ABSTRACT

Objective. The current study examined the effects of clinical factors (i.e., treatment type, history of cerebellar mutism) as well as environmental factors (i.e., family environment) as predictors of cognitive and psychosocial outcomes in children treated for posterior fossa tumors.

Method. Twenty-seven children/adolescents treated for posterior fossa tumors (treatment type: radiation [n = 12], surgery [n = 15]; history of mutism: yes [n = 7], no [n = 20]) and n = 13 healthy controls, aged 8–17 years, and their caregivers completed measures assessing cognitive and psychosocial functioning, as well as the family environment (i.e., parental education, family functioning, family psychiatric history). Hierarchical linear regression analyses were conducted to examine the role of clinical factors and the family environment as predictors of cognitive and psychosocial outcomes. Family environment was also examined as a moderator of clinical factor group differences in outcomes.

Results. Regression analyses revealed lower intelligence scores among the radiation group compared to the control group, lower verbal memory scores among both treatment groups compared to the control group, and a significant positive effect of parental education on verbal memory scores. Further, history of cerebellar mutism predicted poorer performance on a speeded naming task, and this relationship was moderated by family functioning, with a greater effect of mutism present among those with poorer family functioning.

Conclusions. Interventions aimed at improving the family environment may help to mitigate negative cognitive effects of pediatric brain tumors, particularly among those most at-risk for poor outcomes.

摘要

目标。目前的研究检查了临床因素（即治疗类型、小脑缄默病史）以及环境因素（即家庭环境）作为后颅窝肿瘤治疗儿童认知和心理社会结果的预测因素的影响。

方法。27 名儿童/青少年接受后颅窝肿瘤治疗（治疗类型：放射 [ n = 12]、手术 [ n = 15]；缄默病史：是 [ n = 7]，否 [ n = 20]）和n = 13 名年龄在 8-17 岁之间的健康对照者及其照顾者完成了评估认知和社会心理功能以及家庭环境（即父母教育、家庭功能、家庭精神病史）的措施。进行分层线性回归分析以检查临床因素和家庭环境作为认知和社会心理结果的预测因子的作用。家庭环境也被视为临床因素组结果差异的调节因素。

结果。回归分析显示，与对照组相比，放疗组的智力评分较低，两个治疗组的言语记忆评分均低于对照组，父母教育对言语记忆评分有显着的积极影响。此外，小脑缄默症的历史预示着在快速命名任务中的表现较差，并且这种关系受到家庭功能的调节，家庭功能较差的人中缄默症的影响更大。

结论。旨在改善家庭环境的干预措施可能有助于减轻小儿脑肿瘤的负面认知影响，尤其是对那些最有可能导致不良后果的人。