Neural Networks

Why should a childhood brain tumor survivor be followed by a neuropsychologist?

by Celiane Rey-Casserly, PhD, ABPP-CN
Director, Boston Children's Hospital Neuropsychology Program

Impairments in fundamental cognitive processes of working memory, attention, and information processing speed have been identified in studies of children treated for brain tumors. The impact and severity of these deficits differ based on:

• Brain factors: location of tumor, treatments, associated complications and genetic differences
• Developmental factors: age at diagnosis/treatment and time since treatment 
• Contextual factors: family functioning, educational resources, social/cultural influences and community supports

In childhood brain tumor survivors, studies consistently identify younger age at diagnosis and higher intensity of treatment as contributors to increased risk of developing neurocognitive deficits and learning disabilities. Early and continual monitoring is recommended, as late effects typically emerge over time as specific developmental stages and contexts demand mastery of more complex tasks and behaviors.

At the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic at Dana-Farber Cancer Institute, experienced neuropsychologists conduct important evaluations to help determine the nature, extent and impact of late effects, as well as identify the child’s strengths and protective factors. Periodic assessments, particularly at times of significant developmental transitions, are crucial since neuropsychological issues emerge over time. Evaluations should measure specific cognitive processes as well as overall intellectual ability and academic achievement.

An experienced pediatric neuropsychologist is best positioned to promote optimal functioning and adaptation for each child. We personalize plans to optimize neuropsychological and adaptive outcomes. We know how to be risk responsive and address the multiple systems and contexts, as well as how to develop interventions for the educational and home settings. We also develop plans considering the long term situation, offering recommendations for future challenges, such as transitioning to adulthood.