Patel Sunita K, Lai-Yates Judy J, Anderson Jonathan W, Katz Ernest R
City of Hope National Medical Center and Beckman Research Institute, Division of Population Sciences & Pediatrics, Duarte, California 91010-3000, USA.
Pediatr Blood Cancer. 2007 Dec;49(7):970-4. doi: 10.1002/pbc.21151.
The IQ declines observed in children treated for brain tumor emerge as "late effects" and are conceptualized as secondary to changes in underlying mental processes, such as attention. Early identification of the underlying changes might help minimize the long-term adverse outcomes. We evaluated the validity of a time-efficient, standardized parent-report measure in identifying attention dysfunction in childhood brain tumor survivors.
Seventy survivors between ages 6 and 16 who met eligibility criteria and who had completed a standard neuropsychological evaluation were classified into an attention dysfunction group and a non-attention dysfunction group, based on their performance on objective measures of attention. Analysis of covariance was used to evaluate group differences on the widely used, parent report Child Behavioral Checklist (CBCL).
Survivors in the attention dysfunction group were reported by their parents as having significantly more attention problems relative to the group without attention dysfunction on objective testing. Furthermore, survivors categorized as having attention dysfunction based on their neuropsychological test scores were reported on the CBCL by their parents as having significantly more social problems compared to the non-attention dysfunction group.
Standardized parent reporting of attention problems shows promise as a screening tool to detect attention dysfunction among survivors of childhood brain tumors. Findings include a strong association of decreased social functioning with attention dysfunction in brain tumor survivors. Furthermore, exploratory data suggest that the behavioral presentation of attention dysfunction in this group may be different from other clinical groups.
在接受脑瘤治疗的儿童中观察到的智商下降表现为“迟发效应”,并被认为是潜在心理过程变化(如注意力)的继发结果。早期识别潜在变化可能有助于将长期不良后果降至最低。我们评估了一种省时的标准化家长报告测量方法在识别儿童脑瘤幸存者注意力功能障碍方面的有效性。
70名年龄在6至16岁之间、符合入选标准且完成了标准神经心理学评估的幸存者,根据他们在注意力客观测量中的表现,被分为注意力功能障碍组和非注意力功能障碍组。采用协方差分析来评估在广泛使用的家长报告《儿童行为清单》(CBCL)上的组间差异。
与客观测试中无注意力功能障碍的组相比,注意力功能障碍组的幸存者被其父母报告有更多的注意力问题。此外,根据神经心理学测试分数被归类为有注意力功能障碍的幸存者,其父母在CBCL上报告他们比非注意力功能障碍组有更多的社交问题。
标准化的家长对注意力问题的报告有望作为一种筛查工具,用于检测儿童脑瘤幸存者中的注意力功能障碍。研究结果包括脑瘤幸存者的社交功能下降与注意力功能障碍有很强的关联。此外,探索性数据表明,该组中注意力功能障碍的行为表现可能与其他临床组不同。