Can National Tests from the Last Year of Compulsory School Be Used to Obtain More Detailed Information about Academic Performance in Children Treated for Brain Tumours? A Nationwide, Population-Based Study from Sweden

Abstract

Children treated for brain tumours often have late-appearing complications that may affect their school performance. Uneven skill profiles may help reveal late complications that can be compensated for but otherwise remain undetected. We investigated Swedish national school tests of oral, reading and writing skills in the first foreign language (English), the mother tongue (Swedish) and mathematics. Data were obtained from The Swedish Childhood Cancer Registry and Statistics Sweden. The results from 475 children diagnosed with a brain tumour before their 15th birthday and 2197 matched controls showed that children treated for brain tumours evinced more difficulties with national tests than controls in almost all subtests, especially in the subject English, and that they may perform better on oral than written tasks. There were larger differences between female cases and controls than between male cases and controls; age at diagnosis played a significant role for some subtests, whereas tumour grade did not. Missing information from national tests proved to be a strong predictor of poor academic performance. Our results show that regular educational follow-ups, as a complement to neuropsychological follow-ups, are important for all children treated for brain tumours, regardless of sex, age at diagnosis or tumour grade.

Occupational outcomes after high‐grade or low‐grade brain tumors in childhood: A Swedish, nationwide, registry‐based study

“…Unexpectedly, neither age at diagnosis, nor sex, influenced occupational outcomes. In our three previous studies of almost the same cohort, comparing their school grades from school year nine and national tests from the same year, 28 , 29 , 43 we found that children treated at a young age, especially females, were at particular risk of poorer academic performance, but this was not the case for occupational outcomes in the current study. However, the differences between PBTS treated for high‐grade or low‐grade tumors were more evident in this study, when the participants were older and late complications had become more evident over the years.…”

“…All data handled were deidentified and only Statistics Sweden has the key code. The same cohort has been investigated in three previous articles comparing final grades from the last year of compulsory school in theoretical 28 and practical and esthetic 29 school subjects, and the national test grades that preceded the final grades in the three theoretical subjects 43 between PBTS and controls. Only children with grades from the regular school system were included in these studies since the compulsory schools for children with intellectual disabilities did not have a uniform grading system during the study time period and were therefore excluded.…”

“…For more information about inclusion and exclusion, see Lönnerblad et al, 2021. 43 All the parents of the included PBTS have given written permission for the child to be included in the Swedish Childhood Cancer Registry, and all PBTS were asked again when they turned 18 if they wanted to remain in the registry. Ethical approval for this study was given by the Regional Ethical Review Board in Stockholm (no 2017/995–31/5).…”

“…In the present study we have also excluded PBTS and controls that were no longer alive in 2016 (PBTS, n = 23; 4.84%; Controls n = 9; 0.4%). For more information about inclusion and exclusion, see Lönnerblad et al, 2021 43 . All the parents of the included PBTS have given written permission for the child to be included in the Swedish Childhood Cancer Registry, and all PBTS were asked again when they turned 18 if they wanted to remain in the registry.…”

Educational and occupational outcomes in Swedish children treated for sarcomas: A nationwide registry‐based study

“…Nonetheless, in previous studies on children treated for brain tumors, we also found that female survivors were more severely impacted than their male counterparts. 22,35 This might be because females as a group generally perform better than males academically. 36 Consequently, when comparing female cases to their female controls, differences might become more pronounced than when comparing male cases with male controls.…”