Abstract
Objective
As neuropsychologists adopt virtual assessments in the context of COVID-19, the field is shifting toward teleneuropsychology. Comprehensive remote evaluations are proving to be feasible and reliable across domains, though traditional fine motor (FM) tests cannot be administered virtually. In the absence of direct FM measurement, this cross-sectional study considered whether universal FM recommendations are appropriate for patients with pediatric brain tumor (PBT).
Method
Dominant FM z-scores were obtained from 176 patients with PBT (x- age at diagnosis and evaluation = 7.3 and 12.8 years, respectively). There were no significant differences between Lafayette Grooved and Purdue Pegboard performances. FM differences between tumor location (46% infratentorial), chemotherapy (71.6%), and gender (52.3% male) were analyzed.
Results
The sample as a whole performed over 2 SDs below normative age expectations, t(175) = −14.7, p < 0.0001), with more pronounced deficits among patients with infratentorial (x-= − 2.4) than supratentorial (x-= − 1.7) tumors, F(1,174) = 7.1, p = 0.008. Consistent with prior findings, patients performed worse when treated with chemotherapy (x-= − 2.3) than without (x-= − 1.7), F(1,174) = 16.2, p < 0.0001. Time since diagnosis was negatively correlated with FM performance r = −0.27, p < 0.001. While gender differences were not apparent overall, post-hoc analyses revealed FM impairment in over 89% of males and 75% of females by middle school.
Conclusions
Given the likelihood of FM concerns (particularly by middle school), FM recommendations should be offered even in the absence of direct FM measurement for patients with PBT evaluated virtually. Accommodations (e.g., note copies, typing/dictation, abbreviated assignments, extended time) are free/easy to implement and can be incorporated into medically based Section 504 Plans, while early intervention may mitigate long-term effects.
Improved neuropsychological outcomes following proton therapy relative to X-ray therapy for pediatric brain tumor patients
