Clinical psychological treatment of children and adolescents with tumours of the central nervous system
Abstract
In Slovenia, there are on average 20 children and adolescents with central nervous system tumors (CNS tumors) diagnosed annually, which accounts for approximately 20% of all the patients treated at the Clinical Department of the Pediatric Hematology and Oncology (KOOHO) of the Division of Paediatrics, University Medical Centre Ljubljana. The children with CNS tumors need an integrated interdisciplinary treatment, part of which are also an adequate clinical psychological diagnostics and a comprehensive neuro-cognitive rehabilitation that is vital, due to very common cognitive and psychosocial consequences of the illness and treatment. It is performed by a clinical psychologist who is a member of the KOOHO team. The psychosocial and neuropsychological monitoring of a child starts during the treatment itself, after the treatment is completed (followed by regular monitoring every 2−3 years) or when the parent or the hematooncologist notice some significant changes in the functioning of a child. General intelligence, school achievements, executive functions, attention and concentration, memory and learning, neuro-sensory perception, visual and spatial and visual-motor abilities, perceptual processing, speed of processing, speech, adaptive skills, emotional and behavioral functioning and the quality of life are assessed. After recognizing the nature and the severity of the long-term effects of the illness and treatment, the child can be given individual recommendations on measures and adaptations and appropriate early neurorehabilitation that plays an important role in the development of independence and autonomy in adulthood.
A quality integrated treatment of children with CNS tumors affects patients’ survival, reduces the late effects of the treatment and enables children and later adults to live their best possible lives in the areas of health, education, employment, partnership and family relationships. It is important that children and adolescents with incurable brain tumors begin the interdisciplinary palliative care early in order to maintain their and their relatives’ quality of life. This is an active and an integrated care for the patients and an assistance for their loved ones both during illness and in the process of mourning.
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