The Behavior Rating Inventory of Executive Function (BRIEF) to Identify Pediatric Acute Lymphoblastic Leukemia (ALL) Survivors at Risk for Neurocognitive Impairment

Adrienne Viola, Lyn Balsamo, Joseph P Neglia, Pim Brouwers, Xiaomei Ma, Nina S. Kadan-Lottick

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Neurocognitive problems, including executive dysfunction, are potential late effects of pediatric acute lymphoblastic leukemia treatment. Surveillance for neurocognitive impairment in a timely and efficient manner is imperative to ongoing clinical care. We sought to determine if the Behavior Rating Inventory of Executive Function (BRIEF) Parent Form identified leukemia survivors with cognitive impairment. In this 28-site cross-sectional study, parents of 256 children, a mean of 8.9±2.2 years after treatment for standard-risk precursor-B acute lymphoblastic leukemia and in first remission, completed the BRIEF. We used a multivariate logistic regression to calculate the association between elevated scores on 3 composite BRIEF indices (Behavioral Regulation Index, Metacognition Index, Global Executive Composite [GEC]) and special education and attention-deficit/hyperactivity disorder (ADHD) outcomes. All BRIEF index scores were significantly associated with receipt of special education services or ADHD. The BRI was most strongly associated with ADHD (odds ratios=4.33; 95% confidence interval, 1.72-10.9). The GEC was most strongly associated with ADHD (odds ratios=4.46; 95% confidence interval, 1.77-11.22). Elevated scores on the BRIEF GEC were associated with low sensitivity (24.1 to 39.1) for detecting the outcomes but better specificity (range, 87.7 to 89.3). These results suggest that the parent-completed BRIEF is associated with clinical outcomes but is not a sensitive tool to identify leukemia survivors that require a comprehensive neuropsychological assessment.

Original languageEnglish (US)
Pages (from-to)174-178
Number of pages5
JournalJournal of pediatric hematology/oncology
Volume39
Issue number3
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
Supported by American Cancer Society Grant RSGPB-03-167-01-PBP. N.S.K.L. is supported in part by American Cancer Society Scholar Grant 119700-RSGHP-10-107-01-CPHPS and a Team Brent St Baldrick's Foundation Scholar award.

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • childhood leukemia
  • executive functioning
  • late effects
  • neurocognitive
  • survivorship

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