Determinants of social competence in pediatric brain tumor survivors who participated in an intervention study.

Abstract

This prospective study describes disease/treatment, personal characteristics, and social/family contextual variables as risk and resilience factors that predict social competence in pediatric brain tumor survivors (PBTS). Ninety-one PBTS (51% male, mean age 11.21years, off-treatment, attending a regular classroom >50% of the time) participated. PBTS and their primary caregivers (proxy) completed the Social Skills Rating System (SSRS) to assess social competence at baseline, 2, and 8months follow-up. At baseline, medical information (e.g., tumor type and location, cranial irradiation therapy (CIT)), personal characteristics (e.g., child's age and gender, intelligence, executive function, attention, and memory), and social/family factors (family income and ethnicity) were obtained. Using mixed model multivariable analyses with a longitudinal component, tumor type (medulloblastoma) (p<0.01) and poor executive function, specifically, emotional control, were the best predictors of low total and assertion self-reported SSRS scores (p<0.02). Receiving CIT was associated with low proxy-reported assertion (p=0.035), and cooperation score (p=0.02). Poor emotional control was associated with low proxy-reported total (p=0.032), assertion (p=0.023), and self-control scores (p=0.007). Being non-White was associated with low proxy-reported total (p=0.016), self-control (p=0.040), responsibility (p=0.035), and cooperation scores (p=0.002). There were no significant changes over time. This study supports a multifactorial model of insult and non-insult factors (medical, personal, and social context) as determinants of social competence in PBTS. Data from both informants identify determinants of social competence. These factors need to be considered in future interventions to help children better improve their social competence.