Background/Objectives: Pediatric oncology patients and families are at risk for increased distress at diagnosis. The New Oncology Program in Psychology (NOPP) aligns psychological care with the established standards of care at diagnosis. This project aimed to evaluate NOPP and understand the differences between caregivers’ perceptions of feeling informed and prepared to navigate psychosocial concerns for those who did and did not receive psychological services at diagnosis. Methods: A survey was administered via a virtual platform. Frequency analyses summarize caregiver experiences and concerns. Mann–Whitney U tests assess the differences in caregiver knowledge and preparedness between caregivers who did and did not receive psychological services. Results: Caregivers reported difficult emotions at diagnosis and expressed concern for the impact of diagnosis and treatment across broad domains of patient functioning. Caregivers of patients who received psychology consultation felt more informed about difficult emotions and how these may change over time. They felt more prepared and equipped with strategies to manage difficult emotions. Caregivers of patients who completed a cognitive assessment also felt more informed and prepared regarding the potential effects of the diagnosis and treatment on patient cognitive/academic functioning. Conclusions: Psychological services were associated with caregivers’ positive perceptions surrounding the management of difficult emotions and with their knowledge regarding the cognitive/academic impact. The results inform the ongoing modification of NOPP.

Survivors of pediatric brain tumor (BT) are known to be at risk for developing cognitive and psychosocial late effects. Young age at treatment (≤6 years) is typically considered to put patients at increased risk. However, there is limited research specifically exploring functioning in these young patients. Cognitive and psychosocial data were retrospectively abstracted from medical charts for 79 young patients (54.4% male) treated for BT with a variety of treatment modalities (e.g., surgery, radiation therapy, chemotherapy). Children were clinically assessed at 4.52 years of age (range = 1.48–5.98) and most were off-therapy (74.4%). Mean performances on developmental (68.3 ± 10.02), cognitive (88.09 ± 18.38), and pre-academic (86.84 ± 19.75) measures were all below average. Parent report of adaptive functioning was also below average (82.10 ± 16.21), but psychosocial functioning was generally within normal limits. Most patients had impaired functioning (scores <10th percentile) in at least one domain assessed. Exploratory analyses revealed that many patients (27.3–60.6%) exhibited a significant discrepancy between domains of cognitive functioning (e.g., verbal and spatial). Young children treated for BT experienced high rates of impairment in cognitive, pre-academic, and adaptive domains. Future work is needed to focus on serial longitudinal assessment of these young patients, as well as dedicated intervention and prevention efforts.

Objective: Through the use of quality improvement methodology, we aimed to increase the percent of eligible patients seen for developmental testing at our institution from 2.6% to 25% within a 36-month timeframe. Method: The Model for Improvement ( Langley et al., 2009 ) was utilized as a framework to develop and implement an interdisciplinary, hospital-based early intervention program that included comprehensive developmental assessments intended to inform intervention services. A kaizen event was used to map current processes, identify desired future state, and identify potential interventions. Outcomes were demonstrated through use of an annotated run chat and calculation of the percent of eligible patients seen. Descriptive feedback was solicited by e-mail from interdisciplinary team members. Results: The percent of eligible patients seen for clinical comprehensive developmental assessments and provided in-house early intervention services increased to 35.5% ( N = 155). Multidisciplinary team members reported that collaboration has improved, leading to enhanced developmental service delivery. Conclusions: This quality improvement initiative resulted in a program that filled a substantial clinical need at our institution. Pediatric psychologists could utilize the model for improvement to similarly enhance the quality of care for very young patients with cancer in their hospital settings. In doing so, professionals who work at hospitals dependent upon clinical revenues may consider utilization of Medicaid’s early and periodic screening, diagnostic, and treatment benefit. Implications for Impact Statement: Efforts to increase the number of very young children with cancer seen for developmental assessments were successful at one institution. Other settings could implement similar processes to enhance services for young children.

Sleep disturbance is common in young children who are otherwise healthy, and even more so in children with cancer. To address sleep disturbance in early childhood, caregivers may utilize bedsharing...