Examining a Novel Neuropsychological Screening Tool in Pediatric Cancer Patients and Survivors
Rachel S. Werk, Shria K. Haldipurkar, Jennifer L. Reichek, Angela J. Waanders, Suna Paek, Summer Baptiste, Jin‐Shei Lai, Stephanie K. PowellABSTRACT
Background
Childhood cancer patients and survivors are vulnerable to neurocognitive deficits based on malignancy, treatment, and associated comorbidities. This study assessed a novel parent‐report cognitive screening tool developed by the Clinical Neuropsychology Collaborative for Childhood Cancers (CNC3) intended to support decision‐making when referring for neuropsychological evaluations, comparing it with formal neuropsychological test performance among pediatric cancer patients (PCP) and survivors (PCS).
Methods
The CNC3 Caregiver Report Questionnaire (CNC3‐CRQ) was administered to parents of children completing comprehensive neuropsychological assessments. Results were examined in relation to the children's performance on administered neuropsychological measures to evaluate the CNC3‐CRQ's effectiveness in identifying those at risk for neurocognitive impairment.
Results
Of 64 participants, 58 (90.6%) had completed therapy and 26 (40.6%) had a history of central nervous system tumor. Formal neuropsychological testing revealed relatively high rates of both mild impairment (>1SD below the population mean) and moderate impairment (>2SD below) in 49 patients (76.6%) and 30 patients (46.9%), respectively. Youden's J analyses were conducted to determine optimal symptom‐percentage cutoffs for each cognitive domain assessed by the CNC3‐CRQ, relative to performance on formal neuropsychological testing. A cumulative positive screen on the CNC3‐CRQ was calculated based on domain positivity, with 47 (73%) patients screening positive. The CNC3‐CRQ demonstrated 83.3% sensitivity and components of domains of processing speed, memory, and visual‐spatial skills were significantly associated with moderate deficits on formal neuropsychological examinations.
Conclusion
The CNC3‐CRQ is a helpful, efficient tool to identify PCP and PCS who would benefit from referral to neuropsychology services.