Social adjustment in survivors of acute lymphoblastic leukemia without cranial radiation therapy

Abstract

Objective To evaluate group differences in social adjustment in survivors of pediatric acute lymphoblastic leukemia (ALL) compared to survivor siblings and controls; identify disease‐related predictors of social adjustment in survivors; and explore whether executive functioning explained differences in social adjustment across groups and between disease‐related predictors. Methods Survivors of pediatric ALL (n = 38, average age at diagnosis = 4.27 years [SD = 1.97]; average time off treatment = 4.83 years [SD = 1.52]), one sibling (if available, n = 20), and one parent from each family were recruited from a long‐term survivor clinic. Healthy age‐ and sex‐matched controls (n = 38) and one parent from each family were recruited from the community. Parents completed the Behavioral Assessment System for Children, Parent Rating Scale (BASC‐3) Social Withdrawal subscale as a measure of social adjustment, and the Behavior Rating Inventory of Executive Functions (BRIEF‐2) as a measure of executive function for each of their children. Multilevel modeling and mediation analysis were used to achieve the study aims. Results Parents reported that survivors had significantly worse social adjustment compared to controls (b = 6.34, p = .004), but not survivor siblings. Among survivors, greater time off treatment (b = 2.06, p = .058) and poorer executive functioning (b = 0.42, p = .006) were associated with worse social adjustment. Executive function did not mediate differences in social withdrawal between survivors and controls or the relationship between time off treatment and social withdrawal among survivors. Conclusions Survivors of pediatric ALL presenting to follow‐up programs should be screened for difficulties with social adjustment. Future research should examine treatment‐ and nontreatment‐related factors contributing to poorer social outcomes.

Social adjustment in children diagnosed with sickle cell disease: A retrospective study

“…16 In SCD, and other vulnerable pediatric populations, cognitive deficits have been found to contribute to lower quality of life, higher rates of depression, and poorer social adjustment. [17][18][19][20] Further investigation into the contribution of executive functions on social adjustment in children living with SCD is therefore warranted.…”

“…Children with SCD are at risk of cerebral vascular disease, stroke, and silent cerebral infarcts, which can all impact brain health and lead to greater challenges in their executive functioning 16 . In SCD, and other vulnerable pediatric populations, cognitive deficits have been found to contribute to lower quality of life, higher rates of depression, and poorer social adjustment 17–20 . Further investigation into the contribution of executive functions on social adjustment in children living with SCD is therefore warranted.…”