Effect of motivation on academic fluency performance in survivors of pediatric medulloblastoma

Abstract

It has been proposed previously that extrinsic motivation may enable survivors of childhood medulloblastoma to significantly improve aspects of neurocognitive performance. In healthy populations, enhanced motivation has been shown to promote academic fluency, a domain likely more relevant to the educational outcomes of pediatric medulloblastoma survivors than academic skill development. The present study investigates the effect of enhanced extrinsic motivation on fluent (i.e., accurate and efficient) academic performance in pediatric medulloblastoma survivors. Participants were 36 children, ages 7-18, who had completed treatment for medulloblastoma. Participants completed a neuropsychological battery that included administration of equivalent tasks on Forms A and B of the Woodcock-Johnson III Tests of Achievement. Half were randomly assigned to an incentive condition prior to the administration of Form B. Provision of a performance-based incentive resulted in statistically significant improvement, but not normalization of function, in performance on measures of academic fluency. No demographic, treatment-related, academic, neuropsychological, or self-perception variables predicted response to incentive. Findings suggest that academic performance of survivors may significantly improve under highly motivating conditions. In addition to implications for educational services, this finding raises the novel possibility that decreased motivation represents an inherent neuropsychological deficit in this population and provides a rationale for further investigation of factors affecting individual differences in motivational processes. Further, by examining effort in a context where effort is not inherently suspect, present findings also significantly contribute to the debate regarding the effects of effort and motivation on neuropsychological performance.

Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors

“…Supporting this idea, several studies have demonstrated associations between various types of sleep disruption and lower engagement in tasks that are perceived as more cognitively demanding ( Engle-Friedman et al, 2010 , 2018 ; Libedinsky et al, 2013 ). Further, the impact of motivation on performance in PBT survivors was illustrated by Holland et al (2016) , who demonstrated that external incentive improves effort on discrete timed academic tasks, indicating that motivation is a fluctuating variable that can substantively alter the situational performance of PBT survivors. Considering these findings, it may be that PBT survivors who experience sleep difficulties may choose less effortful activities when possible, and this choice may be available to a lesser extent during a neuropsychological evaluation as compared to daily life.…”

Neurocognitive and Psychosocial Outcomes in Pediatric Brain Tumor Survivors

“…For instance, training parents in behavioral modification, cognitive instructional methods and compensatory strategies to allow for ongoing intervention in the child’s natural environment showed some efficacy in improving academic outcomes and warrants further attention [ 111 ]. As another example, a recent randomized study isolated improvements in situational motivation as associated with improved academic performance [ 112 ]. Situational and intrapersonal factors such as level of intrinsic achievement motivation and responsivity to external incentive may have a role in improving academic performance in PBT survivors.…”

Educational Pain Points for Pediatric Brain Tumor Survivors: Review of Risks and Remedies

“…Results suggested modest benefit relative to non-intervention controls on specific academic test scores, and a correlation was noted between time spent in intervention and improvement on a reading comprehension task [ 92 ]. External incentives have shown the potential to improve situational academic performance in PBT survivors [ 93 ], suggesting that intrapersonal factors, such as level of intrinsic achievement motivation and responsivity to situational incentive may be fruitful areas of future research.…”