Screening for cognitive deficit in 8 to 14 year old children with cerebellar tumors using self-report measures of executive and behavioral functioning and health-related quality of life

Abstract

Background We aimed to identify a brief screening measure for detection of cognitive deficit in children treated for cerebellar tumors that would be useful in clinical practice.

Methods A sample of 72 children aged 8-14 years and within three years post-diagnosis for standard risk medulloblastoma (n=37) or low grade cerebellar astrocytoma (n=35) and 38 in a non-tumor group were assessed using teacher-, parent-, and child-report of the Behavior Rating Inventory of Executive Function (BRIEF), Strengths and Difficulties Questionnaire (SDQ), and Pediatric Quality of Life Inventory (PedsQL). The accuracy of these scores as a screen for a full scale Intelligence Quotient (FSIQ) <80 on the Wechsler Intelligence Scale for Children (WISC®-IV UK) was assessed using their receiver operating characteristic (ROC) curves.

Results The questionnaires with the highest areas under the ROC curves were the child- and parent-report PedsQL and the teacher-report BRIEF and SDQ. At optimal cut-off scores, their sensitivities (95% CIs) to cases of FSIQ<80 were 84 (60-96)%, 65 (41-84)%, 79 (54-93)%, and 84 (60-96)% and their specificities (95% CIs) were 79 (68-86)%, 87 (77-93)%, 77 (66-86)%, and 71 (64-84)% respectively. All cases of FSIQ<80 screened positive on either teacher-report SDQ or self-report PedsQL.

Conclusions The PedsQL child- and parent-report and the teacher-report BRIEF and SDQ have moderately good accuracy to discriminate between children with and without a FSIQ<80. The PedsQL could be used in a clinical setting, and the BRIEF and SDQ in an educational setting, to screen for cases with FSIQ<80 in children treated for brain tumors.

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Identifiers

ORCID for Kim S. Bull: orcid.org/0000-0002-5541-4556

ORCID for Christina Liossi: orcid.org/0000-0003-0627-6377

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