The mediational role of executive functions for the relationship between motor ability and academic performance in pediatric cancer survivors

Introduction: Pediatric Cancer Survivors (PCS) bear a high risk for late effects within motor abilities (MAs) and executive functions (EFs). In typically developing children, these domains are interrelated and predictors of academic performance. The current study investigated (i) whether MAs and EFs are also interrelated in PCS, and (ii) whether EFs mediate the relation between MAs and academic performance. Methods: 78 PCS (7-16 years; M = 11.23; SD = 2.49) participated in this study. Three MAs were assessed: coordination and strength (using the German Motor Test) and endurance (using a cycle ergometer test). EFs were assessed: inhibition and cognitive flexibility (Color-Word Interference Test) and working memory (Block Recall test); and academic performance by questionnaire asking for children's grade point average. Results: Pearson correlations revealed associations of coordination and strength with EFs and associations of all three MAs with academic performance. A multiple regression model revealed that among the three MAs, coordination was the only significant predictor of EFs (beta = 0.42, p = .001). Lastly, mediation analyses revealed that the association of MAs with academic performance was mediated by EFs (indirect effect: beta = 0.167, p = .003). Regarding individual motor abilities, this was only true for coordination and strength, but not for endurance. Conclusion: Results show that MAs and EFs are interrelated in PCS and that EFs mediate the relationship between coordination and strength with academic performance. This may be important for the design of future physical activity interventions to improve MAs, EFs and academic performance.