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Executive functioning in pediatric acute lymphoblastic leukemia: CHEXI parent-report vs performance-based assessment

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Abstract

Several studies have emphasized the need for comprehensive neuropsychological assessment in pediatric cancer. To date, no study has analyzed Executive functions (EF) in children with Acute Lymphoblastic Leukemia (ALL) undergo treatment by means of both the Childhood Executive Functioning Inventory (CHEXI), parent form and performance-based measures. The aims of the present study were: (1) to explore the sensitivity of ratings vs. cognitive measures of EF to identify executive functions deficits in children with ALL and (2) to analyze the relationship between the parent-rated data and performance-based measures of EF in children with ALL. We assessed EF in typically developing (TD) children (n = 70) and children with ALL (n = 20) aged 6 to 12 years by means of performance-based measures of EFs (including working memory, cognitive flexibility, and inhibition) and the CHEXI parent form, also including IQ, depression, and anxiety measures. When controlling for age, IQ, depression and anxiety, children with ALL exhibited greater difficulties than their TD peers on working memory, cognitive flexibility (spontaneous and reactive) and inhibitory control tasks. Equally, at a behavioral level, differences between groups were observed regarding the CHEXI’s inhibition and WM subscales. However, the CHEXI parent related poorly to EF performance-based measures, supporting earlier research that suggests that ratings and laboratory measures would assess distinct underlying mental constructs. Overall, our results stress the importance of considering both measures when assessing EF in children with ALL as they would offer distinctive but relevant information. The clinical implications of findings are discussed.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This work was financed by the Argentinean National Council for Scientific and Technical Research (CONICET). We are indebted to the schools and all the children and parents who contributed to this study.

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Authors and Affiliations

  1. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina

    Marisel Gutierrez, Vanessa Arán Filippetti & Viviana Lemos

  2. Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento (CIICSAC), Universidad Adventista del Plata (UAP), 25 de mayo 99, CP3103, Libertador San Martín, Entre Ríos, Argentina

    Marisel Gutierrez, Vanessa Arán Filippetti & Viviana Lemos

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  2. Vanessa Arán Filippetti
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  3. Viviana Lemos
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Correspondence to Marisel Gutierrez.

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Gutierrez, M., Arán Filippetti, V. & Lemos, V. Executive functioning in pediatric acute lymphoblastic leukemia: CHEXI parent-report vs performance-based assessment. Curr Psychol 42, 1126–1136 (2023). https://doi.org/10.1007/s12144-021-01524-x

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