Abstract
Evolving treatment paradigms have led to increased survival rates for children diagnosed with a brain tumor, and this has increasingly shifted clinical and research focus to morbidity and quality of life among survivors. Among unfavorable outcomes, survivors of pediatric brain tumors are at risk for academic failure and low educational attainment, which may then contribute to lower health related quality of life, lower income and vocational status, and a greater likelihood of dependence on others in adulthood. Several specific risk factors for lower educational performance and attainment have been investigated. These are typically examined in isolation from one another which clouds understanding of the full range and potential interplay of contributors to educational difficulties. This review integrates and summarizes what is known about the direct and indirect barriers to educational success and performance (i.e., educational pain points) to enhance clinician knowledge of factors to consider when working with pediatric brain tumor survivors. Specific barriers to educational success include neurocognitive difficulties, school absences, psychosocial challenges, challenges to knowledge and communication, and physical and sensory difficulties. Finally, we discuss the current state of educational interventions and supports and offer recommendations for future research to improve educational outcomes for pediatric brain tumor survivors.
Highlights
Brain tumors comprise more than 15% of pediatric cancers and are the second most common cancer in children and adolescents [1]
pediatric brain tumor (PBT) survivors tend to have the lowest health related quality of life (HRQOL) among all pediatric cancer types [3], and this population is at significant risk for dependence on others into adulthood [4]
PBT survivors consistently perform below healthy peers and other pediatric cancer survivors across metrics of educational performance
Summary
Brain tumors comprise more than 15% of pediatric cancers and are the second most common cancer in children and adolescents [1]. While neurocognitive late effects clearly affect a significant number of PBT survivors, a relatively consistent finding has been that PBT survivors generally demonstrate broadly average performances on standardized measures of basic academic skills [41,42,43]. This is perplexing in light of the clearly and consistently documented difficulties with educational performance and attainment described above. This pattern indicates that other factors, beyond neurocognitive dysfunction, contribute to educational pain points experienced by PBT survivors
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