Cognitive Dysfunction
Managing Cognitive Dysfunction in Children with Cancer

Cognitive remediation programs have established usefulness in assisting children and adolescents with cancer to rise above and work around the cognitive impairment experienced as a part of their illness.

Cognitive remediation programs put in place strategies for preparing the child to engage in learning, strategies used during tasks to maintain peak alertness and attention, and cool down post task exercises to ensure optimal performance.

• Warm up My Brain- teach the child about brain functioning at an age appropriate level. This idea conveys that ones brain is activated during a cognitive task.



• Magic/Special Words- the child should chose at least three words that serve as cues to alert the child/adolescent that they are to do their very best work.



• World Record- Use this strategy as a motivational opportunity to promote the highest level of performance. It may be helpful to encourage the child to keep a personal record of his/her performance as an opportunity to gage improvements.

• Talk to Myself- this is a cognitive-behavioral strategy that is both self-encouraging and self-alerting and serves an internal dialogue.



• Mark My Place- Losing one's place when working with a complex material is a common experience. Making tick marks at the beginning or end of rows will aid one in not losing his/her place.



• Look for Shortcuts- children with cognitive impairments should be taught to analyze a task and determine the most efficient way to achieve the end goal.



• Time Out/Start Over- children should be encouraged to recognize when they are making errors, becoming overwhelmed or frustrated. In response to these feelings the child should be encouraged to take a break, ask for help and start over.



• Look at the Floor- many children engage in distraction behaviors. When one becomes distracted it can be helpful to stare at the floor or a blank surface.



• Hints- If a child is struggling, they should be encouraged and taught to seek assistance or a hint.

• Check Your Work



• Ask for Feedback- the child should be encouraged to seek feedback on their level of performance and look for opportunities for improvement



• Reward Yourself- create opportunities to celebrate improved performance or achievement

Note. Adapted from "Attentional processes and their remediation in children treated for cancer: A literature review and the development of a therapeutic approach," by R. Butler and D. Copeland, 2002, Journal of the International Neuropsychological Society, p. 115-124.