Children who underwent treatment for cancers not related to the central nervous system (CNS) before age 4 years progressed more slowly in vocabulary, in such cognitive functions as attention and memory, and in motor skills than did healthy controls in a study that prospectively documented neurodevelopmental consequences of non-CNS cancers and related treatment. However, having cancer did not appear to affect children’s social and emotional development.

With survival rates for many types of childhood cancer having increased in recent years, quality of life for these patients has become a major concern. To assess how infants and toddlers develop after cancer diagnosis and treatment, a team led by Marc H. Bornstein, PhD, of the National Institute of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, evaluated 61 children aged 6 months to 42 months who were being treated for tumors or blood cancers upon study enrollment (mean age at diagnosis: 19 months).

All the children with cancer had undergone treatment for at least 3 months when Bornstein and coinvestigators administered a neuropsychological test battery to these youngsters as well as to 61 matched controls. The patients were also videotaped while at play with their mothers, and the mothers answered questions about their child’s language ability and behavior 1 month before, 1 week before, and on the day of the cognitive, motor, and social/emotional testing.

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The children with cancer did not score as well as their healthy counterparts on tests of language, cognition, and motor milestones: They were about 7 points below average on tests of mental development and 14 points below average on motor tests.

However, the researchers found no differences in social and emotional development between the two groups. The ability of the children with cancer to respond to their parents was comparable to that of their cancer-free peers, and both sets of children were equally able to engage in make-believe play, such as pretending to pour and serve tea.

“This study identifies deficits as well as spared functions in children with non-CNS cancers,” explained Bornstein and colleagues in Journal of Pediatric Psychology. “The results suggest ways parents and healthcare professionals may plan specific remediations to enhance quality of life in young cancer survivors.”