Longitudinal, multimodal assessment of neuropsychological functioning in children diagnosed with high-risk acute lymphoblastic leukemia (HR-ALL): Using early changes to predict later impairment

项目摘要 患有“高危”白血病的儿童接受强化治疗，在挽救生命的同时， 导致他们的学习和思考方式出现问题。这并不发生在所有 接受这些治疗的儿童，但我们还不能预测谁会出现问题。一 我们缺乏这些信息的原因是，通常很难测试孩子们在生活方式上的变化。 在接受治疗的同时学习。孩子们可能会觉得太恶心而无法完成测试， 心理学家并不总是可以做评估，保险公司也不一定 涵盖所需的测试。 在这个项目中，我们的目标是通过一个简短的， 计算机化测试程序这些测试可以在诊所由护士或其他工作人员进行， 很少的钱。我们将在白血病确诊后不久开始对儿童进行检测， 时间在他们的治疗过程中，这样我们就可以发现问题，只要他们 开始发生。我们研究中的儿童还将接受一个小时的评估， 学习和记忆的测试，由心理学家给出，五年后他们的诊断。我们将 确定计算机化测试的结果是否能够预测 心理学家给出的更传统的测试如果早期进行计算机化测试， 治疗可以帮助我们更好地预测谁会继续有困难，我们可以帮助减缓 或消除这些问题。 最后，我们想确定其他因素在多大程度上也会导致问题， 是白血病治疗的结果。我们特别感兴趣的是 众所周知，影响儿童的思维和学习技能，如家庭获得资源，精神 健康困难以及治疗期间可能发生的医疗问题。我们也会问 孩子们告诉我们，他们是多么累，生病，或在痛苦之前，他们完成了 计算机化测试程序因为有证据表明这些类型的 症状可能会影响儿童在认知测试中的表现，我们认为， 描述这些症状对儿童思维和学习的任何影响， 治疗，也是后来的事。如果我们能更好地理解所有这些因素是如何与 幸存者的思维和学习模式，我们可以更好地预测哪些人可能是 受到这些问题的影响。

PROJECT SUMMARY Children with “high-risk” leukemia receive intense treatments that, while life-saving, can also cause them to develop problems with the way they learn and think. This does not happen to all children receiving these treatments, but we cannot yet predict who will develop problems. One reason that we lack this information is that it is often difficult to test changes in the way children learn while they are receiving medical treatment. Children may feel too sick to complete testing, psychologists are not always available to do the evaluations, and insurance companies may not cover the testing that is needed. In this project, we aim to identify the first signs of changes in thinking and learning using a short, computerized testing program. The tests can be given in clinic by nurses or other staff, and cost very little money. We will test children starting shortly after leukemia is diagnosed, and several times during the course of their treatment, so that we can identify problems as soon as they start to occur. Children in our study will also receive a one-hour evaluation with widely-used tests of learning and memory, given by a psychologist, five years after their diagnosis. We will determine whether results from the computerized tests are able to predict performance on the more traditional tests given by the psychologists. If computerized testing done early in treatment helps us to better predict who will go on to have difficulties, we can help to slow down or eliminate these problems. Finally, we want to determine the extent to which other factors also contribute to problems that develop as a result of leukemia treatment. We are especially interested in looking at factors known to affect children's thinking and learning skills, like a family's access to resources, mental health difficulties, and medical problems that can occur during treatment. We will also be asking children to tell us about how tired, sick, or in pain they are right before they complete the computerized testing program. Because there is some evidence indicating that these types of symptoms may affect children's performance on cognitive tests, we believe that it's important to describe any impact that these symptoms have on children's thinking and learning, both early in treatment and also much later. If we can better understand how all of these factors relate to survivors' patterns of thinking and learning, we can better predict which individuals may be affected by those problems.