BUFFALO, NY--A cognitive remediation program that stresses skills
acquisition rather than reiterative practice may improve attention
and concentration deficits in cognitively impaired survivors of
childhood cancer, Robert W. Butler, PhD, reported at the Fourth
International Conference on Long-Term Complications of Treatment
of Children and Adolescents for Cancer.
The conference, hosted by Roswell Park Cancer Institute, was co-sponsored
by the Bristol-Myers Squibb Oncology Division and the NCI.
"Attentional dysfunction is one of the most common neurocognitive
side effects of cranial irradiation and several chemotherapies,
and negatively affects a child's quality of life and academic
achievement," said Dr. Butler, a researcher at the Child
Development & Rehabilitation Center, Oregon Health Sciences
For the past several years, Dr. Butler and his colleagues have
been developing and pilot testing cognitive remediation programs
to improve attention/concentration, nonverbal reasoning, and spatial
processing in children whose cancer or treatment has affected
the central nervous system.
The result is a cognitive remediation model that emphasizes skills
acquisition and deemphasizes (but includes) the more traditional
"Practice! Practice! Practice!" component.
The model integrates psychotherapy (to address quality of life
issues) and multisensory modality instruction (to improve academic
performance, particularly in arithmetic). Overarching this model
is a strong support network of parents, teachers, and therapists.
Saturation training with massed practice has been used with partial
success in adult remediation programs, but its usefulness in children
had been largely untested, said Dr. Butler, who discovered early
on that this model would need to be "reconceptualized"
before adapting it a younger population. "Pilot testing suggested
that massed practice alone provided few benefits in children,"