Abstract The acute lymphoid leukemia is the most common type of cancer in children. Evidence suggests the presence of adverse effects of the disease and treatment for cognitive, behavioral, and learning domains among survivors, although the etiology of these changes is not fully understood. Given this, it became relevant to investigate the behavioral profiles and school reintegration of 36 children aged 7 to 13 years. These were divided into two groups, one of survivors of acute lymphoid leukemia and the other of healthy children and adolescents. Behavioral and reintegration profiles were assessed using the Child Behavior Checklist and the Deasy-Spinetta Behavioral Questionnaire. The data of the instruments were analyzed using descriptive and inferential statistics. It was recorded a high prevalence of internalized complaints and learning disabilities, especially among girls and those diagnosed above five years. The results highlight the need for monitoring of surviving children, promoting interventions that ensure their development.

Resumo A Leucemia Linfoide Aguda é o tipo mais comum de câncer na faixa pediátrica. Evidências sugerem a presença de efeitos adversos da doença e do tratamento para os domínios cognitivo, comportamental e de aprendizagem entre os sobreviventes, embora a etiologia dessas alterações não seja completamente compreendida. Diante disso, tornou-se relevante investigar os perfis de comportamento e reinserção escolar de 36 crianças com idades entre sete e 13 anos. Estas foram divididas em dois grupos, sendo um de sobreviventes de Leucemia Linfoide Aguda e outro de crianças e adolescentes saudáveis. Os perfis de comportamento e de reinserção escolar foram avaliados através do Child Behavior Checklist e do Questionário Comportamental Deasy-Spinetta, aplicados aos pais e professores. Realizou-se análise dos dados através de estatística descritiva e inferencial. Constatou-se alta prevalência de queixas internalizantes, além de dificuldades de aprendizagem no grupo de sobreviventes, notadamente entre as meninas e aqueles que tiveram o diagnóstico em idade superior a cinco anos. Os resultados ressaltam a necessidade de monitoramento das crianças sobreviventes, promovendo intervenções que auxiliem no seu desenvolvimento.

O objetivo deste estudo foi avaliar a habilidade intelectual de crianças com Diabetes Mellitus do Tipo 1 (DM1). Para tanto, foram consideradas as variáveis clínicas: idade ao diagnóstico e exposição a episódios de hipoglicemia. Utilizou-se como medida de avaliação da inteligência o WISC III. 20 crianças com DM1, de ambos os sexos e com idades entre seis a nove anos, participaram do estudo. Os dados obtidos foram interpretados a partir de análises descritivas e inferenciais. Observou-se que 80% dos participantes obtiveram rendimento global classificado dentro da variação normal de inteligência. As pontuações mais baixas obtidas pelas crianças diagnosticadas com DM1 foram identificadas no dominio da Organização Perceptual. A análise do impacto das variáveis clínicas sobre o desenvolvimento da inteligência apontou diferenças significativas entre crianças com início precoce da doença quando comparadas àquelas com início tardío, nos diferentes subtestes que compõem a escala. Os dados sugerem que a DM1 está diretamente relacionada a alterações no funcionamento cognitivo, especialmente em casos de início precoce da doença.

The aim of this study is to evaluate the intellectual capacity of children with DM1. We considered the clinical variables: onset of disease and exposure to episodes of severe hypoglycemia. The WISC-III was used for evaluating the intellectual abilities of the participants. 20 children with DM1, of both sexes and aged six to nine years, participated in the study. We carried out the descriptive and inferential analysis of the data. We observed that 80% of the participants had a global performance classified within the normal intelligence range. Considering the four Index Scores, we observed that the children with DM1 obtained their lowest scores on the Perceptual Organization Index. Regarding the possible influence of clinical variables, this study found significant statistical differences between children with early onset of DM1 and late onset in subtests of the WISC-III. These data suggest that DM1 is causally related to alterations in cognitive functioning, especially in cases of early beginning of the disease.

Resumo O presente estudo investigou o desempenho de crianças da região Nordeste, entre 7 e 10 anos, em tarefas de fluência verbal fonológica e semântica. Participaram da pesquisa 102 sujeitos de ambos os sexos, os quais realizaram três tarefas de fluência fonológica e três de fluência semântica. Os dados encontrados foram submetidos a análises correlacionais e de variância, considerando a influência das variáveis idade e sexo sobre o desempenho dos participantes. Não houve efeito do sexo sobre o desempenho das crianças. Contrastes significativos entre as faixas etárias foram verificados, observando-se melhor desempenho nas tarefas do componente fonológico com o avanço da idade e em comparação com o semântico. Os resultados encontrados parecem estar respaldados por aspectos neurodesenvolvimentais, visto que os sistemas de memória explícita apresentam curso maturacional mais precoce e de consolidação anterior em relação às funções executivas e os lobos frontais, cujo desenvolvimento se estende à idade adulta.

Abstract This study investigated the performance of children from the Brazilian Northeast region, from 7 to 10 years in phonemic and semantic verbal fluency tasks. The participants were 102 subjects (62 girls and 40 boys) who performed three phonemic and three semantic fluency tasks. The results were submitted to correlational and variance analysis to investigate the influence of the variables age and gender on the subjects performance. There was no effect of gender on the results. Significant contrasts between age groups were found, and better performance was observed on phonemic tasks. Also, the performance in this task changed along development, in contrast to what happened with the semantic fluency. The findings seem to be in accordance to neurodevelopmental aspects, taken into account that explicit memory systems show more precocious maturational course, with earlier consolidation, in comparison to the executive functions and frontal lobes, which go on developing until adult ages.

Resumen El presente estudio investigó el desempeño de 102 niños de la región nordeste, entre 7 y 10 años, en tareas de fluidez verbal fonética y semántica. Participaron 102 sujetos de ambos sexos, que realizaron tres tareas de fluencia fonética y tres de fluencia semántica. Los datos encontrados fueron sometidos a análisis correlacionales y de varianza, teniendo en cuenta la influencia de las variables edad y sexo sobre el desempeño de los participantes. El sexo no influyó en el desempeño de los niños. Fueron verificados contrastes significativos entre las edades, con un mejor desempeño en tareas del componente fonológico a medida que avanza la edad comparándolo con el semántico. Los resultados encontrados parecen estar respaldados por aspectos neurológicos del desarrollo, dado que los sistemas de memoria explícita presentan un proceso de maduración más precoz y de consolidación anterior en relación a las funciones ejecutivas y los lóbulos frontales, cuyo desarrollo se extiende a la edad adulta.

Na atualidade cresce a preocupação com a neurotoxicidade do tratamento antineoplásico e o neurodesenvolvimento. O objetivo deste estudo foi comparar o impacto da modalidade de tratamento sobre a capacidade intelectiva de 22 sobreviventes de Tumores de Fossa Posterior e Leucemia Linfóide Aguda com idades entre seis e 14 anos. Participantes com astrocitoma foram submetidos à cirurgia; aqueles com meduloblastoma à cirurgia, à quimioterapia sistêmica e à radioterapia de crânio e neuroeixo (54Gy) e; aqueles com LLA à quimioterapia sistêmica e intratecal. Apenas os participantes com astrocitoma obtiveram desempenho dentro do esperado. Observou-se contrastes estatisticamente significativos entre os grupos, notadamente entre as crianças com meduloblastoma e as demais nos escores não verbais. Sugere-se que a combinação cirurgia, quimioterapia sistêmica e radioterapia potencializou as sequelas cognitivas, e reforça-se a hipótese de que a radioterapia acarreta danos à substância branca. A quimioterapia intratecal associada à sistêmica promoveu impactos significativos sobre o funcionamento executivo.

Concerns about the neurotoxicity of antineoplastic treatment and neurodevelopment are increasing nowadays. The aim of this study was to compare the impact of treatment modality on intellectual functioning of 22 survivors of Posterior Fossa Tumors and Acute Lymphoblastic Leukemia aged from six to 14 years. The astrocytoma group underwent surgery; the medulloblastoma group underwent surgery, systemic chemotherapy, and cranial and neuraxis radiation (54Gy); the LLA group underwent systemic and intrathecal chemotherapy. Only the astrocytoma group obtained average performance. Significant contrasts were obtained between groups, especially among the medulloblastoma group and others in non-verbal scores. Results suggest that the combination of surgery, radiotherapy and systemic chemotherapy increase the cognitive sequelae and enhance the hypothesis that radiation damages white matter. The association between intrathecal and systemic chemotherapy leads to significant impact on executive functioning.

The present study investigated cognitive function in children diagnosed with acute lymphoblastic leukemia (ALL). The subjects were 20 children between the ages of 6 and 12 years of both genders who were diagnosed with ALL and underwent exclusively triple intrathecal prophylactic chemotherapy of the central nervous system. The protocol used for the neuropsychological assessment included the following cognitive aspects: intellectual performance, attention, memory and executive function. Data were analyzed by descriptive and inferential statistics using the Mann-Whitney U test and Student t-test. The effects of gender, age at diagnosis, and time since the initiation of treatment on the children's performance were determined. The evaluation of intellectual performance revealed reduced scores in the group of children who were female and younger than 5 years of age at diagnosis, especially difficulty with verbal skills and working memory. With regard to attention systems, the different groups presented expected performance for their age. We observed lower scores in the different groups in executive function, aspects of the development of problem-solving strategies, self-regulation, cognitive flexibility and inhibitory control. Better performance was observed for episodic memory and semantic memory (immediate and recognition), but lower scores were found for learning and recall after interference. In conclusion, the present findings are both consistent and discordant with the literature in the field that alludes to the impact of chemotherapy on the maturation of the central nervous system.

The present study investigated the relationship between posterior fossa tumors (astrocytoma and medulloblastoma) and their respective treatments and cognitive performance in Brazilian children by measuring Intelligence Quotient (IQ). Twenty children were enrolled in the study, of whom 13 were diagnosed with astrocytoma (average age at evaluation, 10.2 years; eight girls and five boys) and seven were diagnosed with medulloblastoma (average age at evaluation, 9.2 years; five girls and two boys). The first subgroup underwent exclusively tumor resection surgery, and the second subgroup underwent surgery, chemotherapy (Vincristine, Cisplatine, and Carmustine), and radiotherapy (total dose, 54 Gy). The inclusion criteria for the clinical group were normal social and emotional behavior before the diagnosis and motor and visual performance not excessively deteriorated after surgery. All participants were submitted to the Wechsler Intelligence Scale for Children - third version, and their scores were related to standard norms established for Brazilian children and compared with regard to the diagnosis subgroups and treatment modalities. Statistically significant differences were identified between the two diagnosis subgroups in Performance IQ and Processing Speed scores. The medulloblastoma subgroup presented poorer performance in all domains compared with the astrocytoma subgroup. Time interval between diagnosis and neuropsychological evaluation also had a significant effect on Processing Speed and Freedom from Distractibility in the medulloblastoma subgroup. These results provide empirical evidence of a possible significant effect of radiotherapy exposure on processing speed and global intellectual capacity.