Monitoring children's language development following intrathecal chemotherapy for acute lymphoblastic leukaemia

Abstract

The majority of children diagnosed with acute lymphoblastic leukaemia (ALL) become long-term survivors. Hence, much emphasis is placed on optimising survivorship. Previous studies have used point-in-time language assessments to describe language outcomes subsequent to intrathecal chemotherapy (ITC), but this method of monitoring may be misleading in the absence of pre-morbid performance data. In the current study, we demonstrate the use of developmental trajectories to individually track the language development of eight children (M age at diagnosis = 4.8 years; M age at initial language assessment = 7.6 years) with a history of ALL treated with ITC. Basic and high-level language skills were assessed at a minimum of two assessment points over 2 years. Local comparative data were obtained from age- and sex-matched control participants (M age at initial assessment = 7.10 years). The skill development relevant to each test was tracked over time using the raw scores attained by each child treated for ALL, the average raw scores of his/her control group, and the test's raw scores at the 50th percentile (test average). Results revealed variability in language outcomes. With long-term negative impacts of chemotherapy calling for extended monitoring of children post-treatment, the use of developmental trajectories to track language development over time serves as an efficient, sensitive tool for providing follow-up services for children treated with ITC. Individualised language intervention can promptly commence when a child's performance deviates from expected trajectories.