Acceptability, feasibility and preliminary effects of an online group psychotherapy intervention for adolescents and young adults with cancer.

BACKGROUND: Adolescents and young adults (AYAs; ages 15-29 years) diagnosed with cancer are increasingly recognized as an oncology population with distinct psychosocial needs. However, few specialized psychosocial interventions for AYAs currently exist. This study reports on the development of a novel group-based psychotherapy intervention to address the psychosocial needs of AYAs. The objective was to evaluate the acceptability, feasibility, and preliminary effects of the intervention. METHODS: The manualized group psychotherapy program is delivered virtually over an 8-week period by registered psychologists. Four groups (n = 5-11 AYAs per group) with a total of N = 33 participants (Mage = 20.97 years, SD = 3.68, range = 15-29 years, 76% women) were conducted. Recruitment and retention data assessed intervention feasibility. Patient-reported psychosocial outcomes were measured at baseline and immediately following the intervention to assess preliminary effects. Acceptability was assessed following the intervention using a self-report measure of participant satisfaction. RESULTS: Overall, the completion rate of the intervention was 85% (n = 28). All participants "strongly agreed" (88%) or "agreed" (13%) that they were satisfied with the group. Meeting, sharing experiences, and expressing feelings with other AYAs were identified as the most helpful aspects. Participants reported significant improvements in emotional (p < 0.05) and functional (p < 0.01) quality of life from baseline to immediately post-intervention with medium effect sizes (d = 0.58-0.70). CONCLUSIONS: Findings suggest that the intervention is feasible, acceptable, and shows promise for improving psychosocial outcomes for AYAs. Further research will refine the intervention and establish efficacy in a randomized trial.

Pediatric Hematopoietic Cell Transplantation: A Longitudinal Assessment of Health-Related Quality of Life of Pediatric Donors.

Pediatric donors may be at increased risk of psychological and social challenges following hematopoietic cell transplantation (HCT). Through a retrospective chart review, we evaluated the health-related quality of life (HRQL) of pediatric donors over time and examined facilitators and barriers to implementing a longitudinal psychosocial assessment. Fifty-one pediatric donors (M = 10.7 years, SD = 3.7) completed an HRQL questionnaire across six time points (T1 to T6) from prior to donation to 2 years after. Change in mean scores was assessed using a linear mixed-effect model for repeated measures design. Facilitators and barriers to implementation were examined. HRQL of pediatric donors improved between T1 and T6 with significant change in physical, emotional, and overall functioning. Facilitators to retention included the support of a clinical coordinator. Barriers to implementation included the absence of infrastructure to maintain contact with pediatric and their families. HRQL of pediatric donors of HCT improved steadily over time. Pattern of results suggests a need to further explore factors that contribute to change across time. Development of a longitudinal standardized assessment protocol that can be prospectively and feasibly implemented is integral to supporting the well-being of this group.

The pain of survival: Prevalence, patterns, and predictors of pain in survivors of childhood cancer.

OBJECTIVE: Survivors of childhood cancer experience late effects as a result of their cancer treatment. Evidence for the prevalence of pain as a late effect has been equivocal. This study aimed to describe the prevalence and patterns of pain and biospsychosocial variables that may be related to pain in this population. METHOD: Survivors of childhood cancer (n = 299; 52.5% male; median age = 16.1[4.6-32.6] years; years off therapy = 9.1[2.0-23.7]) were included. Survivors completed a health assessment questionnaire as part of their long-term survivor clinic appointment (median = 3.0 appointments, range = 1.0-7.0) annually or biannually between 2014 and 2017 (Time 1-Time 4). Prevalence of pain was examined and latent class analysis (LCA) was used to identify patterns of pain based on longitudinal reports of pain. Binary logistic regression examined biopsychosocial variables at Time 1 (T1) associated with class membership. RESULTS: Forty-seven percent of survivors reported pain during at least one clinic visit. Headaches were the most prevalent type of pain (26.4%). Survivors of Wilms' Tumor and Ewing's Sarcoma reported the highest prevalence of pain (51.5% and 50.0%, respectively). LCA revealed two clinically relevant profiles: "infrequent or no pain" (74.3%) and "persistent pain" (25.7%). Logistic regression showed that female sex (odds ratio, OR = 2.69, 95% confidence interval, CI [.99, 7.31]), depressive symptomatology at T1 (OR = 2.27, 95% CI [1.31, 3.94]), and drinking to intoxication at T1 (OR = 3.07, 95% CI [1.03, 9.15]), were related to persistent pain. CONCLUSION: Pain is prevalent among survivors of childhood cancer. Future research should characterize the experience of pain in this population so interventions may be developed. Assessment of pain during regular long-term follow-up appointments is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Preschoolers Flexibly Shift Between Speakers' Perspectives During Real-Time Language Comprehension.

In communicative situations, preschoolers use shared knowledge, or "common ground," to guide their interpretation of a speaker's referential intent. Using eye-tracking measures, this study investigated the time course of 4-year-olds' (n = 95) use of two different speakers' perspectives and assessed how individual differences in this ability related to individual differences in executive function and representational skills. Gaze measures indicated partner-specific common ground guided children's interpretation from the earliest moments of language processing. Nonegocentric online processing was positively correlated with performance on a Level 2 visual perspective-taking task. These results demonstrate that preschoolers readily use the perspectives of multiple partners to guide language comprehension and that more advanced representational skills are associated with the rapid integration of common ground information.

When You're Happy and I Know It: Four-Year-Olds' Emotional Perspective Taking During Online Language Comprehension.

Using a novel emotional perspective-taking task, this study investigated 4-year-olds' (n = 97) use of a speaker's emotional prosody to make inferences about the speaker's emotional state and, correspondingly, their communicative intent. Eye gaze measures indicated preschoolers used emotional perspective inferences to guide their real-time interpretation of ambiguous statements. However, these sensitivities were less apparent in overt responses, suggesting preschoolers' ability to integrate emotional perspective cues is at an emergent state. Perspective taking during online language processing was positively correlated with receptive vocabulary and an offline measure of emotional perspective taking, but not with cognitive perspective taking, conflict or delay inhibitory control, or working memory. Together, the results underscore how children's emerging communicative competence involves different kinds of perspective inferences with distinct cognitive underpinnings.

Words are not enough: how preschoolers' integration of perspective and emotion informs their referential understanding.

When linguistic information alone does not clarify a speaker's intended meaning, skilled communicators can draw on a variety of cues to infer communicative intent. In this paper, we review research examining the developmental emergence of preschoolers' sensitivity to a communicative partner's perspective. We focus particularly on preschoolers' tendency to use cues both within the communicative context (i.e. a speaker's visual access to information) and within the speech signal itself (i.e. emotional prosody) to make on-line inferences about communicative intent. Our review demonstrates that preschoolers' ability to use visual and emotional cues of perspective to guide language interpretation is not uniform across tasks, is sometimes related to theory of mind and executive function skills, and, at certain points of development, is only revealed by implicit measures of language processing.

Learning from picture books: Infants' use of naming information.

The present study investigated whether naming would facilitate infants' transfer of information from picture books to the real world. Eighteen- and 21-month-olds learned a novel label for a novel object depicted in a picture book. Infants then saw a second picture book in which an adult demonstrated how to elicit the object's non-obvious property. Accompanying narration described the pictures using the object's newly learnt label. Infants were subsequently tested with the real-world object depicted in the book, as well as a different-color exemplar. Infants' performance on the test trials was compared with that of infants in a no label condition. When presented with the exact object depicted in the picture book, 21-month-olds were significantly more likely to attempt to elicit the object's non-obvious property than were 18-month-olds. Learning the object's label before learning about the object's hidden property did not improve 18-month-olds' performance. At 21-months, the number of infants in the label condition who attempted to elicit the real-world object's non-obvious property was greater than would be predicted by chance, but the number of infants in the no label condition was not. Neither age group nor label condition predicted test performance for the different-color exemplar. The findings are discussed in relation to infants' learning and transfer from picture books.

That's not what you said earlier: preschoolers expect partners to be referentially consistent.

In a conversation, adults expect speakers to be consistent in their use of a particular expression. We examine whether four-year-olds expect speakers to use consistent referential descriptions and whether these expectations are partner-specific. Using an eye-tracking paradigm, we presented four-year-olds with arrays of objects on a screen. During training, Experimenter 1 (E1) used a target expression to identify one object (i.e. "the spotted dog" to identify a dog that is both spotted and fluffy). Following training, either E1 or a new conversational partner (E2) presented children with test trials. Here, the target objects were referred to using either the original expression (e.g. "the spotted dog") or a new expression (e.g. "the fluffy dog"). Eye-movements indicated that preschoolers were quicker to identify the target referent when the original expression was used by the same speaker. This suggests that four-year-olds, like adults, expect communicative partners to adhere to referential pacts.

ELIA: a software application for integrating spoken language and eye movements.

We have developed a new software application, Eye-gaze Language Integration Analysis (ELIA), which allows for the rapid integration of gaze data with spoken language input (either live or prerecorded). Specifically, ELIA integrates E-Prime output and/or .csv files that include eye-gaze and real-time language information. The process of combining eye movements with real-time speech often involves multiple error-prone steps (e.g., cleaning, transposing, graphing) before a simple time course analysis plot can be viewed or before data can be imported into a statistical package. Some of the advantages of this freely available software include (1) reducing the amount of time spent preparing raw eye-tracking data for analysis; (2) allowing for the quick analysis of pilot data in order to identify issues with experimental design; (3) facilitating the separation of trial types, which allows for the examination of supplementary effects (e.g., order or gender effects); and (4) producing standard output files (i.e., .csv files) that can be read by numerous spreadsheet packages and transferred to any statistical software.

Distinct labels attenuate 15-month-olds' attention to shape in an inductive inference task.

We examined the role of distinct labels on infants' inductive inferences. Thirty-six 15-month-old infants were presented with target objects that possessed a non-obvious property, followed by test objects that varied in shape similarity relative to the target. Infants were tested in one of two groups, a Same Label group in which target and test objects were labeled with the same noun, and a Distinct Label group in which target and test objects were labeled with different nouns. When target and test objects were labeled with the same count noun, infants generalized the non-obvious property to both test objects, regardless of similarity to the target. In contrast, labeling the target and test objects with different count nouns attenuated infants' generalization of the non-obvious property to both high and low-similarity test objects. Our results suggest that by 15 months, infants recognize that object labels provide information about underlying object kind and appreciate that distinct labels are used to designate members of different categories.