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 tumours (CNS tumours) diagnosed annually, which accounts for approximately 20 % of all the patients treated at the Clinical Department of the Paediatric Haematology and Oncology (KOOHO) of the Division of Paediatrics, University Medical Centre Ljubljana. Children with CNS tumours need an integrated interdisciplinary treatment, including an adequate clinical psychological diagnostics and a comprehensive neuro-cognitive rehabilitation, which 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 the child starts already during the treatment, after the treatment is completed (followed by regular monitoring every 2−3 years) or when the parent or the haematooncologist notice some significant changes in the functioning of the child. General intelligence, attention and concentration, memory and learning, speech, perceptual processing, visual-spatial and vi-sual-motor abilities, processing speed, executive functions, school achievements, adaptive skills, emotional and behavioural functioning and the quality of life are assessed. After determining 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 as well as 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 tumours favourably affects patients’ survival, reduces the late sequellae of the treatment and enables children and later adults to live their best possible lives in terms of health, education, employment, partnership and family relationships. It is important that children and adolescents with incurable brain tumours begin the interdisciplinary palliative care early in order to maintain their own as well as their relatives’ quality of life. This is an active and integrated care for the patients, and assistance to their loved ones both during illness and in the process of mourning.