Neurological outcome of childhood brain tumor survivors.

We assessed neurological and neurocognitive outcome in childhood brain tumor survivors. Altogether, 75 out of 80 brain tumor survivors diagnosed below 17 years between 1983 and 1997; and treated in Tampere University Hospital, Finland, were invited to participate in this population-based cross-sectional study. Fifty-two (69%) participated [mean age 14.2 (3.8-28.7) years, mean follow-up 7.5 (1.5-15.1) years]. Neurological status was abnormal in 69% cases. All were ambulatory, but only 50% showed normal motor function. Twenty-nine percent showed clumsiness/mild asymmetry and 21% hemiparesis. One suffered from intractable epilepsy. According to structured interview, 87% coped normally in daily living. Median full-scale IQ was 85 (39-110) in 21 6-16 year olds (70%); in 29% IQ was <70. Thirty of the 44 school-aged subjects attended school with normal syllabus and 32% needed special education. Six of the 16 patients over 18 years of age were working. Regarding quality of life, 38% were active without disability, 33% active with mild disability, 21% were partially disabled, but capable of self-care, and 8% had severe disability, being incapable of self-care. Supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy were associated with neurological, cognitive and social disabilities. In conclusion, of the 52 survivors, neurological status was abnormal in 69%; 71% lived an active life with minor disabilities, 29% had major neurological, cognitive and social disabilities, and 8% of them were incapable of self-care. Predictors of these disabilities included supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy. Survivors need life-long, tailor-made multiprofessional support and follow-up.

Language and motor speech skills in children with cerebral palsy.

UNLABELLED: The aim of the study was to investigate associations between the severity of motor limitations, cognitive difficulties, language and motor speech problems in children with cerebral palsy. Also, the predictive power of neonatal cranial ultrasound findings on later outcome was investigated. For this purpose, 36 children (age range 1 year 10 months to 9 years 0 months) with cerebral palsy due to premature birth and white-matter damage (periventricular leukomalacia) participated in the study. Twenty-two children (62%) had an intelligence level above 70. One-half of this group exhibited motor speech problems. Children with an intelligence level below 70 (n=14, 38%) showed problems in motor speech skills as well as in verbal expressive and comprehensive skills. Neonatal cranial ultrasonography findings were moderately associated with the severity of functional motor limitations. LEARNING OUTCOMES: Readers will be able to: (1) describe different hypotheses regarding the relationship between language, speech, intelligence level and severity of cerebral palsy, (2) discuss how intelligence and functional motor limitations impact language and speech performance for children with cerebral palsy and (3) discuss the predictability of the ultrasound methodology.

Children with functional motor limitations: the effects on family strengths.

Sixty children with functional motor limitations (age range from 15 months to 7 years 3 months) and their parents participated in the study. The objective was to explore the relationship of the severity of their restrictions on family strengths. Functional motor abilities of the children were assessed using Autti-Ramo's Scale. Cognitive functions were assessed using the Swedish standardized version of the Griffiths Scales of Mental Development. Family strengths were indexed using the Family Functioning Style Scale. The social-economical status, children's age and caretakers' age were taken into account. Overall, the results indicated that family strengths were rather strong. Only families rearing a child with severe participation limitations (functional motor limitations and cognitive difficulties) showed less strengths concerning family identity and internal coping relative to families with a child with milder participation limitations.

A retrospective neurocognitive study in children with spastic diplegia.

The study presents the results on neonatal cranial ultrasonography (US) and later intelligence (Wechsler Intelligence Scale-Third Edition and Wechsler Preschool and Primary Scale of Intelligence-Revised) and Neuropsychological assessments of 15 children with spastic diplegia. The assessments were undertaken when the children were 5 to 12 years of age. The children's IQ scores were, as a group, at the lower end of the normal distribution. The neuropsychological assessment indicated that deficits in visuomotor and visuospatial processing were characteristic of the children. No association was found between the neonatal cranial US findings and the IQ and neurocognitive scores. However, the cranial US findings strongly predicted functional motor limitations of the children.