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Returning to School After Pediatric Brain Tumor Treatment

Returning to School After Pediatric Brain Tumor Treatment

Question

My 7 year old is being treated for a craniopharyngioma with surgery and radiation. What should I expect when he is ready to go back to school? Will he be able to rejoin his classmates or have to stay back a year?

Carol Armstrong, PhD, Director of Neuropsychology Lab, Neuro-Oncology Program at CHOP, responds:

Answer

It would probably be helpful if your child had a neuropsychological evaluation before returning to school. A little thought can go into when the evaluation occurs, since a person's cognitive abilities continue to recover for two years after surgery, and there is a decline and then rebound in memory for children over two years after radiation, and your child might continue to have improvement in cognition after the neuropsy evaluation. On the other hand, there can be decline in cognitive function during the year after surgery if brain tissue dies back, called encephalomalacia - this is unpredictable and doesn't occur in everyone.

In any case, a neuropsychological evaluation should give detail on the cognitive functions that underlay intellect, and it is very important to have both visual and verbal memory tested. The detailed and comprehensive neuropsychological evaluation will lead to better recommendations for the type of learning supports your child might need.

Depending on the cognitive, physical, and sensory impairments your child has, he should be able to return to school (unless he needs an alternate environment because he is too dependent). In fact, it is best if your child returns to school, but your own expectations of his goals and capacity to achieve may change. Look at some of the website for children with brain tumors, such as the Children's Brain Tumor Foundation, and see what they have to offer to help you understand what to do.