INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #100 The Interaction of Bilingualism and Hearing Loss on Working Memory in Pediatric Cancer Survivors Karla Rodas, Children's Hospital Los Angeles, Los Angeles, United States Melissa Balderrama, Children's Hospital Los Angeles, Los Angeles, United States Julianna Blackman, Children's Hospital Los Angeles, Los Angeles, United States David Freyer, Children's Hospital Los Angeles, Los Angeles, United States Etan Orgel, Children's Hospital Los Angeles, Los Angeles, United States Category: Cancer Keyword 1: working memory Keyword 2: bilingualism/multilingualism Keyword 3: pediatric neuropsychology Objective: Pediatric cancer and its treatment place survivors at risk of cognitive late effects, with working memory (WM) being a commonly cited area of concern. Treatment-related sensorineural hearing loss (SNHL) has been found to predict worse neurocognitive deficits (including WM) in this population, even after controlling for radiation therapy. While prior research has suggested a bilingual cognitive advantage in healthy, non-cancer deaf/hard of hearing, and other medical populations (e.g., epilepsy), this has not yet been replicated in pediatric cancer. However, studies examining the role of bilingualism on cognitive late effects are sparse, have not consistently accounted for the confounding influence of socioeconomic status (SES), and have not examined the potential interplay of bilingualism and SNHL on cognitive outcomes in this population. Therefore, the goal of this study was to further understand the influence that bilingualism has on cognitive outcomes (specifically WM) in pediatric cancer survivors and determine if there is an interaction effect with SNHL. Participants and Methods: Sixty-seven patients aged 6-20 years with a history of cancer (brain tumor/non-CNS tumor) underwent neuropsychological evaluation. Participants were categorized as having SNHL if they were prescribed hearing aids by the time of neuropsychological evaluation (n=24). Bilingualism was determined by parent- and/or patient-report (n=35). SES was estimated for each patient using the median household income for their zip code. WM was assessed using Digit Span (DS; WISC-IV/V; WAIS-IV). Group differences and group interaction effects (while controlling for SES) were determined by independent samples T-test and ANCOVA. Results: After adjusting for SES, there were no significant interaction effects of bilingualism and SNHL on any of the DS scales. However, there was a slight trend for DS Forward (DSF; p=.09), with bilingual patients with SNHL having the lowest performance. When examining only the bilingual group, there was a trend for bilingual patients with SNHL to perform worse on DSF than bilingual patients without SNHL (p =.06) – with no similar trend for the monolingual group. Further, when only examining patients with SNHL, the bilingual patients performed worse than their monolingual counterparts (p<.05). However, this finding was no longer significant after controlling for SES. Conclusions: There was no clear interaction effect of bilingualism and SNHL on working memory in our population of pediatric cancer survivors. Nonetheless, this study highlights that bilingual cancer survivors with SNHL may be at greater risk of cognitive late effects in comparison to their monolingual counterparts (which is counter to the protective role it is purported to play in other populations), and that relative socioeconomic disadvantage may be contributing to this added vulnerability in our sample. Our study is limited by a small sample size and imprecise indicators of SNHL and bilingualism (both of which may be better characterized by continuous instead of dichotomous variables using formalized measures) as well as SES. We also did not control for important treatment factors (e.g., radiation). Given the importance of working memory in functional outcomes, future studies that address these limitations are needed in order to better identify patients at most risk in this area.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

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

Final Abstract #100

The Interaction of Bilingualism and Hearing Loss on Working Memory in Pediatric Cancer Survivors

Karla Rodas, Children's Hospital Los Angeles, Los Angeles, United States
Melissa Balderrama, Children's Hospital Los Angeles, Los Angeles, United States
Julianna Blackman, Children's Hospital Los Angeles, Los Angeles, United States
David Freyer, Children's Hospital Los Angeles, Los Angeles, United States
Etan Orgel, Children's Hospital Los Angeles, Los Angeles, United States

Category: Cancer

Keyword 1: working memory
Keyword 2: bilingualism/multilingualism
Keyword 3: pediatric neuropsychology

Objective:

Pediatric cancer and its treatment place survivors at risk of cognitive late effects, with working memory (WM) being a commonly cited area of concern. Treatment-related sensorineural hearing loss (SNHL) has been found to predict worse neurocognitive deficits (including WM) in this population, even after controlling for radiation therapy. While prior research has suggested a bilingual cognitive advantage in healthy, non-cancer deaf/hard of hearing, and other medical populations (e.g., epilepsy), this has not yet been replicated in pediatric cancer. However, studies examining the role of bilingualism on cognitive late effects are sparse, have not consistently accounted for the confounding influence of socioeconomic status (SES), and have not examined the potential interplay of bilingualism and SNHL on cognitive outcomes in this population. Therefore, the goal of this study was to further understand the influence that bilingualism has on cognitive outcomes (specifically WM) in pediatric cancer survivors and determine if there is an interaction effect with SNHL.

Participants and Methods:

Sixty-seven patients aged 6-20 years with a history of cancer (brain tumor/non-CNS tumor) underwent neuropsychological evaluation. Participants were categorized as having SNHL if they were prescribed hearing aids by the time of neuropsychological evaluation (n=24). Bilingualism was determined by parent- and/or patient-report (n=35). SES was estimated for each patient using the median household income for their zip code. WM was assessed using Digit Span (DS; WISC-IV/V; WAIS-IV). Group differences and group interaction effects (while controlling for SES) were determined by independent samples T-test and ANCOVA.

Results:

After adjusting for SES, there were no significant interaction effects of bilingualism and SNHL on any of the DS scales. However, there was a slight trend for DS Forward (DSF; p=.09), with bilingual patients with SNHL having the lowest performance. When examining only the bilingual group, there was a trend for bilingual patients with SNHL to perform worse on DSF than bilingual patients without SNHL (p =.06) – with no similar trend for the monolingual group. Further, when only examining patients with SNHL, the bilingual patients performed worse than their monolingual counterparts (p<.05). However, this finding was no longer significant after controlling for SES.

Conclusions:

There was no clear interaction effect of bilingualism and SNHL on working memory in our population of pediatric cancer survivors. Nonetheless, this study highlights that bilingual cancer survivors with SNHL may be at greater risk of cognitive late effects in comparison to their monolingual counterparts (which is counter to the protective role it is purported to play in other populations), and that relative socioeconomic disadvantage may be contributing to this added vulnerability in our sample. Our study is limited by a small sample size and imprecise indicators of SNHL and bilingualism (both of which may be better characterized by continuous instead of dichotomous variables using formalized measures) as well as SES. We also did not control for important treatment factors (e.g., radiation). Given the importance of working memory in functional outcomes, future studies that address these limitations are needed in order to better identify patients at most risk in this area.