Assessment of neurocognitive impairment in childhood cancer survivors: Symptoms and evaluation

Abstract

Neurocognitive impairment, a late effect commonly observed in childhood cancer survivors (CCS), can significantly affect long-term quality of life, particularly in areas such as academic performance and employment. However, in Japan, systematic evaluations to develop effective support strategies remain limited. This paper describes four major types of neurocognitive impairments frequently observed following pediatric cancer treatment: (1) global intellectual decline, (2) impairments in attention and working memory, (3) difficulties in automatic information processing, and (4) executive function deficits. Among these, impairments (1), (2), and (3) can be identified using the Wechsler Intelligence Scale, whereas impairment (4) is most effectively assessed with the addition of the Das–Naglieri Cognitive Assessment System (DN-CAS). Furthermore, we summarize the causes and risk factors of neurocognitive impairment from five perspectives. Before conducting assessments, examiners are expected to collaborate with physicians to exchange relevant information, such as disease characteristics, treatment history, individual factors, social environment, and other late effects, and to integrate this contextual understanding into the evaluation process.