a Department of Psychology and the Neuroscience Institute , Georgia State University , Atlanta , GA , USA.
Child Neuropsychol. 2019 Jan;25(1):1-21. doi: 10.1080/09297049.2017.1380178. Epub 2017 Sep 28.
Childhood brain tumors and related treatments disrupt the developing brain and have a cascading impact on core cognitive skills and intellectual (intelligence quotient [IQ]) and academic achievement outcomes. Theoretical models for this cascade have been developed based on the literature, but no studies thus far have empirically evaluated the models. The current study aimed to empirically test the two extant models and generate a new data-driven model of the relationships among neurodevelopmental risk factors, core cognitive skills (i.e., processing speed, attention span, working memory), and IQ and achievement outcomes. Fifty-seven adult survivors of childhood brain tumors and fifty-seven demographically matched neurotypical individuals were included in the current study. The average age at brain tumor diagnosis was 8 years, and the average time since diagnosis was 17 years. Three a priori path models tested the hypothesized relationships among variables. Results of the path analyses revealed that the hybrid model best fit the data for both survivors and controls based on all statistical criteria. For survivors, processing speed was the core cognitive skill most widely associated with neurodevelopmental risk factors and outcomes. However, working memory and attention span also had unique contributions to IQ and academic achievement. Processing speed appears to be the central cognitive skill that disrupts the other core cognitive skills of attention span and working memory, and all three make a unique contribution to IQ and academic achievement. This is best demonstrated by a novel neurodevelopmental model that combines components of two earlier untested theoretical models.
儿童脑肿瘤及其相关治疗会破坏大脑发育，并对核心认知技能以及智力（智商 [IQ]）和学业成绩产生级联影响。基于文献已经开发出了针对这种级联的理论模型，但迄今为止尚无研究对这些模型进行实证评估。本研究旨在对现有的两个模型进行实证检验，并生成一个新的神经发育风险因素、核心认知技能（即处理速度、注意力持续时间、工作记忆）与 IQ 和学业成绩之间关系的基于数据的模型。本研究纳入了 57 名儿童脑肿瘤成年幸存者和 57 名在人口统计学上与之匹配的神经典型个体。脑肿瘤诊断的平均年龄为 8 岁，诊断后的平均时间为 17 年。三个先验路径模型检验了变量之间的假设关系。路径分析的结果表明，基于所有统计标准，混合模型最适合幸存者和对照组的数据。对于幸存者，处理速度是与神经发育风险因素和结果最广泛相关的核心认知技能。然而，工作记忆和注意力持续时间对 IQ 和学业成绩也有独特的贡献。处理速度似乎是破坏注意力持续时间和工作记忆等其他核心认知技能的核心认知技能，并且所有三个都对 IQ 和学业成绩有独特的贡献。这在一个新的神经发育模型中得到了最好的体现，该模型结合了两个以前未经测试的理论模型的组件。
