Education and Cognitive Late Effects of Childhood Cancer

Young children who received cranial radiation, high dose systemic MTX, and/or IT MTX can develop subtle learning disabilities. This is well documented in the scientific literature. The most common problems are with handwriting, spelling, reading or reading comprehension, understanding math concepts, attention deficits (tend to drift off and are easily distracted), short term memory and information retrieval, planning and organizational skills, social maturity and social skills. The articles linked to below will help you if you think that your child is having problems in school because of the cancer treatment. The IEP comments are especially written for parents of children with late cognitive effects.

A lot of good information on resources for educating the child with cancer is listed in the "back to school" section of this web site:

ped-onc back to school section

Articles on cognitive late effects (online)

Cognitive Late Effects of Childhood Cancer (article from the book Childhood Leukemia, by Nancy Keene) Identifying cognitive late effects; your legal rights; Individual Education Plan; services for infants and preschoolers; record keeping; on accepting disabilities.
Cognitive and Late Effects Related to Childhood Cancer, transcript of a presentation Jan. 2005 by Dr. Armstrong.
NK's post to ped-onc (re-produced here with her permission, similar to the above link but more informal)
Cognitive Late effects in Leukemia Survivors from a Candlelighters Newsletter
Cognitive Late Effects To The Brain—Part II from a Candlelighters Newsletter
Neuropsychological Testing: An Excerpt from Educating the Child with Cancer in the Fall 2004 Candlelighters Newsletter
Educational Issues After Childhood Cancer on survivorshipguidelines.org

Bibliography

Technical bibliography on neurocognitive function:

on the Bibliography: Late Effects page

Comments - IEPs for off-treatment (late cognitive effects)

The following items were included in an IEP of a childhood cancer survivor. I'm leaving them as they were categorized in the plan.

Environmental Accomodations:

check in with the student regularly
provide preferential seating as necessary to assist with focusing and maintaining attention

Organizational Accommodations:

provide written outlines for assignments
Set clear time limits for assignments
provide review/reinforcementopportunities for new concepts
provide extra time to complete assignments

Reading Accommodations:

provide instructional materials geared towards students instructional level (e.g.: high interest,low vocabulary reading material)
modify expectations regarding the quantity of reading expected by breaking tasks into smaller parts to be completed over spaced intervals

Written Language Accommodations:

have the student use a computer for word processing,proofreading,editing (eg. spell and grammar checker)
negotiate the required length and appropriate deadlines for written assignments
provide a print copy of chalkboard notes
organize worksheets and tests so they are clear, spacious and easy to follow
minimize copying work from chalkboard or textbook to notebook
encourage student to review the completeness of notebooks with adult or peers

Testing Accommodations:

allow additional time
provide a quiet location which is free from distraction
allow use of calculators where appropriate
allow flexibility in the number of questions to be answered
allow student practise opportunites prior to test(sample test)
provide a study guide prior to tests