Neurodevelopmental consequences of pediatric cancer and its treatment: applying an early adversity framework to understanding cognitive,behavioral, and emotional outcomes

Today, children are surviving pediatric cancer at unprecedented rates, making it one of modern medicine’s true success stories. However, we are increasingly becoming aware of several deleterious effects of cancer and the subsequent “cure” that extend beyond physical sequelae. Indeed, survivors of childhood cancer commonly report cognitive, emotional, and psychological difficulties, including attentional difficulties, anxiety, and posttraumatic stress symptoms (PTSS). Cognitive late- and long-term effects have been largely attributed to neurotoxic effects of cancer treatments (e.g., chemotherapy, cranial irradiation, surgery) on brain development. The role of childhood adversity in pediatric cancer – namely, the presence of a life-threatening disease and endurance of invasive medical procedures – has been largely ignored in the existing neuroscientific literature, despite compelling research by our group and others showing that exposure to more commonly studied adverse childhood experiences (i.e., domestic and community violence, physical, sexual, and emotional abuse) strongly imprints on neural development. While these adverse childhood experiences are different in many ways from the experience of childhood cancer (e.g., context, nature, source), they do share a common element of exposure to threat (i.e., threat to life or physical integrity). Therefore, we argue that the double hit of early threat and cancer treatments likely alters neural development, and ultimately, cognitive, behavioral, and emotional outcomes. In this paper, we (1) review the existing neuroimaging research on child, adolescent, and adult survivors of childhood cancer, (2) summarize gaps in our current understanding, (3) propose a novel neurobiological framework that characterizes childhood cancer as a type of childhood adversity, particularly a form of early threat, focusing on development of the hippocampus and the salience and emotion network (SEN), and (4) outline future directions for research.     

Does the pot melt,boil, or brew? Black children and white assessment procedures

The experiences Black youths bring to school with them constitute a distinctive, viable culture. Their subsequent performance in educational and psychological testing situations cannot be assessed adequately without consideration of their particular attitudes, perceptions, and behavioral patterns, for all of these are determined by a kind of cultural conditioning which differs, in some fundamental ways, from mainstream Americans. Several of the social and psychological characteristics of Black culture are discussed. Included are Blacks' attitudes toward whites, systems of time allocations, expressions of identity, attitudes toward learning, dissemination of information among Blacks, Black learning styles and maturation processes. Each is discussed further in terms of its manifestation in a testing or assessment situation; how it conflicts with the assessor's orientations and expectations; and how distorted, unreliable evaluations result from the failure of assessors to consider implications of cultural relativism in interpreting Black behavior.     

Sex differences in a human analogue of the Radial Arm Maze: the "17-Box Maze Test"

This study investigated sex differences in spatial memory using a human analogue of the Radial Arm Maze: a revision on the Nine Box Maze originally developed by called the 17-Box Maze Test herein. The task encourages allocentric spatial processing, dissociates object from spatial memory, and incorporates a within-participants design to provide measures of location and object, working and reference memory. Healthy adult males and females (26 per group) were administered the 17-Box Maze Test, as well as mental rotation and a verbal IQ test. Females made significantly fewer errors on this task than males. However, post hoc analysis revealed that the significant sex difference was specific to object, rather than location, memory measures. These were medium to large effect sizes. The findings raise the issue of task- and component-specific sexual dimorphism in cognitive mapping.     

The construction of large number representations in adults

What is the nature of our mental representation of quantity? We find that human adults show no performance cost of comparing numerosities across vs. within visual and auditory stimulus sets, or across vs. within simultaneous and sequential sets. In addition, reaction time and performance in such tasks are determined by the ratio of the numerosities to be compared; absolute set size has no effect. These findings suggest that modality-specific stimulus properties undergo a non-iterative transformation into representations of quantity that are independent of the modality or format of the stimulus.     

A conservative inverse normal test procedure for combining p-values in integrative research

The use ofp-values in combining the results of independent studies often involves studies that are potentially aberrant either in quality or in actual values. A robust data analysis suggests the use of a statistic that takes these aberrations into account by trimming some of the largest and smallestp-values. We present a trimmed statistic based on an inverse cumulative normal transformation of the orderedp-values, together with a simple and convenient method for approximating the distribution and first two moments of this statistic.The author thanks Ingram Olkin, David Rogosa, Jim Hodges and two anonymous reviewers for providing many useful comments and suggestions.