Childhood Cancer 1

Childhood Cancer: The Effects and Methods of Support

Brianna Choy

University of Washington

ECFS 200: Introduction to Early Childhood and Family Studies

Ms. Cinthia Palomino

November 3, 2021
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Childhood Cancer: The Effects and Methods of Support

When considering a child’s development and early childhood learning, one must also pay

particular attention to the risk factors present in the child’s surroundings and if they have

experienced any Adverse Childhood Experiences. The emergence of cancer and having to

undergo many stages of treatment in the early years of one’s life can be a traumatic experience.

This raises the question of, with the added challenges that come with being physically ill, what

are the academic and social effects of cancer on children? Are there any long-term effects for

children diagnosed with cancer? What methods can be used to buffer the effects of their

treatment?

How cancer affects child development is especially important to me because I aspire to

be a child life specialist. This will require me to interact with many children being treated for

cancer. Advancements in healthcare have led to an increase in survival rates for children with

cancer; therefore, I believe it is necessary for me to consider and find solutions to the

long-lasting psychological and physical effects that emerge during cancer treatment, in order to

better understand and support my patients. In regards to the broader field of Early Childhood and

Family Studies, childhood cancer serves as a stressor which can have lasting impacts on a child.

Emotionally, they must come to terms with the possibility of death, which is a concept that even

adults struggle to grasp. Furthermore, the time spent in the hospital and the lack of social

interaction can also heavily impact a child’s development. By affecting the child directly on all

fronts, cancer is considered a risk factor at the individual level, having the potential to be a threat

to a child's development.

In the research study, Educational and social late effects of childhood cancer and related

clinical, personal, and familial characteristics, conducted by Maru Barrera, Amanda K. Shaw,
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Kathy N. Speechley, Elizabeth Maunsell, and Lisa Pogany, it was discovered that there is a

positive correlation between childhood cancer survivors and circumstances that demonstrate

educational and social difficulties (Barrera et al., 2005). The observed outcomes include

repeating a grade, attending learning-disability or special-education programs, having academic

or other school problems, receiving a below average of failing grade, using a friend as a

confidant, and having few close friends (Barrera et al., 2005). When compared to the population

control group of children who were not diagnosed with cancer, the study found that survivors

were more likely to suffer from these outcomes. For instance, 20.6% of childhood cancer

survivors had to repeat a grade compared to the 8.5% of children who did not have cancer, and

19.4% of survivors had one or no close friends while only 8.3% of children in the control group

related to this statement (Barrera et al., 2005). The significant differences in percentages for all

of the outcomes further emphasize the connection between cancer and difficulties a child may

face in school and with social interactions.

This correlation can be attributed to the type of cancer the child is diagnosed with. For

instance, it states, “Poor educational achievement has been reported in survivors of leukemia and

brain tumors,” (Barrera et al., 2005). That being said, according to the Healthcare Cost and

Utilization Project’s statistical brief, Pediatric Cancer Hospitalizations, 2009, children diagnosed

with leukemia had the highest number of hospital stays totalling an estimate of 26,400 stays and

the longest mean length of a hospital stay with 17.4 days, compared to all other types of cancer

(Price et al., 2012). With the information provided, it can be implied that the more time a child

spends in the hospital, the more likely they are to suffer from educational and social setbacks.

This is attributed to the idea of social isolation, in which most of their time is spent at the

hospital, thus causing them to miss school and have an absence of social relationships that extend
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beyond the hospital. These children are constantly surrounded by adult healthcare workers and

the majority of their interactions with peers are mainly limited to children with terminal illnesses.

Subsequently, in addition to handling the traumatic stressor of being diagnosed with cancer, they

are also placed in a stressful environment, where they develop meaningful relationships with

other children whose likelihood of surviving is extremely uncertain.

While the type of cancer can be indicative of the social and educational difficulties a

child with cancer may face, the types of treatment they receive has been shown to also be an

important factor. According to the same study, children who were treated with cranial radiation

therapy (CRT) “were more likely have reports of repeating a grade, attending a learning-disabled

or special-education program, and experiencing academic or other school problems compared

with survivors who received treatment that excluded CRT or IT MTX [intrathecal methotrexate]”

(Barrera et al., 2005). Cranial radiation therapy involves high levels of radiation being directed at

the brain, and intrathecal methotrexate is a shot delivered into the spinal cord and is distributed

throughout the central nervous system. Furthermore, results from the study revealed being

treated with CRT, by itself or with IT MTX, can have implications on a child’s mathematical

ability (Barrera et al., 2005). Being that both of these treatments affect the brain, it is

understandable why they have a major impact on a child’s cognitive functioning. Despite these

side effects, CRT and IT MTX are necessary in treatment when dealing with certain types of

cancers, thus making these adverse effects unavoidable.

In a pilot study conducted by Robert W. Butler and Donna R. Copeland, they examined

the effectiveness of their developed Cognitive Remediation Program (CRP) for pediatric cancer

patients, which attempts to improve the effects that accompany certain treatments, such as the

ones mentioned previously. The goal of this program was to potentially replace the traditional
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methods that were found only to be “effective in improving the individual’s performance on

tasks similar to the training exercises” (Butler & Copeland, 2002). On the other hand, CRP aims

to allow childhood cancer patients to better apply what they already have in a more generalized

approach that can help a variety of patients in everyday life. Furthermore, this program

incorporates various techniques from three areas: brain injury rehabilitation, special

education/educational psychology, and clinical psychology (Butler & Copeland, 2002). Utilizing

the Attention Process Training (APT) activity that is commonly used during rehabilitation for a

brain injury, Butler and Copeland (2002) also draw in a child’s attention during this first part of

the CRP by adding colorful and exciting effects. In order to address preparedness, task approach,

on-task behavior, and generalization, Butler and Copeland (2002) compiled around fifteen

metacognitive strategies, which are used to assist children with their learning abilities. These

strategies are separated into segments that guide the children through the process of completing a

certain task. For instance, to prepare for a task, a child may be asked to participate in a breathing

exercise, in which they visualize a bowl of soup to smell and blow on to regulate their breathing

(Butler & Copeland, 2002). By compiling a variety of strategies, the CRP caters to a broader

range of children that each benefit from using their own unique assortment of strategies.

Furthermore, the CRP integrates clinical psychology by including cognitive-behavioral

interventions that “are designed to improve resistance to distraction, and also to help the child

learn how to be his/her own coach over the course of a long and difficult activity,” (Butler &

Copeland, 2002). This part is important because it sets up the child for success that extends

beyond the duration of the program by preparing them with the necessary tools and

self-discipline to handle everyday tasks and situations. Through the implementation of this

program in children’s hospitals across the nation, statistically, academic improvement will be
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more achievable for children with cancer following their intense treatment, a causative factor of

cognitive impairment.

The studies conducted by Barrera et al. (2005) and Butler and Copeland (2002) have

immensely shaped my understanding of the effects of childhood cancer and rehabilitation

methods. Both of these studies answered my questions by revealing the many ways in which

childhood cancer can affect a child educationally and socially, how the type of cancer and

treatment can determine the prevalence of certain adverse effects, and the methods used to

remedy the effects of cancer treatment. This information will be useful for many people in the

child’s immediate environment, including their teachers, healthcare team, and parents. A child’s

diagnosis with cancer is already difficult; however, through gaining a better understanding of the

recently discovered and unrecognized effects of cancer and cancer treatment, the child’s support

system will be adequately prepared for dealing with and helping them through this transition.

This is important because with these protective factors in place, it can help buffer the effects on

the child’s developing brain and early development. With the advancements in cancer treatment

rapidly progressing, one question I am left with is, will there be any new developments that

mitigate the effects mentioned and how effective will they be?
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References

Barrera, M., Shaw, A. K., Speechley, K. N., Maunsell, E., & Pogany, L. (2005, September 12).

Educational and social late effects of childhood cancer and related clinical, personal,

and familial characteristics. American Cancer Society Journals. Retrieved November 2,

2021, from [Link]

Butler, R. W., & Copeland, D. R. (2002, January 11). Attentional processes and their remediation

in children treated for cancer: A literature review and the development of a therapeutic

approach. Cambridge Core. Retrieved November 2, 2021, from

[Link]

-society/article/attentional-processes-and-their-remediation-in-children-treated-for-cancer

-a-literature-review-and-the-development-of-a-therapeutic-approach/1F28ED63C61959E

FD848637C8B663A67#tbl002.

Price, R. A. P. A., Stranges, E., & Elixhauser, A. (2012, May). Pediatric Cancer

Hospitalizations, 2009. Statistical brief #132. Retrieved November 2, 2021, from

[Link]