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Social Adjustment in Survivors of Acute Lymphoblastic Leukemia without Cranial Radiation Therapy
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  • Fiona Schulte,
  • Erin Merz,
  • K Russell,
  • Courtney Tromburg,
  • Sara Cho,
  • Andrew Tran,
  • Kathleen Reynolds,
  • Lianne Tomfohr
Fiona Schulte
University of Calgary Cumming School of Medicine

Corresponding Author:[email protected]

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Erin Merz
California State University Dominguez Hills
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K Russell
University of Calgary
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Courtney Tromburg
University of Alberta Faculty of Medicine & Dentistry
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Sara Cho
University of Calgary Cumming School of Medicine
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Andrew Tran
University of Calgary
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Kathleen Reynolds
Alberta Children's Hospital
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Lianne Tomfohr
University of Calgary
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Objective: To evaluate group differences in social adjustment in survivors of pediatric ALL compared to survivor siblings, and controls; identify disease-related predictors of social adjustment in survivors; and explore whether executive functioning explained differences in social adjustment across groups and between disease-related predictors. Methods: Survivors of pediatric ALL (n=38, average age at diagnosis=4.27 years [SD=1.97]; average time off treatment=4.83 years [SD=1.52]), one sibling (if available, n=20), and one parent from each family were recruited from a long-term survivor clinic. Healthy age- and sex-matched controls (n=38) and one parent from each family were recruited from the community. Parents completed the Behavioral Assessment System for Children, Parent Rating Scale (BASC-3) Social Withdrawal subscale as a measure of social adjustment and the Behavior Rating Inventory of Executive Functions (BRIEF-2) as a measure of executive function for each of their children. Results: Parents reported that survivors had significantly worse social adjustment compared to controls (b=6.34, p=.004), but not survivor siblings. Among survivors, greater time off treatment (b=2.06, p=.058) and poorer executive functioning (b=0.42, p=.006) were associated with worse social adjustment. Executive function did not mediate differences in social withdrawal between survivors and controls or the relationship between time off treatment and social withdrawal among survivors. Conclusions: Survivors of pediatric ALL presenting to follow-up programs should be screened for difficulties with social adjustment. Future research should examine treatment- and non-treatment-related factors contributing to poorer social outcomes.
21 Jun 2021Submission Checks Completed
21 Jun 2021Assigned to Editor
21 Jun 2021Submitted to Pediatric Blood & Cancer
26 Jun 2021Reviewer(s) Assigned
16 Jul 2021Review(s) Completed, Editorial Evaluation Pending
26 Jul 2021Editorial Decision: Revise Major
08 Sep 2021Submission Checks Completed
08 Sep 2021Assigned to Editor
08 Sep 20211st Revision Received
09 Sep 2021Reviewer(s) Assigned
23 Sep 2021Review(s) Completed, Editorial Evaluation Pending
27 Sep 2021Editorial Decision: Accept
Jan 2022Published in Pediatric Blood & Cancer volume 69 issue 1. 10.1002/pbc.29407