Adjustment of Pediatric Brain Tumor Survivors

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DESCRIPTION (provided by applicant): Intracranial tumors are the second most common form of pediatric cancer. The location of these tumors, and the risk to cerebral integrity posed by standard treatments, may increase psychosocial morbidity for brain tumor (BT) survivors compared to children treated for other types of malignancies. Numerous studies have documented cognitive deficits for children treated for BT, but less attention has focused on their social, emotional, behavioral, and family functioning. Existing data suggests that survivors of pediatric BT are at risk for longstanding social and emotional difficulties. Caring for BT survivors also may affect parental distress and family functioning. However, no work has identified specific pathways that lead to long-term difficulties for these children and families. Information about the processes that might mediate the impact of pediatric BT is essential before empirically derived interventions can begin. Potential mediators for difficulties in children might include social skills, nonsocial attributes (e.g., physical appearance, athletic ability), peer relationships, and health status. Mediators that warrant exploration for parental distress include the child's health status and caregiver burden. The proposed research will evaluate school aged (8-15 years) children who have completed treatment for BT. For each child, a classmate of the same race, gender, and age will be recruited as a comparison (COMP). Identical data will be obtained for all participants from multiple sources in classrooms (teacher, peer, self-report) and homes (mother, father, and child-report) to allow tests of group differences in social, emotional, behavioral, and parent/family functioning. Analyses will examine group differences as well as begin to identify mechanisms that may mediate differences in outcomes. This work will provide preliminary data and direction for larger scale studies that can make a significant contribution to the design of clinical trials to prevent or ameliorate long-term psychosocial morbidity in BT survivors.Specific Aim 1 Compare the social, emotional, and behavioral functioning of children who have received treatment for BT and demographically similar COMP.Specific Aim 2 Compare parent and family functioning for children treated for BT and COMP.Specific Aim 3 Explore processes that might mediate the occurrence of difficulties in adjustment among children treated for BT and their families.Specific Aim 4 Begin to identify moderators that categorize subgroups at higher risk for difficulties based on background characteristics (e.g., age, gender) and disease factors (e.g., type of tumor or treatment).