Family functioning as a moderator of neurocognitive outcome among survivors of Acute Lymphoblastic Leukemia

Evidence from the pediatric traumatic brain injury and pediatric brain tumor populations suggests that positive family functioning serves as a protective factor for neurocognitive outcomes of children who survive these conditions. However, no research has been found that examines whether positive family functioning similarly moderates the effects of CNS-directed chemotherapy on the neurocognitive functioning of survivors of pediatric ALL. The purpose of this study is to examine the effect of family functioning upon neurocognitive outcome among survivors of pediatric ALL treated with chemotherapy. Based upon a multidimensional model of attention and Anderson’s model of executive function (EF), four subcomponents of attention (selective, divided, sustained, and shifting) and four subcomponents of EF (working memory, planning, inhibition, and processing speed) will be examined. Sequential, or hierarchical, multiple regression analyses will be conducted to examine the relationship between family functioning and neurocognitive functioning among survivors of pediatric ALL as well as a comparison group of healthy children. Data for the ALL group and the comparison group will be examined using separate analyses, with demographic and treatment-related variables entered first, followed by a family functioning variable. For the ALL group, family functioning is expected to explain a significant amount of variance in neurocognitive outcome, even after controlling for demographic and treatment-related variables. It is expected that this relationship will not be found for the comparison group. If so, this would have important implications for the survivors and their families. For example, survivors from families with lower levels of functioning could be identified early through screening measures and their families could receive targeted interventions aimed at improving family functioning and thus survivor outcomes.