Prophylactic academic intervention for children treated with cranial radiation therapy

Abstract

This single case study investigated the feasibility and effectiveness of a prophylactic intervention for improving academic skills in a child with a brain tumour deemed at high risk for cognitive delay and academic failure because of cranial radiation treatment (CRT). An 8 year old boy participated in a 12 week home and hospital based tutoring programme. Standardized and non-standardized measures of academic achievement were administered at pre- and post-intervention. A follow-up assessment took place 8 months post-intervention (standardized measures only). Pre-test and follow-up neuropsychological data was collected. Significant improvement was observed on the Wechsler Individual Achievement Test-2nd Edition (WIAT-II) pseudoword decoding and spelling sub-tests and on measures of single word and grapheme knowledge. There was no improvement on the WIAT-II math sub-tests. At follow-up, gains were maintained or improved for reading-related sub-tests but declined for math and spelling sub-tests. Overall, neuropsychological data showed decreased performance. The gains in reading skills were made in the context of an overall decline in neuropsychological functioning, suggesting that the intervention helped to preserve reading skills and may be protective against difficulty with skill acquisition, but did not prevent a more global decrease in functioning. This study is the first reported prophylactic intervention delivered concurrently with intensive medical treatment.