Share on Facebook
Share on Twitter
Share on LinkedIn
Share by Email
Print
Moderately independent survivors were not living independently as adults, but most of them were working and did not need assistance with routine or personal care tasks. Cognitive impairment was not a significant predictor of a moderately independent classification, but weak muscle strength and poor adaptive physical function were.
Adult survivors who received their diagnosis at a younger age and who were treated with craniospinal radiation were at increased risk of being nonindependent. Cognitive impairment was also more likely to lead to nonindependence as an adult.
“The findings show that for children with CNS tumors, 5- or even 10-year survival is not enough,” stated the St Jude group. “The ultimate goal should be to deliver therapies that maximize both survival and opportunities for functional and social independence throughout the lifespan.”1 This can be accomplished, in part, by providing education and resources to survivors and their families throughout the course of survivorship. Interventions such as cognitive training, rehabilitation, and physical exercise or strength training may help survivors overcome barriers in their environment and achieve greater independence. Existing programs such as vocational rehabilitation and driving rehabilitation can also help adult survivors achieve greater levels of independence.
Team Effort
Dr Brinkman believes that boosting the independence of survivors should be a priority of the entire multidisciplinary care team. With increased awareness of potential adult outcomes, parents can begin to promote independence in their children during adolescence and young adulthood. However, parents need to realize that goals or expectations for their children may need to be modified to match the child’s cognitive and physical limitations. Parents should work closely with their child’s medical team to determine appropriate goals for independence.
References
1. Brinkman TM, Ness KK, Li Z, et al. Attainment of functional and social independence in adult survivors of pediatric CNS tumors: a report from the St Jude Lifetime Cohort Study [published online September 20, 2018]. J Clin Oncol. doi: 10.1200/JCO.2018.77.9454
2. Wechsler D. Wechsler Abbreviated Scale of Intelligence™ (WASI™). San Antonio, TX: Psychological Corporation; 1999.
