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Neuropsychology is ideally suited to assess the wide-ranging areas encompassed in transition readiness and to facilitate the transition process. Based on these findings, we propose a family-centered and multidisciplinary care model that promotes both medical and broader psychosocial transition processes.
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The literature supports increased evaluation and intervention targeted at psychosocial barriers to transition. We explore the potential utility and added benefit of systematically incorporating neuropsychology in the transition process for pediatric brain tumor survivors. consideration of patients' cognitive and functional capacities, yet currently available transition readiness tools are limited in scope and do not possess adequate normative data across pediatric medical populations. Several recently developed healthcare transition models include. We review current transition models and the potential role of neuropsychology in the transition process for adolescent and young adult brain tumor survivors. Transition-age patients with history of a pediatric brain tumor are at significant risk for difficulties transitioning to adulthood. Further examination in a larger sample is warranted. Outcomes were similar to patients receiving surgery only. We observed stable cognitive functioning, independent of age at treatment, following PRT for LGG. Age at treatment was not associated with slope or performance at last follow-up in either group (all p>0.05). Slopes (i.e., change in scores over time) did not differ between groups (all p>0.1). Both PRT and SO groups displayed stable cognitive functioning over time (all p>0.1). There were no group differences in diagnosis age, tumor volume, or shunt history (all p>0.05). Surgical outcomes were: 75.0% gross total resection, 21.9% biopsy/other. Median age of SO patients was 8.2 years at diagnosis (range 2.9–18.6). Tumor sites included: 31.2% hypothalamic/suprasellar, 25.0% optic pathway, 18.8% temporal, 25.0% other. 13 PRT patients also received surgery: 53.8% biopsy, 30.8% subtotal resection, 15.4% gross total resection.
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Median age of PRT patients was 8.2 years at diagnosis (range 1.0–14.4) and 9.4 years at PRT (range 4.2–16.7). The sample included 16 patients treated with PRT and 32 with SO (median follow-up=3.1 years, range 0.9–6.1). General linear mixed models evaluated change in cognitive scores over time. We examined cognitive scores of 48 LGG patients on a prospective, longitudinal study. We examined the impact of age at treatment on cognitive trajectories in LGG patients treated with proton radiotherapy (PRT) compared to patients treated without radiotherapy (surgery only SO). Younger age at radiotherapy increases cognitive risk for patients with pediatric low grade glioma (LGG).