Monitoring and Assessment of Neuropsychological Outcomes as a Standard of Care in Pediatric Oncology

Abstract

Central nervous system cancers or exposure to CNS‐directed therapies increase risk for neuropsychological deficits. There are no accepted guidelines for assessment of neuropsychological functioning in this population. A multifaceted literature search was conducted and relevant literature reviewed to inform the guidelines. Studies of neuropsychological outcomes are widely documented in the pediatric oncology literature. There is strong evidence of need for neuropsychological assessment, but insufficient evidence to guide the timing of assessment, nor to recommend specific interventions. Children with brain tumors and others at high risk for neuropsychological deficits should be monitored and assessed for neuropsychological deficits. Pediatr Blood Cancer 2015;9999:1–52. © 2015 Wiley Periodicals, Inc.

Communication, Documentation, and Training Standards in Pediatric Psychosocial Oncology

“…Recognition of the interplay between cultural and spiritual beliefs and practices in the context of the family's and patient's reactions to illness and treatment are, similarly, basic aspects of the care psychosocial providers provide . Some psycho‐oncology providers are also experts in psychopharmacologic and neuropsychological assessment.…”

Implementing the psychosocial standards in pediatric cancer: Current staffing and services available

“…However, comprehensive psychosocial care consistent with the Standards and models of care such as the Pediatric Psychosocial Preventative Health Model is compromised by the absence of a truly multidisciplinary psychosocial team, one including psychologists, neuropsychologists, and psychiatrists, at all but the largest programs. The lack of access to multidisciplinary professionals makes it difficult to implement Standards related to pain, neurocognitive effects of treatment, and mental health and to fully implement models of care that require specialized interventions . Although psychiatrists were available in most cases on a consultation basis, they were members of the psychosocial team in less than 20% of programs, a finding that did not vary by size of the institution.…”

Psychosocial Follow‐Up in Survivorship as a Standard of Care in Pediatric Oncology

“…We chose to target specific negative psychosocial late effects most often identified in the literature. We did not include studies assessing global or abstract constructs such as QoL, neurological, or cognitive late effects (addressed within this special issue ), or positive outcomes, though promoting such outcomes may contribute to survivor well‐being and QoL . A full review of assessment instruments and effective interventions for each outcome was beyond the scope of the project and is reviewed elsewhere .…”