Cross-sectional Descriptive Study of the Cognitive Assessment of Children at a Pediatric Oncology Outpatient Clinic in Rio de Janeiro, Brazil, 2022-2023

ABSTRACT

Introduction:  Cancer diagnosis during childhood can negatively impact cognitive and emotional development.

Objective:  To investigate the cognitive performance of children undergoing diagnostic evaluation or beginning oncological treatment at a pediatric oncology outpatient clinic of the Brazilian National Health System.

Method:  Cross-sectional descriptive study with 43 children aged 6 to 11 years, using a neuropsychological test battery to assess executive functions, memory, attention, and behavioral changes, as well as questionnaires to collect sociodemographic, developmental, behavioral, and disease-related information.

Results:  Most children (90.8%) were undergoing diagnostic investigation, and in many cases neoplasia was not confirmed. Nonetheless, most showed below-average performance compared to normative data, with significant difficulties in working memory, inhibitory control, and cognitive flexibility. Additionally, approximately 64% of children reported behavioral changes, with anxiety being the most prevalent.

Conclusion:  The study revealed overall cognitive performance below normative standards regardless of diagnostic or treatment phase, along with behavioral changes, particularly anxiety. It highlights the importance of studies in specific subgroups, adapted evaluations, and interventions addressing cognitive and emotional aspects. Despite competing with patient activities and the lack of appropriate space, it was possible to administer the tests at the outpatient setting. Socioeconomic, educational, emotional, and illness-related factors may have negatively influenced cognition. Adapting evaluations to the outpatient/hospital setting, creating a safe and welcoming environment, is essential to facilitate the assessment process. The development of specific tools for this population is necessary.

Key words:
Mental Status and Dementia Tests/statistics & numerical data; Neoplasms/psychology; Neuropsychological Tests; Executive Function; Child Development