a Department of Psychology , St. Jude Children's Research Hospital , Memphis , TN , USA.
Child Neuropsychol. 2019 May;25(4):548-560. doi: 10.1080/09297049.2018.1503647. Epub 2018 Jul 26.
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.
众所周知,接受癌症治疗的儿童存在认知和功能障碍的风险。这类研究主要基于对学龄期或大龄儿童晚期效应的研究。然而,对于接受癌症治疗的学龄前儿童的执行功能弱点,人们知之甚少。因此,本研究旨在检查临床转介的年轻肿瘤患者的执行功能及其与更广泛的功能领域的关系。从接受临床认知评估的 61 名癌症患儿中提取并纳入本研究的数据。患者评估时年龄为 5.00 岁(标准差=0.72),男性占 54.1%,三分之二(63.9%)曾接受过脑瘤治疗。大多数执行功能明显与平均值存在差异,47.5%的学龄前儿童的父母报告其在临床显著范围内存在工作记忆问题。诊断或治疗状况对执行功能没有影响。父母报告的执行功能与整体智力和适应功能密切相关,一些指标还与非语言问题解决和学术前技能相关。最终,结果表明癌症患儿存在执行功能的新弱点,这也增加了越来越多的文献,强调了儿童早期癌症诊断相关的潜在认知和行为风险。