cured. Closer school-hospital liaison is essential to maximize integration and achievement in these children.
脑肿瘤幸存儿童面临诸多重大困难，包括学习问题、长期缺课和心理社会问题，所有这些都会影响学校生活。我们的目的是为家长和教师提供有关该群体技能和资源的信息。具体而言，我们旨在：描述这些儿童的特殊教育需求；记录诊断和治疗对上学出勤率的影响；比较家长和教师对社交、情感和行为困难的评估。
40个家庭同意参与（回复率=58.82%）。这些儿童（19名男性和21名女性）年龄在6至16岁之间，至少在2年前完成了治疗（范围=2年至12年5个月）。母亲和教师完成了问卷（优势与困难问卷和学校经历问卷）。
根据家长和教师的报告，幸存者存在广泛的身体、学习和人际困难。近一半的儿童（n=19）有持续的神经问题，严重到需要在学校获得特殊帮助。读写能力和计算能力是最常见的学习困难。家长们还认为脑肿瘤幸存者的行为和情感问题比一般人群预期的更多。例如，与一般人群预期相比，幸存者在总困难（t=6.86，P<0.001）、情感症状（t=8.82，P<0.001）、多动（t=2.25，P=0.03）、同伴关系问题（t=7.58，P<0.001）以及亲社会行为较差（t=-3.34，P=0.002）方面的得分更高。这些问题也被认为对儿童的功能有重大影响（t=3.95，P<0.001）。教师认为这些问题没有家长认为的那么严重。
这些儿童在诊断后一段时间且被认为医学治愈时，在学校仍存在重大问题。加强学校与医院的联系对于使这些儿童最大限度地融入学校并取得成绩至关重要。
