TY - JOUR
T1 - Parent ratings of executive functioning in pediatric survivors of medulloblastoma and pilocytic astrocytoma
AU - Holland, Alice Ann
AU - Shamji, Jabeen F.
AU - Clem, Matthew A.
AU - Perez, Roger
AU - Palka, Jayme M.
AU - Stavinoha, Peter L.
N1 - Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2024
Y1 - 2024
N2 - The present study compared parent-rated executive functioning in pediatric medulloblastoma (MB) and pilocytic astrocytoma (PA) survivors. Although standard care for both includes surgical resection, children with MB additionally receive chemotherapy and craniospinal irradiation. Given well-documented neurocognitive late effects associated with the latter, we anticipated poor parent-reported executive functioning in MB survivors. Parents/guardians of 36 MB survivors and 20 PA survivors completed the Behavior Rating Inventory of Executive Functioning (BRIEF). PA survivors were younger at diagnosis (t[51.97] = 3.07, p <.001, d = 0.86) and demonstrated higher IQ (t[54] = −3.51, p <.001, d = 0.95). However, relative to the MB group, the PA group was rated as having significantly more problems on all BRIEF scales (all p ≤.05; d = 0.30 − 1.10), except the Shift scale. Additionally, all mean BRIEF scores for MB survivors were within normal limits, whereas for PA survivors, all mean BRIEF scores except for Organization of Materials were significantly discrepant from normative means. Overall, PA survivors were rated as demonstrating poorer executive function than MB survivors. Five theories are discussed as possible explanations for these surprising findings: two related to group differences, two related to potential sources of parental bias, and one related to the nature of questionnaire-based assessment. All these theories represent directions for future research. Parent questionnaires such as the BRIEF may have real-world implications for pediatric brain tumor survivors. Future research should explore factors affecting parent ratings of executive functioning in these populations, along with comparison to performance-based measures.
AB - The present study compared parent-rated executive functioning in pediatric medulloblastoma (MB) and pilocytic astrocytoma (PA) survivors. Although standard care for both includes surgical resection, children with MB additionally receive chemotherapy and craniospinal irradiation. Given well-documented neurocognitive late effects associated with the latter, we anticipated poor parent-reported executive functioning in MB survivors. Parents/guardians of 36 MB survivors and 20 PA survivors completed the Behavior Rating Inventory of Executive Functioning (BRIEF). PA survivors were younger at diagnosis (t[51.97] = 3.07, p <.001, d = 0.86) and demonstrated higher IQ (t[54] = −3.51, p <.001, d = 0.95). However, relative to the MB group, the PA group was rated as having significantly more problems on all BRIEF scales (all p ≤.05; d = 0.30 − 1.10), except the Shift scale. Additionally, all mean BRIEF scores for MB survivors were within normal limits, whereas for PA survivors, all mean BRIEF scores except for Organization of Materials were significantly discrepant from normative means. Overall, PA survivors were rated as demonstrating poorer executive function than MB survivors. Five theories are discussed as possible explanations for these surprising findings: two related to group differences, two related to potential sources of parental bias, and one related to the nature of questionnaire-based assessment. All these theories represent directions for future research. Parent questionnaires such as the BRIEF may have real-world implications for pediatric brain tumor survivors. Future research should explore factors affecting parent ratings of executive functioning in these populations, along with comparison to performance-based measures.
KW - Executive functioning
KW - medulloblastoma
KW - pediatrics
KW - pilocytic astrocytoma
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U2 - 10.1080/21622965.2022.2123707
DO - 10.1080/21622965.2022.2123707
M3 - Article
C2 - 36111630
AN - SCOPUS:85138240950
SN - 2162-2965
VL - 13
SP - 52
EP - 61
JO - Applied Neuropsychology: Child
JF - Applied Neuropsychology: Child
IS - 1
ER -