Table I.

Summary of Studies on the Social Competence of Pediatric Brain Tumor Survivors.

Study	Purpose	Study design	Sample	Measures	Results
Aarsen et al [79]	Document functional outcomes of survivors of low-grade astrocytomas	Cross-sectional study; assessed survivors 3–11 years post diagnosis	38 survivors of low-grade astrocytomas	Child Behavior Checklist, Teacher Report Form, Youth Self Report	Infratentorial tumors related to more teacher-reported social problems; tumor recurrences related to more self-reported social problems
Armstrong et al [82]	Describe associations between region-specific radiation dose and self-reported neuropsychological and social outcomes	Retrospective cohort study -Childhood Cancer Survivorship Study (CCSS)	818 CCSS participants with CNS malignancies	Short-Form 36 Social Functioning subscale (2 items that assess extent physical or emotional health problems interfere with social activities)	Radiation to temporal region associated with significantly more health-related disruptions in social activities per self-report
Barrera et al [75]	Compare social outcomes of childhood cancer survivors with controls	Retrospective, cohort study	800 survivors of childhood cancer (122 CNS tumors) age 6–16 and 923 controls	Child Behavior Checklist, Ontario Child Health Survey	BT survivors more likely than controls to have no close friends; cranial radiation increased risk for having no friends
Bonner et al [33]	Assess social functioning and facial expression recognition skills of BT survivors compared to children with juvenile rheumatoid arthritis (JRA)	Cross-sectional	51 survivors of BT and 31 children with JRA ages 6–17	Child Behavior Checklist, Diagnostic Analysis of Nonverbal Accuracy – Revised, Social Skills Rating System; Wechsler Intelligence Scale for Children – 3rd edition	BT group worse social functioning and made more errors reading adult facial expressions after controlling for IQ; poorer facial recognition and younger age at diagnosis associated with worse parent-rated social adjustment
Brinkman et al [80]	Examine longitudinal parent-reported social outcomes among children treated for embryonal BTs	Longitudinal; parents completed measures at diagnosis and yearly for 5 years	220 youth diagnosed with embryonal BT (ages 5–21 at diagnosis); categorized into high-risk and average-risk groups	Child Behavior Checklist, Woodcock Johnson Test of Cognitive Abilities	Parent-reported social problems increased at greater rate over time for high-risk group compared to average risk group; posterior fossa syndrome increased risk for social problems over time; better IQ associated with better social functioning over time
Carey et al [84]	Examine whether BT survivors evidence nonverbal learning disability and examine associations between neuropsychological and social functioning	Cross-sectional	15 childhood BT survivors, ages 8–12	Beery Developmental Test of Visual-Motor Integration – 4th edition, Child Behavior Checklist, Grooved Pegboard Test, NEPSY subtests, Social Skills Rating System, Teacher Report Form, Wechsler Intelligence Scale for Children – 3rd edition, Youth Self-Report	Survivors had significantly higher parent-reported social problems compared to norms; nonsignificant trend for poorer nonverbal neuropsychological abilities being related to more parent-reported social problems
Carlson-Green et al [83]	Examine contextual factors associated with behavioral and neurocognitive outcomes over time	Longitudinal; family data obtained at diagnosis and child data from approximately 24 months later	63 children treated for BT, ages 2–6 at diagnosis	Child Behavior Checklist, Coping Health Inventory for Parents, Family Environment Scale, Family Inventory of Life Events, Stanford-Binet Intelligence Scale – Fourth Edition, Vineland Adaptive Behavior Scale	Higher family socio-economic status at diagnosis associated with better parent-rated survivor adaptive functioning
Carpentieri et al [31]	Compare social adjustment of BT survivors with non-CNS cancer survivors; examine changes in social adjustment over time	Cross-sectional comparison of two survivor group; longitudinal examination of BT group data	40 BT survivors and 40 non-CNS cancer survivors, ages 4–16	Child Behavior Checklist, Rating of cosmetic and functional impairment, Wechsler Intelligence Scale for Children – Revised	BT group had worse parent-rated social adjustment compared to non-CNS cancer group; BT group demonstrated increases in parent-rated social problems over time; children with abnormal brain volume and non-third ventricle tumor have more social problems
Carpentieri et al [91]	Describe psychosocial functioning of adolescent survivors of childhood BT	Cross-sectional	32 BT survivors, ages 12–18	Behavior Assessment System for Children – 2nd edition – self, parent and teacher report	No difficulties related to social skills or interpersonal relationships reported across raters
Foley et al [78]	Compare adjustment in children with hypothalamic BTs to other BT group; examine associations between family functioning and survivor adjustment	Cross-sectional	29 children treated for hypothalamic BT and 29 children treated for other types of BT; both groups off treatment at least 6 months	Child Behavior Checklist, McMaster Family Assessment Device	Combined sample had more parent-rated social problems compared to normative sample; in combined sample, younger age at diagnosis related to more parent-rated social problems
Hardy et al [76]	Examine and compare social outcomes of children with BTs both on and off therapy	Cross-sectional	15 children with BT on treatment and 15 children with BT ≥ 6 months post-treatment, ages 7–16	Child Behavior Checklist, Harter’s Self-Perception Profile for Children, Wechsler Scale of Intelligence – 3rd edition	No difference between groups on parent-ratings of survivor social adjustment; off-therapy participants self-reported lower social acceptance; lower self-reported social acceptance related to more parent-rated problems with aggression, depression and somatization
Holmquist et al [71]	Investigate emotional and behavioral outcomes of pediatric BT survivors	Cross-sectional	54 survivors of childhood BT, mean age of 10, approximately 3 years off treatment	California Verbal Learning Test – Children’s edition, Child Behavior Checklist, Conners’ Rating Scales – Revised, Wechsler Intelligence Scale for Children – 3rd edition	Lower IQ related to increased parent-rated social problems; poor verbal learning related to parent-rated social withdrawal
Kullgren et al [70]	Examine long-term social outcomes in pediatric BT survivors	Longitudinal – first time point 1–2 years after diagnosis and second time point 3–4 years after diagnosis	40 survivors of childhood BT, age 4–16 at Time 1	Child Behavior Checklist, Family Life Inventory of Life Events, Stanford-Binet Intelligence Scale – 4th edition, Vineland Adaptive Behavior Scales	Survivors demonstrate poor parent-rated social adjustment over time; lower IQ predictive of more parent-rated social problems over time; higher number of treatment modalities and low family socio-economic status predictive of more parent-rated social problems over time
Long et al [92]	Examine pediatric BT survivor perceptions of interactions with peers at school	Cross-sectional	22 BT survivors and 22 healthy comparisons, ages 8–18	School Experiences Questionnaire (developed for study)	No differences in self-reported perceptions of peer interactions between groups
Moyer et al [66]	Examine impact of survivor attentional abilities on social functioning in ALL and BT survivors	Cross-sectional	211 BT survivors and 258 ALL survivors, ages 6–19	Conners’ Rating Scales – revised short version, Social Skills Rating System, Wechsler Intelligence Scale for Children – 3rd edition or Wechsler Adult Intelligence Scale – 3rd edition	More parent-and teacher-reported attention problems associated with more parent-reported social problems; female gender, lower IQ and parent-rated attention problems predicted more parent-reported social problems
Mulhern et al [68]	Compare adjustment of children with BT with non-CNS cancers and examine predictors of adjustment	Cross-sectional	81 children with recently diagnosed BT and 31 children with recently diagnosed non-CNS cancers, ages 4–16	Child Behavior Checklist, rating of cosmetic and functional impairment, Wechsler Intelligence Scale for Children – Revised	Lower IQ related to less participation in social activities; single-parent status and severe functional impairment related to more parent-rated social problems
Patel et al [72]	Examine attention dysfunction in pediatric BT survivors	Cross-sectional	70 pediatric BT survivors, ages 6–16	California Verbal Learning Test for Children, Child Behavior Checklist, Trails Making Test A and B, Wechsler Intelligence Scale for Children – 3rd edition	Survivors characterized as having attention dysfunction had more parent-reported social problems than non-attention dysfunction survivors
Poggi et al [67]	Evaluate presence of cognitive and psychological disorders in pediatric BT survivors	Cross-sectional	76 pediatric BT survivors, ages 0–18	Child Behavior Checklist, Vineland Adaptive Behavior Scales, age appropriate Wechsler Intelligence Scales	Greater time since diagnosis related to worse parent-rated social skills; lower IQ related to more parent-reported social problems
Schulte et al [69]	Examine associations between body mass index, cognitive functioning and social competence in childhood BT survivors	Cross-sectional	54 survivors of childhood BTs, ages 8–18	Child Behavior Checklist, Social Skills Rating System, Self-Perception Profile, Wechsler Abbreviated Scale of Intelligence, Youth Self-Report	Higher BMI and higher IQ related to better parent-reported social competence; IQ moderated effect of BMI in predicting self-perceptions of close friendships – survivors with lower BMI and lower IQ had lower self-perceptions of close friendships
Vannatta et al [18]	Examine behavioral reputation and peer acceptance of childhood BT survivors	Cross-sectional; data collected from survivors, teachers and peers	28 childhood BT survivors and 28 nonchronically ill, same classroom, same gender comparison peers, ages 8–18	Likert Rating Scale (of all children in class), Revised Class Play, Three Best Friends	BT survivors described by peer, teacher and self-reports as more socially isolated than comparisons; BT survivors selected as best friend less often than comparisons; no differences on reciprocated friendships or like ratings between groups; peers perceived BT survivors as being more sick, more fatigued and often absent
Willard et al [77]	Examine emotional, behavioral and neurocognitive functioning in ependymoma survivors over time	Longitudinal; data presented from pre-radiation baseline evaluation and 5 years later	113 youth treated for pediatric ependymoma using conformal radiation therapy, age 1–16 at baseline	Child Behavior Checklist, age appropriate Wechsler Intelligence Scales	Parent-rated survivor social competence significantly differed from norms at Year 5 but not at baseline; no significant change in parent ratings of survivor social competence over time
Willard et al [73]	Examine relation between gender, history of cranial radiation therapy and facial expression recognition in pediatric BT survivors	Cross-sectional	53 pediatric BT survivors (27 females), ages 6–17; 34 survivors received cranial radiation therapy	Diagnostic Analysis of Nonverbal Accuracy – Revised, Social Skills Rating System, Wechsler Intelligence Scale for Children – 3rd edition	Interaction between gender and history of cranial radiation therapy on facial expression recognition – females with history of cranial radiation therapy performed more poorly than females without history of cranial radiation therapy
Wolfe et al [49]	Examine associations between executive function and social skills in pediatric BT survivors	Cross-sectional	24 pediatric BT survivors, ages 8–18	Behavior Rating Inventory of Executive Function, Social Skills Information System, Tasks of Executive Control, Wechsler Abbreviated Scale of Intelligence or Wechsler Intelligence Scale for Children – 4th edition	Poorer parent-rated survivor executive function was related to poorer parent-rated survivor social skills but not survivor self-reported social skills; lower levels of response inconsistency on executive function task related to poorer parent-and survivor-reported social skills; greater variability in response style on task predicted both parent-and survivor-reported social skills while controlling for IQ
Wolfe-Christensen et al [81]	Assess if posterior fossa syndrome is associated with increased risk for social problems in pediatric BT survivors	Cross-sectional	21 pediatric BT survivors, ages 6–17; 6 of 21 had posterior fossa syndrome	Child Behavior Checklist, Conners Rating Scale-93	Posterior fossa syndrome associated with increased risk in parent-reported survivor social problems