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Summary of Clinical Practice Guideline

National Cancer Institute

Long-Term Follow-up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers, Version 3.0
Children’s Oncology Group. (2008).
Arcadia, CA: Children’s Oncology Group, 222 pages.

AGREE Rating: Highly Recommended

Description:
This guideline provides information and recommendations pertaining to therapeutic agents, potential late effects, risk factors, screening and evaluation, counseling, and referral for conditions or exposures as a result of pediatric cancer. Several recommendations relevant to audiological screening and evaluation and speech-language pathology referral are included in chemotherapy, radiology, and neurosurgery sections.

Recommendations:

Head and Neck Cancer

  • Assessment/Diagnosis

    • Assessment Areas

      • Cognition

        • Children with a head or neck cancer who received radiation with a potential impact to the brain or cranium should receive “[f]ormal neuropsychological evaluation to include tests of processing speed, computer-based attention, visual motor integration, memory, comprehension of verbal instructions, verbal fluency, executive function and planning. Refer patients with neurocognitive deficits to [a] school liaison in [the] community or cancer center (psychologist, social worker, school counselor) to facilitate acquisition of educational resources and/or social skills training” (p. 54).

      • Hearing

        • For children with a head or neck cancer who received radiation with a potential impact to the ear, the following recommendations apply:

          • Children should receive “[a] complete audiological evaluation “yearly after completion of therapy for 5 years [for patients <10 years old, continue yearly until age 10], then every 5 years.” 

          •  “If hearing loss is detected, test at least yearly or as recommended by [an] audiologist” (p. 75). 

          • “If [there is a] clinical suspicion of hearing loss at any time, test as clinically indicated” (p. 75).

          • “If [the] audiogram is inconclusive or unevaluable, refer to [an] audiologist for consideration of electrophysiologic testing e.g., otoacoustic emissions [OAEs]” (p. 75).

          • “Consider specialized evaluation for specific needs and/or preferential classroom seating, FM amplification system, and other educational assistance as indicated” (p. 75).

Social Communication Map

  • Treatment

    • Cognition/Language

      • Pragmatic/Social Skills Treatments

        • General Findings

          • In regards to patients exposed to chemotherapy-antimetabolites and/or radiation (potential impact to brain/cranium), or who have undergone neurosurgery,  "refer patients with neurocognitive deficits to [a] school liaison in [the] community or cancer center (psychologist, social worker, school counselor) to facilitate acquisition of educational resources and/or social skills training" (p. 22).

  • Service Delivery

    • Provider

      • In regards to patients exposed to chemotherapy-antimetabolites and/or radiation (potential impact to brain/cranium), or who have undergone neurosurgery,  "refer patients with neurocognitive deficits to [a] school liaison in [the] community or cancer center (psychologist, social worker, school counselor) to facilitate acquisition of educational resources and/or social skills training" (p. 22).

Keywords:
Cancer

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