Psychology ETDs


Sarah Hile

Publication Date



Childhood cancer survivors are at risk for long-term neurocognitive morbidities. Current research has only recently begun to examine how these neurocognitive late effects translate into impairments across important aspects of daily living. Additionally, research remains in its early stages of identifying risk factors associated with neurocognitive and broad functional impairments. The current study explores a proposed model of neurocognitive late effects by examining the relationship between neurocognitive deficits and broad functional impairment in cancer survivors relative to healthy controls. The current study also explores the contribution of associated risk factors including treatment severity and time since treatment among cancer survivors and long-term stress reactivity among both cancer survivors and healthy controls. Cancer survivors and healthy controls were between the ages of five and eighteen years. Hair samples were collected from the children to assess cortisol, a measure of long-term stress reactivity. Parents completed a functional impairment questionnaire while a brief neurocognitive exam was administered to the children. Results found no differences in neurocognitive performance or levels of functional impairment in cancer survivors relative to healthy controls; however, verbal reasoning was found to be a more robust predictor of functional impairment (FI) in cancer survivors in comparison to healthy controls. Importantly, and calling into question the validity of FI measurement in children, approximately half of both cancer survivors and health controls reported clinically significant levels of FI. This was in excess of that reported by parents. Additionally, cortisol levels were found to differentially predict neurocognitive performance in cancer survivors relative to healthy controls. Taken together, these findings suggest that verbal reasoning predicts functional impairment, but only in cancer survivors. Additional risk factors require more exploration in future research.

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First Committee Member (Chair)

Yeo, Ron

Second Committee Member

Annett, Robert

Third Committee Member

Emery Thompson, Melissa




pediatric cancer, neurocognitive, late effects, functional impairment

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