INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #26 Aspects of Executive Functioning and their Relationship to Adaptive Skills in Pediatric Cancer Survivors Amanda Cook, University of Alabama at Birmingham (UAB), Birmingham, United States Julie Trapani, Emory University, Atlanta, United States Victoria Seghatol-Eslami, University of Alabama at Birmingham (UAB), Birmingham, United States Caroline Schock, University of Alabama at Birmingham (UAB), Birmingham, United States Satvi Penala, University of Alabama at Birmingham (UAB), Birmingham, United States Donna Murdaugh, University of Alabama at Birmingham (UAB), Birmingham, United States Category: Cancer Keyword 1: pediatric neuropsychology Keyword 2: executive functions Keyword 3: adaptive functioning Objective: Given the rapidly growing pediatric cancer survivor population, emphasis has increasingly been placed on understanding the long-term sequelae of pediatric cancer and its treatments. Pediatric cancer survivors demonstrate an elevated risk for problems with cognitive functions, with deficits commonly seen in executive functioning (EF) and adaptive functioning. Adaptive functioning (AF) reflects one’s ability to carry out age-appropriate independence skills, is known to predict independence in adulthood, and may be associated with EF. AF has long-term implications and so understanding its relationship to behavioral aspects of EF can help identify potential intervention targets for childhood cancer survivors. This study explored the contributions of multiple aspects of EF in predicting parent-rated adaptive skills. Participants and Methods: Participants were selected from a retrospective database of pediatric cancer survivors who were seen clinically for neuropsychological evaluation and included 60 pediatric survivors of cancers of non-central nervous system (CNS) origin. Multiple linear regressions were conducted to examine associations between risk factors, including biological sex, age at diagnosis, methotrexate exposure, radiation exposure, and different behavioral aspects of EF using parent-rated EF and verbal fluency in predicting parent-rated adaptive skills. Parent-rated EF was assessed using The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2). Verbal fluency was assessed using the Delis-Kaplan Executive Function System (D-KEFS) letter fluency task. Parent-rated adaptive skills were assessed using The Behavior Assessment System for Children (BASC-2). Results: The results indicated that higher parent-rated General Executive Composite (GEC), reflecting greater EF difficulties, significantly predicted lower adaptive skills (β = -.56, p<.001) as did female sex (β = .23, p = .04) and methotrexate exposure (β = -.26, p = .02). An additional regression was conducted to explain the variance within the GEC by examining the BRIEF2’s three composite indexes: Behavior Regulation Index (BRI), Emotion Regulation Index (ERI), and Cognitive Regulation Index (CRI), which was also significant (R² =.54, F(9,50)=6.56, p<.001). In this model, it was found that higher CRI significantly predicted lower adaptive skills (β = -.36, p = .01) as did female sex (β = .27, p = .01) and methotrexate exposure (β = -.24, p = .03), but ERI and BRI did not. Verbal fluency task performance was not uniquely predictive of adaptive skills in this model (β = .063, p> .05). Conclusions: Among a sample of pediatric cancer survivors (non-CNS origin), risk factors, neuropsychological task performance, and parent-rated executive function significantly predicted parent-rated adaptive skills. Within the parent-rated executive function General Executive Composite, the Cognitive Regulation Index explained most of the variance in parent-rated adaptive skills. This index reflects a child or adolescent’s ability to problem solve, regulate cognitive processes, and complete tasks in various contexts. The other indices which did not significantly contribute represent behavior regulation (e.g., inhibition, self-monitoring) and emotional regulation (e.g., shifting, emotional control). These results suggest that interventions targeting EF, including initiation, working memory, planning/organization, and task-monitoring, may be beneficial in improving adaptive skills in pediatric cancer survivors.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #26

Aspects of Executive Functioning and their Relationship to Adaptive Skills in Pediatric Cancer Survivors

Amanda Cook, University of Alabama at Birmingham (UAB), Birmingham, United States
Julie Trapani, Emory University, Atlanta, United States
Victoria Seghatol-Eslami, University of Alabama at Birmingham (UAB), Birmingham, United States
Caroline Schock, University of Alabama at Birmingham (UAB), Birmingham, United States
Satvi Penala, University of Alabama at Birmingham (UAB), Birmingham, United States
Donna Murdaugh, University of Alabama at Birmingham (UAB), Birmingham, United States

Category: Cancer

Keyword 1: pediatric neuropsychology
Keyword 2: executive functions
Keyword 3: adaptive functioning

Objective:

Given the rapidly growing pediatric cancer survivor population, emphasis has increasingly been placed on understanding the long-term sequelae of pediatric cancer and its treatments. Pediatric cancer survivors demonstrate an elevated risk for problems with cognitive functions, with deficits commonly seen in executive functioning (EF) and adaptive functioning. Adaptive functioning (AF) reflects one’s ability to carry out age-appropriate independence skills, is known to predict independence in adulthood, and may be associated with EF. AF has long-term implications and so understanding its relationship to behavioral aspects of EF can help identify potential intervention targets for childhood cancer survivors. This study explored the contributions of multiple aspects of EF in predicting parent-rated adaptive skills.

Participants and Methods:

Participants were selected from a retrospective database of pediatric cancer survivors who were seen clinically for neuropsychological evaluation and included 60 pediatric survivors of cancers of non-central nervous system (CNS) origin. Multiple linear regressions were conducted to examine associations between risk factors, including biological sex, age at diagnosis, methotrexate exposure, radiation exposure, and different behavioral aspects of EF using parent-rated EF and verbal fluency in predicting parent-rated adaptive skills. Parent-rated EF was assessed using The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2). Verbal fluency was assessed using the Delis-Kaplan Executive Function System (D-KEFS) letter fluency task. Parent-rated adaptive skills were assessed using The Behavior Assessment System for Children (BASC-2).

Results:

The results indicated that higher parent-rated General Executive Composite (GEC), reflecting greater EF difficulties, significantly predicted lower adaptive skills (β = -.56, p<.001) as did female sex (β = .23, p = .04) and methotrexate exposure (β = -.26, p = .02). An additional regression was conducted to explain the variance within the GEC by examining the BRIEF2’s three composite indexes: Behavior Regulation Index (BRI), Emotion Regulation Index (ERI), and Cognitive Regulation Index (CRI), which was also significant (R² =.54, F(9,50)=6.56, p<.001). In this model, it was found that higher CRI significantly predicted lower adaptive skills (β = -.36, p = .01) as did female sex (β = .27, p = .01) and methotrexate exposure (β = -.24, p = .03), but ERI and BRI did not. Verbal fluency task performance was not uniquely predictive of adaptive skills in this model (β = .063, p> .05).

Conclusions:

Among a sample of pediatric cancer survivors (non-CNS origin), risk factors, neuropsychological task performance, and parent-rated executive function significantly predicted parent-rated adaptive skills. Within the parent-rated executive function General Executive Composite, the Cognitive Regulation Index explained most of the variance in parent-rated adaptive skills. This index reflects a child or adolescent’s ability to problem solve, regulate cognitive processes, and complete tasks in various contexts. The other indices which did not significantly contribute represent behavior regulation (e.g., inhibition, self-monitoring) and emotional regulation (e.g., shifting, emotional control). These results suggest that interventions targeting EF, including initiation, working memory, planning/organization, and task-monitoring, may be beneficial in improving adaptive skills in pediatric cancer survivors.