Neuropsychological Test Performance of Pediatric Cancer Patients at Diagnosis and One Year Later

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Abstract
More children with cancer are surviving, and the effects of medical treatments are of interest to patients, parents, educators, and the treatment team, since results may influence further treatment planning and delivery of educational services. Longitudinal investigations employing baseline measures are essential to distinguish preexisting learning problems from treatment effects and transient effects from long-term sequelae. In this report, neuropsychological test performance is compared at baseline and 1 year postdiagnosis between 19 leukemia patients who received central nervous system and systemic chemotherapy and 19 patients who received only systemic chemotherapy. Patients were evaluated with a comprehensive test battery developed for children to assess general intelligence, memory, language, academic achievement, and visual-spatial and constructional, tactile-perceptual, and fine-motor skills. No significant treatment group, time, or interaction effects were obtained for higher order cognitive abilities (intelligence, memory, language, academic achievement). Mean scores for both groups on these measures were within the normal range. Significant treatment group effects were obtained on tasks requiring fine-motor and tactile-perceptual skills. An interaction effect was noted on the tactile-perceptual test, in which the performace of one group improved, while that of the other group declined. Results are discussed in relation to the preservation of higher order cofnitive abilities and the peripheral effects of systemically administered chemotherapies.