Grant: Master's Award: Canada Graduate Scholarships

Brain tumours account for 1/4 of childhood cancer cases. Frontline treatments, such as radiation therapy, damage brain tissue and can lead to negative cognitive outcomes. While advances in proton radiation therapy (PRT) have improved survival rates, negative cognitive outcomes remain very high. Attention and executive function (A/EF; i.e., cognitive processes associated with learning and goal-directed behaviour) are especially vulnerable to PRT, predisposing children to lifelong academic, psychological and social challenges. Previous studies show that A/EF interventions can improve cognitive function in children with acquired brain injuries. Hence, we seek to pilot-test the feasibility and efficacy of a novel tablet-delivered A/EF intervention, delivered by a support worker during the treatment period, to children receiving PRT for brain tumours. We will utilize a non-concurrent multiple baseline case series design with 2 comprehensive assessments pre- and post-intervention and 5 brief baseline/intervention probes before/during the intervention. Five children receiving PRT for brain tumours (ages 4-10 years) will be recruited through our existing partnership with a radiation oncology hospital center. The primary outcome of our pilot study will focus on feasibility, defined as the proportion of planned intervention sessions completed and intervention fidelity. The secondary outcome will be the preliminary efficacy of our intervention, assessed by comparing changes in A/EF following our intervention with estimates of cognitive decline associated with PRT in the literature. Our pilot data will position us to conduct a multicenter randomized clinical validation trial to bridge a critical treatment gap for children receiving PRT and improve long-term health outcomes.