Development of figurative language skills following central nervous system-directed chemotherapy delivered in early childhood

Abstract

Central nervous system (CNS)-directed chemotherapy is delivered for the treatment of childhood acute lymphoblastic leukaemia (ALL). Figurative language deficits have been described in children following CNS-directed chemotherapy; however, comprehensive analysis of figurative interpretation errors, potentially providing clinical utility to assist with intervention planning, has never been performed. The present study aimed to compare the figurative language skills of seven children treated with CNS-directed chemotherapy for ALL before the age of 6 years (mean age at diagnosis 3 years 10 months) and a matched control group of children, using the Test of Language Competence-Expanded Edition (TLC-E) Figurative Language sub-test. It was hypothesised that the children treated with CNS-directed chemotherapy would demonstrate a decreased performance in and an alternative method of interpreting figurative language. The results suggest no negative effects of CNS-directed chemotherapy on figurative language. There were no statistically significant differences between groups for TLC-E Figurative Language sub-test composite scores and picture component errors, nor were there clinically significant differences observed from descriptive comparisons of individual case data and error analysis. As these skills continue to emerge beyond childhood, the need to monitor skill development in ALL survivors beyond childhood is highlighted.

Keywords::

• Central nervous system chemotherapy
• intrathecal chemotherapy
• childhood acute lymphoblastic leukaemia
• high-level language skills
• figurative language

Acknowledgements

The authors acknowledge and appreciate the support of the staff at the Mater Children's Hospital and the Royal Children's Hospital in the recruitment of the seven ALL survivors for the study. The researchers thank the children and their family for their support and interest in the research. This article is a modified version of Emma Dowling's Honours thesis under the supervision of Dr Fiona Lewis.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This study was supported financially by Cancer Council Queensland (Grant 51145).