Spcr-08 academic readiness among children treated for brain tumors in infancy

Abstract BACKGROUND Children treated for brain tumors are more likely to have academic difficulties, receive special education services, and experience lower educational attainment than peers. Infants receiving treatment are at highest risk due to increased vulnerability of the developing brain and missed early developmental opportunities. The current study is the first to examine the emergence of academic readiness in children treated for brain tumors in infancy. METHODS Children were treated on a prospective, longitudinal multisite study with chemotherapy, with or without focal proton or photon radiation therapy (SJYC07). Academic readiness was monitored with the Bracken School Readiness Composite (SRC), and once age-appropriate, academic skills were assessed with the Woodcock Johnson III (WJII) word reading and applied math subtests. A subset of patients (n=70; median age at treatment 1.7 years; 67% male; 79% White) who completed the SRC during at least 2 timepoints were included. RESULTS Linear mixed models revealed SRC scores decreased significantly over time (p=0.033). There was a main effect of socioeconomic status (SES) such that lower SES predicted lower SRC scores, irrespective of time since treatment (p<0.0001). Other demographic and clinical factors were not predictive (i.e., age at diagnosis, disease risk, resection extent, number of surgeries, chemotherapy vs photon irradiation vs proton irradiation, shunt status, tumor location; ps>0.05). At the most distal assessment timepoint (median time since treatment 5.96 years), 28.8% and 20.3% scored below average (less than one standard deviation) on WJIII word reading and applied math, respectively; the former was significantly greater than normative expectations (16%, p=0.007). CONCLUSIONS Treatment for brain tumors in infancy appears to slow development of academic readiness skills, with SES predictive of risk and a disproportionate number of long-term survivors performing below age expectations in reading. These findings suggest the need for monitoring and interventions targeting early academic skills in this population.