NCOG-41. INTEGRATING NEUROPSYCHOLOGICAL CARE INTO A PEDIATRIC LONG-TERM SURVIVORSHIP CLINIC

Abstract

Abstract Pediatric cancer survivors are vulnerable to neurocognitive deficits due to their treatment history including chemotherapy and radiation therapy. These treatments are associated with damage to the brain’s white matter pathways, contributing to neurocognitive “late effects” such as deficits in processing speed, working memory, executive function, visuospatial abilities, and fine motor skills. However, these neurocognitive deficits may go undiagnosed and therefore unsupported due to difficulties accessing neuropsychological care. This study seeks to improve survivors’ access to care, thereby increasing the likelihood of patients obtaining educational and therapeutic supports when needed, by integrating brief neuropsychological screenings into an existing medical clinic. During survivors’ annual oncology clinic visit, patients were administered a neurocognitive screening battery to assess their working memory, processing speed, and executive functions and thereby determine which patients would benefit from more comprehensive neuropsychological testing. The current sample of 22 patients (55% female) ranges from 6 to 21 years of age (M = 14). Based on testing performance, 23% of the sample (n = 5) demonstrated neurocognitive deficits according to the Neuropsychological Impairment Rule (NIR), and therefore was referred for more comprehensive neuropsychological assessment. Additionally, 9% of the sample (n = 2) was referred for further assessment, despite not meeting the NIR threshold, due to report of academic concerns. Importantly, 68% of the sample (n = 15) did not meet the NIR threshold and did not endorse neurocognitive concerns, and therefore did not require referral for further neuropsychological assessment. Current results demonstrate the utility of integrating neuropsychological care into long-term survivorship clinics via a neurocognitive screening battery as the majority of patients did not evidence significant deficits and therefore were adequately served from a neuropsychological lens without requiring additional assessment. In addition to increasing access to care, these efforts help to preserve families’ resources and reduce waitlists for patients in need.