2007 — 2008 |
Hardy, Kristina K. |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Triccs: Targeting Inattention in Childhood Cancer Survivors
[unreadable] DESCRIPTION (provided by applicant): [unreadable] [unreadable] Since the 1960's there has been a marked increase in the 5-year survival rates among children diagnosed with cancer (current rate = 77%). Despite the favorable prognosis for survival, patients are at high risk for both acute and late occurring sequelae associated with their disease and treatments. Children who receive therapies that impact the central nervous system are at even higher risk for cognitive, social and psychological deficits. Collectively, these problems limit their quality of survival well into adulthood. As such, investigators have recently focused on development of interventions targeted at improving neurocognitive deficits in survivors, particularly problems with attention and working memory. One novel approach that has shown preliminary and robust efficacy in children with attention problems is computerized cognitive training (CT). However, such an intervention has never been empirically tested with survivors of childhood cancer. Therefore, given the preliminary nature of this field of investigation, prior to launching a large-scale randomized clinical trial, it is first of crucial importance to determine whether this type of home-based, computerized cognitive training task is feasible and acceptable for use with survivors of pediatric cancer. Acquisition of these data will allow us to power a larger intervention study with this vulnerable patient population. To this end, the current study has two specific aims: 1) to assess the feasibility and acceptability of a home- based, computerized attention training program with survivors of central nervous system (CNS) impacting pediatric cancer (e.g. ALL, brain tumors), and 2) to estimate the effect size of this attention training program with survivors of childhood cancer to determine whether a larger- scale clinical trial is warranted. We propose to pilot an 8-week randomized, placebo-controlled, CT intervention with a small sample of survivors of childhood cancer (n = 24). Feasibility, acceptability, and preliminary efficacy data will be collected post-treatment and after a 3-month follow-up period. Primary outcomes will be parent- and survivor-reported technical feasibility, ease-of-use, and satisfaction, as well as computer-tracked compliance, and performance on standardized measures of attention and working memory. We hypothesize that the intervention will be associated with adequate feasibility, acceptability, and compliance. Further, we predict that increases in working memory and attention from baseline to post-intervention will be of moderate effect size, and will be maintained at 3-month follow-up. [unreadable] [unreadable] [unreadable] [unreadable]
|
1 |
2017 — 2021 |
Embry, Leanne Hardy, Kristina K. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Longitudinal, Multimodal Assessment of Neuropsychological Functioning in Children Diagnosed With High-Risk Acute Lymphoblastic Leukemia (Hr-All): Using Early Changes to Predict Later Impairment @ Children's Research Institute
PROJECT SUMMARY Children with ?high-risk? leukemia receive intense treatments that, while life-saving, can also cause them to develop problems with the way they learn and think. This does not happen to all children receiving these treatments, but we cannot yet predict who will develop problems. One reason that we lack this information is that it is often difficult to test changes in the way children learn while they are receiving medical treatment. Children may feel too sick to complete testing, psychologists are not always available to do the evaluations, and insurance companies may not cover the testing that is needed. In this project, we aim to identify the first signs of changes in thinking and learning using a short, computerized testing program. The tests can be given in clinic by nurses or other staff, and cost very little money. We will test children starting shortly after leukemia is diagnosed, and several times during the course of their treatment, so that we can identify problems as soon as they start to occur. Children in our study will also receive a one-hour evaluation with widely-used tests of learning and memory, given by a psychologist, five years after their diagnosis. We will determine whether results from the computerized tests are able to predict performance on the more traditional tests given by the psychologists. If computerized testing done early in treatment helps us to better predict who will go on to have difficulties, we can help to slow down or eliminate these problems. Finally, we want to determine the extent to which other factors also contribute to problems that develop as a result of leukemia treatment. We are especially interested in looking at factors known to affect children's thinking and learning skills, like a family's access to resources, mental health difficulties, and medical problems that can occur during treatment. We will also be asking children to tell us about how tired, sick, or in pain they are right before they complete the computerized testing program. Because there is some evidence indicating that these types of symptoms may affect children's performance on cognitive tests, we believe that it's important to describe any impact that these symptoms have on children's thinking and learning, both early in treatment and also much later. If we can better understand how all of these factors relate to survivors' patterns of thinking and learning, we can better predict which individuals may be affected by those problems.
|
0.904 |