Psychosocial Functioning
All BASC mean T-scores were in the normal range at follow-up (Table 2), although scores were variable ranging from within the normal range to the impaired range across most scales. No significant relationship (p ≥ 0.10) was found between mean T-scores for the Behavioral Symptoms Index or the Adaptive Skills score and the following factors: gender, hydrocephalus at diagnosis, history of surgical resection, tumor location, radiation field, treatment with chemotherapy, or SES. Younger age at baseline was significantly related to a higher Behavioral Symptoms Index mean score(p = 0.016) and the Adaptive Skills mean score (p = 0.001), although both mean scores were within the normal range. Histology was significantly related to the Behavioral Symptoms Index mean score (p = 0.038); the ependymoma group had a higher mean score than the other histology groups. No significant relationship was found between the Adaptive Skills mean score and histology. The time interval between baseline and follow-up was not significantly correlated with the Behavioral Symptoms Index or Adaptive Skills mean scores (bothp values ≥ 0.10).
There was a significant difference in the mean Behavioral Symptoms Index for the age by radiation field groups (p = 0.038); younger patients who received CSI had significantly more problem behaviors compared to older patients who received either CSI (p = 0.014) or focal PRT (p = 0.007). However, there was no significant difference (p = 0.10) in problem behaviors (Behavioral Symptoms Index) between younger patients who received CSI or focal PRT. Likewise, there was a significant difference in the Adaptive Skills mean score for the age by radiation field groups (p= 0.008); younger patients who received CSI had significantly lower adaptive skills compared to older patients who received either CSI (p = 0.012) or focal PRT (p = 0.022). However, no significant difference (p = 0.24) was seen between younger patients who received CSI or focal PRT.
Compared to the normative mean, a significantly elevated mean score was found for the total sample on Withdrawal (p < 0.001) while mean scores were significantly lower (indicating less problems) than expectation on Hyperactivity (p = 0.001), Aggression (p < 0.001), Conduct Problems (p < 0.001), Adaptability (p = 0.013), Social Skills (p < 0.001), and the Behavioral Symptoms Index (p = 0.032). Scores were at or near the normative mean on the remaining BASC scales (p values ≥ 0.063), including Anxiety, Depression, Somatization, Attention Problems, and Adaptive Skills.
Rates of impairment for the Behavioral Symptoms Index and Adaptive Skills scale for the total sample were similar to expected rates in the general population as were the scores on Hyperactivity, Aggression, Conduct Problems, Depression, Anxiety, Atypicality, Attention Problems, Adaptability, Social Skills, Leadership, and Functional Communication. In contrast, rates of impairment on Somatization, Withdrawal, and Activities of Daily Living exceeded expectations. There was no significant difference between the rates of impairment and the younger and older age groups on any scale (p > 0.10), although there was a relatively greater rate of impairment for the younger group in Anxiety, Withdrawal, and Activities of Daily Living. Rates of impairment were generally higher in the younger group treated with CSI compared to focal PRT for Withdrawal (8/19, 42.1% vs. 7/43, 16.2%) and Anxiety (4/19, 21.1% vs. 5/42, 11.9%), but not for Activities of Daily Living (3/19, 15.8% vs. 10/44, 22.7%).