Social competence in newly diagnosed pediatric brain tumor patients

Brain tumors (BTs) are a common pediatric malignancy. Improved treatment has resulted in higher survival rates. There is, however, increasing concern about adverse effects of the disease and its treatment, including effects on social competence (i.e. effective social functioning in everyday life). The aim of this study is to examine multiple levels of social competence (i.e. social skills and social adjustment) in newly diagnosed pediatric BT patients. Thirty newly diagnosed BT patients aged 5-12 years were assessed shortly after diagnosis with a neuropsychological test battery focusing on social competence, including tests for IQ, social skills (i.e. social-affective and executive functioning) and social adjustment (rated by parents and teachers). Their performance was compared to 95 healthy controls who completed the same assessment. Patients and healthy controls were largely comparable with regard to demographic and environmental factors and did not differ on measures of IQ, social skills and social adjustment. Furthermore, age was found to have a positive significant effect on social skills independent of group. Shortly after diagnosis, pediatric BT patients did not perform different from healthy controls on IQ and measures of social skills and social adjustment. This is an encouraging finding. However, because of potentially neurotoxic adjuvant therapy and the ongoing development of social skills, longitudinal follow-up studies are needed to investigate long-term outcome regarding social competence in BT survivors.

Language comprehension in young people with severe cerebral palsy in relation to language tracts: a diffusion tensor imaging study

Patients with severe cerebral palsy (CP) often have poor speech ability but potentially better language comprehension. The arcuate fasciculus and the extreme capsule are two important language tracts between the Wernicke and Broca areas. Using diffusion tensor imaging, we visualized language tracts and pyramidal tracts in both hemispheres in 10 controls (5 to 18 years) and 5 patients (5 to 23 years) with severe CP. Language comprehension was assessed with a recently designed instrument (the Computer-Based instrument for Low motor Language Testing [C-BiLLT]). The language tracts were visualized in all control children and in four CP patients. In one CP patient without any objective language comprehension skills, no language tract could be visualized. Both language and pyramidal tracts were smaller in patients than in controls. These preliminary data indicate a relation between language tracts and language skills. Further research is necessary to study the value of structural integrity of language tracts in predicting language comprehension in CP patients.

Utility of language comprehension tests for unintelligible or non-speaking children with cerebral palsy: a systematic review

AIM

to identify the use and utility of language comprehension tests for unintelligible or non-speaking children with severe cerebral palsy (CP).

METHOD

severe CP was defined as severe dysarthria (unintelligible speech) or anarthria (absence of speech) combined with severe limited mobility, corresponding to Gross Motor Function Classification System levels IV to V. An electronic search in the databases of PubMed, PsychInfo, Embase, and CINAHL was made of studies published between January 1965 and December 2008. Indexing terms and free-text terms for 'cerebral palsy', 'language', and 'instrumentation' were used. Studies were included when (1) the focus was to investigate comprehension of spoken language of children (0-18 y) with severe CP, and (2) language tests were described.

RESULTS

twelve standardized tests and five experimental instruments were identified. All standardized tests were developed for children without limited mobility. Only the Peabody Picture Vocabulary Test - Revised was frequently used and feasible for older children with severe CP (> 9y). The other tests were used occasionally. To establish utility, adaptations of standardized test procedures were necessary.

INTERPRETATION

language comprehension tests for children with severe CP are scarce. A language comprehension test specifically designed for these children is warranted. Cite this as: Dev Med Child Neurol 52: e267-e277.

Utility of language comprehension tests for unintelligible or non-speaking children with cerebral palsy: a systematic review

AIM

to identify the use and utility of language comprehension tests for unintelligible or non-speaking children with severe cerebral palsy (CP).

METHOD

severe CP was defined as severe dysarthria (unintelligible speech) or anarthria (absence of speech) combined with severe limited mobility, corresponding to Gross Motor Function Classification System levels IV to V. An electronic search in the databases of PubMed, PsychInfo, Embase, and CINAHL was made of studies published between January 1965 and December 2008. Indexing terms and free-text terms for 'cerebral palsy', 'language', and 'instrumentation' were used. Studies were included when (1) the focus was to investigate comprehension of spoken language of children (0-18 y) with severe CP, and (2) language tests were described.

RESULTS

twelve standardized tests and five experimental instruments were identified. All standardized tests were developed for children without limited mobility. Only the Peabody Picture Vocabulary Test - Revised was frequently used and feasible for older children with severe CP (> 9 y). The other tests were used occasionally. To establish utility, adaptations of standardized test procedures were necessary.

INTERPRETATION

language comprehension tests for children with severe CP are scarce. A language comprehension test specifically designed for these children is warranted.

Is the Sleep-deprivation EEG a Burden for Both Child and Parent?

BACKGROUND AND PURPOSE

Inducing sleep deprivation is supposed to increase interictal epileptic discharges on EEGs from children suspected of having epilepsy. Although it is supposed that depriving a child from sleep is a burden for both child and parent, this assumption has not been investigated in any study so far.

METHODS

To analyze the perception of the sleep deprivation procedure, we developed two questionnaires, one for the parent and one for the child over ten years of age at the time of the SDEEG. These questionnaires were sent to parents of all 179 patients and 47 children (older than ten) from which a SDEEG was obtained because of suspected epilepsy. A total of 103 questionnaires were returned by the parents and 18 by the children. The extent to which the SDEEG turned out to be inconvenient was assessed with regard to issues that covered the psychological and physical impact of the SDEEG.

RESULTS

Our results showed that the whole procedure of the SDEEG proved to be a burden for 18.6% of the parents and 23.5% of the children. 49.6% of the parents reported complaints including their child- like fatigue, illness and in 2 cases even an increase in seizure frequency. Overall, 47.1% of the children described having symptoms the next day. These consisted mainly of fatigue.

CONCLUSION

Our survey shows that the SDEEG places a notable burden on both parent and child. This should be taken into consideration before requesting an SDEEG.