Clinical trial NCT06769334: Preparing for Life and Academics for Young Childhood Cancer Survivors
Official title: Digital Health Intervention to Improve Neurodevelopmental Outcomes for Young Childhood Cancer Survivors in Underserved Communities
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Childhood Cancer
Keywords: positive parenting
development
school readiness
digital health
caregiver stress
school advocacy
Lead sponsor: Nationwide Children's Hospital
Sponsor class: OTHER
First posted: 2025-01-10
Enrollment: 15
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SUPPORTIVE_CARE

Brief summary: The goal of this clinical trial is to test and improve an online program for caregivers of young childhood cancer survivors called the Preparing for Life and Academics for Young survivors program (PLAY). The PLAY program was created with a group of caregivers of young children with cancer and healthcare providers. Ultimately, investigators hope to see if the program can improve positive parenting behaviors, reduce caregiver stress, and help get young children ready for school. In the preliminary phase of this clinical trial, investigators are aiming to answer these questions:

1. Are caregivers of childhood cancer survivors willing to participate in the PLAY program and complete assessments before and after the program?
2. Do caregivers of childhood cancer survivors rate the PLAY program as easy to use?
3. Are caregivers of childhood cancer survivors satisfied with the PLAY program?
4. How can the PLAY program be improved in the future?

When the child is transitioning to maintenance phase therapies or off cancer treatment, caregivers will be invited to participate and complete surveys when they begin the study as well as a videotaped interaction task with their child. Children will complete brief developmental testing at the beginning of the program.

Caregivers will then complete the PLAY Program, which will involve completing 7 weekly or bi-weekly online modules and meeting with a trained coach by videoconference for up to 8 one-hour sessions over three months. Sessions will focus on helping their child get ready for school and help their family adjust and cope with stress.

Caregivers will repeat the surveys and videotaped interaction task again three months later, after the PLAY program is completed. They will also be invited to participate in an interview to learn about their experience in the program.

Detailed description: The aim of this study is to refine PLAY to optimize feasibility and acceptability (ORBIT Phase Ib) through rapid-cycle testing with families of YCCS (n=5 per group, up to 15 total) in partnership with advisory boards comprised of 10 families of YCCS, including rural and Appalachian YCCS, and 10 healthcare providers ("co-designers"). Rapid cycle testing to iteratively refine PLAY will determine its optimal timing, dose, and duration until three caregivers sequentially endorse above-average usability (System Usability Scale score \>68), feasibility, and acceptability ratings (\>80%), or n=15 families have completed the PLAY program.

Eligibility criteria: Inclusion Criteria:

* Caregiver is the legal guardian of the child (e.g., mothers, fathers, grandparents, adoptive parents)
* Caregiver lives with the child more than 50% of the time
* Caregiver primary language is English
* Caregiver lives within 150 miles of Nationwide Children's Hospital
* Childhood cancer survivor received treatment for their cancer (e.g., chemotherapy, surgical resection, radiation therapy)
* Childhood cancer survivor completed cancer treatment or on maintenance therapy only, without evidence of recurrent disease
* Childhood cancer survivor is currently between the ages of 3 years old to 6 years old, but no older than 6.5 years old at study enrollment

Exclusion Criteria:

* Childhood cancer survivor has documented neurodevelopmental disorder prior to their cancer diagnosis (e.g., neurofibromatosis, tuberous sclerosis, Down's syndrome, autism)
* Childhood cancer survivor did not receive any treatment (e.g., chemotherapy, surgical resection, radiation)
* Childhood cancer survivors was treated for a benign tumor

Primary outcomes:
measure: System Usability Scale
timeFrame: 3 Months Post-Enrollment
measure: Appropriateness Measure (AM)
timeFrame: 3 Months Post-Enrollment
measure: Acceptability of Intervention Measure (AIM)
timeFrame: 3 Months Post-Enrollment
measure: Feasibility of Intervention (FIM)
timeFrame: 3 Months Post-Enrollment
measure: Adapted Website Evaluation Questionnaire (WEQ)
timeFrame: 3 Months Post-Enrollment
Secondary outcomes:
Other outcomes:
Locations:
city: Columbus
country: United States
facility: Nationwide Children&#39;s Hospital
state: Ohio
Study officials:
References:
citation: Yao N, Alcala HE, Anderson R, Balkrishnan R. Cancer Disparities in Rural Appalachia: Incidence, Early Detection, and Survivorship. J Rural Health. 2017 Sep;33(4):375-381. doi: 10.1111/jrh.12213. Epub 2016 Sep 7.
citation: Wochos GC, Semerjian CH, Walsh KS. Differences in parent and teacher rating of everyday executive function in pediatric brain tumor survivors. Clin Neuropsychol. 2014;28(8):1243-57. doi: 10.1080/13854046.2014.971875. Epub 2014 Oct 24.
citation: Winter AL, Conklin HM, Tyc VL, Stancel H, Hinds PS, Hudson MM, Kahalley LS. Executive function late effects in survivors of pediatric brain tumors and acute lymphoblastic leukemia. J Clin Exp Neuropsychol. 2014;36(8):818-30. doi: 10.1080/13803395.2014.943695. Epub 2014 Aug 15.
citation: Willard VW, Qaddoumi I, Zhang H, Huang L, Russell KM, Brennan R, Wilson MW, Rodriguez-Galindo C, Phipps S. A longitudinal investigation of parenting stress in caregivers of children with retinoblastoma. Pediatr Blood Cancer. 2017 Apr;64(4):10.1002/pbc.26279. doi: 10.1002/pbc.26279. Epub 2016 Nov 3.
citation: Willard VW, Gordon ML, Means B, Brennan RC, Conklin HM, Merchant TE, Vinitsky A, Harman JL. Social-Emotional Functioning in Preschool-Aged Children With Cancer: Comparisons Between Children With Brain and Non-CNS Solid Tumors. J Pediatr Psychol. 2021 Aug 11;46(7):790-800. doi: 10.1093/jpepsy/jsab018.
citation: Willard VW, Cox LE, Russell KM, Kenney A, Jurbergs N, Molnar AE Jr, Harman JL. Cognitive and Psychosocial Functioning of Preschool-Aged Children with Cancer. J Dev Behav Pediatr. 2017 Oct;38(8):638-645. doi: 10.1097/DBP.0000000000000512.
citation: Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3.
citation: Ward R, Reynolds JE, Pieterse B, Elliott C, Boyd R, Miller L. Utilisation of coaching practices in early interventions in children at risk of developmental disability/delay: a systematic review. Disabil Rehabil. 2020 Oct;42(20):2846-2867. doi: 10.1080/09638288.2019.1581846. Epub 2019 Apr 25.
citation: Wade SL, Cassedy AE, Shultz EL, Zang H, Zhang N, Kirkwood MW, Stancin T, Yeates KO, Taylor HG. Randomized Clinical Trial of Online Parent Training for Behavior Problems After Early Brain Injury. J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):930-939.e2. doi: 10.1016/j.jaac.2017.09.413. Epub 2017 Sep 14.
citation: Vance YH, Eiser C. The school experience of the child with cancer. Child Care Health Dev. 2002 Jan;28(1):5-19. doi: 10.1046/j.1365-2214.2002.00227.x.
citation: Van Schoors M, Caes L, Knoble NB, Goubert L, Verhofstadt LL, Alderfer MA; Guest Editors: Cynthia A. Gerhardt, Cynthia A. Berg, Deborah J. Wiebe and Grayson N. Holmbeck. Systematic Review: Associations Between Family Functioning and Child Adjustment After Pediatric Cancer Diagnosis: A Meta-Analysis. J Pediatr Psychol. 2017 Jan 1;42(1):6-18. doi: 10.1093/jpepsy/jsw070.
citation: Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 2003 Aug 1;1:29. doi: 10.1186/1477-7525-1-29.
citation: Schorr E, Wade SL, Taylor HG, Stancin T, Yeates KO. Parenting styles as a predictor of long-term psychosocial outcomes after traumatic brain injury (TBI) in early childhood. Disabil Rehabil. 2020 Aug;42(17):2437-2443. doi: 10.1080/09638288.2019.1602676. Epub 2019 Apr 21.
citation: Rodriguez EM, Dunn MJ, Zuckerman T, Vannatta K, Gerhardt CA, Compas BE. Cancer-related sources of stress for children with cancer and their parents. J Pediatr Psychol. 2012 Mar;37(2):185-97. doi: 10.1093/jpepsy/jsr054. Epub 2011 Aug 13.
citation: Robinson KE, Kuttesch JF, Champion JE, Andreotti CF, Hipp DW, Bettis A, Barnwell A, Compas BE. A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatr Blood Cancer. 2010 Sep;55(3):525-31. doi: 10.1002/pbc.22568.
citation: Riggs NR, Jahromi LB, Razza RP, Dillworth-Bart JE, Mueller U. Executive function and the promotion of social-emotional competence. Journal of Applied Developmental Psychology. 2006;27(4):300-9.
citation: Potter JL, Wade SL, Walz NC, Cassedy A, Stevens MH, Yeates KO, Taylor HG. Parenting style is related to executive dysfunction after brain injury in children. Rehabil Psychol. 2011 Nov;56(4):351-8. doi: 10.1037/a0025445. Epub 2011 Sep 19.
citation: Phillips SM, Padgett LS, Leisenring WM, Stratton KK, Bishop K, Krull KR, Alfano CM, Gibson TM, de Moor JS, Hartigan DB, Armstrong GT, Robison LL, Rowland JH, Oeffinger KC, Mariotto AB. Survivors of childhood cancer in the United States: prevalence and burden of morbidity. Cancer Epidemiol Biomarkers Prev. 2015 Apr;24(4):653-63. doi: 10.1158/1055-9965.EPI-14-1418.
citation: Peterson CC, Drotar D. Family impact of neurodevelopmental late effects in survivors of pediatric cancer: review of research, clinical evidence, and future directions. Clin Child Psychol Psychiatry. 2006 Jul;11(3):349-66. doi: 10.1177/1359104506064980.
citation: Patel SK, Wong AL, Cuevas M, Van Horn H. Parenting stress and neurocognitive late effects in childhood cancer survivors. Psychooncology. 2013 Aug;22(8):1774-82. doi: 10.1002/pon.3213. Epub 2012 Oct 25.
citation: Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000 Dec 15;23(8):1043-51.
citation: Ostrom QT, Gittleman H, Xu J, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2009-2013. Neuro Oncol. 2016 Oct 1;18(suppl_5):v1-v75. doi: 10.1093/neuonc/now207. No abstract available.
citation: Neu MA, Schlecht J, Schmidt MF, Robinson AL, Spix C, Grabow D, Kaatsch P, Erdmann F, Faber J, Urschitz MS; IkidS Study Group. Mental health and health-related quality of life in preschool-aged childhood cancer survivors. Results of the prospective cohort study ikidS-OEVA. Pediatr Blood Cancer. 2021 Aug;68(8):e29039. doi: 10.1002/pbc.29039. Epub 2021 May 7.
citation: Moscato E, Patronick J, Wade SL. Family functioning and adaptation following pediatric brain tumor: A systematic review. Pediatr Blood Cancer. 2022 Feb;69(2):e29470. doi: 10.1002/pbc.29470. Epub 2021 Nov 29.
citation: McKercher KA. Beyond Sticky Design: Codesign for Real Inscope Books; 2020.
citation: McClelland MM, Acock AC, Morrison FJ. The impact of kindergarten learning-related skills on academic trajectories at the end of elementary school. Early childhood research quarterly. 2006;21(4):471-90.
citation: Merz EC, Landry SH, Montroy JJ, Williams JM. Bidirectional Associations Between Parental Responsiveness and Executive Function During Early Childhood. Soc Dev. 2017 Aug;26(3):591-609. doi: 10.1111/sode.12204. Epub 2016 Jul 22.
citation: Maurice-Stam H, Oort FJ, Last BF, Brons PP, Caron HN, Grootenhuis MA. Longitudinal assessment of health-related quality of life in preschool children with non-CNS cancer after the end of successful treatment. Pediatr Blood Cancer. 2008 May;50(5):1047-51. doi: 10.1002/pbc.21374.
citation: Mann TD, Hund AM, Hesson-McInnis MS, Roman ZJ. Pathways to school readiness: Executive functioning predicts academic and social-emotional aspects of school readiness. Mind, Brain, and Education. 2017;11(1):21-31.
citation: Maggard BL, Gies LM, Sidol CA, Moscato EL, Schmidt M, Landry SH, Makoroff KL, Rhine TD, Wade SL. Online Intervention for Caregivers of Children with Early Traumatic Brain Injury: Pilot Trial. J Pediatr Psychol. 2023 Mar 20;48(3):205-215. doi: 10.1093/jpepsy/jsac080.
citation: Loyd BH, Abidin RR. Revision of the Parenting Stress Index. J Pediatr Psychol. 1985 Jun;10(2):169-77. doi: 10.1093/jpepsy/10.2.169. No abstract available.
citation: Lansford JE, Odgers CL, Bradley RH, Godwin J, Copeland WE, Rothenberg WA, Dodge KA. The HOME-21: A revised measure of the home environment for the 21st century tested in two independent samples. Psychol Assess. 2023 Jan;35(1):1-11. doi: 10.1037/pas0001183. Epub 2022 Sep 29.
citation: Landry SH, Zucker TA, Williams JM, Merz EC, Guttentag CL, Taylor HB. Improving school readiness of high-risk preschoolers: Combining high quality instructional strategies with responsive training for teachers and parents. Early Childhood Research Quarterly. 2017;40:38-51.
citation: Landry SH, Taylor HB, Guttentag C, Smith KE. Responsive parenting: Closing the learning gap for children with early developmental problems. International review of research in mental retardation. 2008;36:27-60.
citation: Landry SH, Smith KE, Swank PR, Zucker T, Crawford AD, Solari EF. The effects of a responsive parenting intervention on parent-child interactions during shared book reading. Dev Psychol. 2012 Jul;48(4):969-86. doi: 10.1037/a0026400. Epub 2011 Nov 28.
citation: Landry SH, Smith KE, Swank PR, Guttentag C. A responsive parenting intervention: the optimal timing across early childhood for impacting maternal behaviors and child outcomes. Dev Psychol. 2008 Sep;44(5):1335-53. doi: 10.1037/a0013030.
citation: Krull KR, Hardy KK, Kahalley LS, Schuitema I, Kesler SR. Neurocognitive Outcomes and Interventions in Long-Term Survivors of Childhood Cancer. J Clin Oncol. 2018 Jul 20;36(21):2181-2189. doi: 10.1200/JCO.2017.76.4696. Epub 2018 Jun 6.
citation: Kenney AE, Harman JL, Molnar AE Jr, Jurbergs N, Willard VW. Early Cognitive and Adaptive Functioning of Clinically Referred Infants and Toddlers with Cancer. J Clin Psychol Med Settings. 2020 Mar;27(1):41-47. doi: 10.1007/s10880-019-09619-1.
citation: Kendall S, Bloomfield L. Developing and validating a tool to measure parenting self-efficacy. J Adv Nurs. 2005 Jul;51(2):174-81. doi: 10.1111/j.1365-2648.2005.03479.x.
citation: Kaminski JW, Barrueco S, Kelleher KJ, Hoagwood K, Edwards A, Fox EG. Vital Signs for Pediatric Health: School Readiness. NAM Perspect. 2023 Jun 26;2023:10.31478/202306b. doi: 10.31478/202306b. eCollection 2023. No abstract available.
citation: Vrijmoet-Wiersma CM, van Klink JM, Kolk AM, Koopman HM, Ball LM, Maarten Egeler R. Assessment of parental psychological stress in pediatric cancer: a review. J Pediatr Psychol. 2008 Aug;33(7):694-706. doi: 10.1093/jpepsy/jsn007. Epub 2008 Feb 19.
citation: Jacola LM, Krull KR, Pui CH, Pei D, Cheng C, Reddick WE, Conklin HM. Longitudinal Assessment of Neurocognitive Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia Treated on a Contemporary Chemotherapy Protocol. J Clin Oncol. 2016 Apr 10;34(11):1239-47. doi: 10.1200/JCO.2015.64.3205. Epub 2016 Feb 8.
citation: Hullmann SE, Wolfe-Christensen C, Meyer WH, McNall-Knapp RY, Mullins LL. The relationship between parental overprotection and health-related quality of life in pediatric cancer: the mediating role of perceived child vulnerability. Qual Life Res. 2010 Nov;19(9):1373-80. doi: 10.1007/s11136-010-9696-3. Epub 2010 Jun 24.
citation: Hocking MC, McCurdy M, Turner E, Kazak AE, Noll RB, Phillips P, Barakat LP. Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology. Pediatr Blood Cancer. 2015 Mar;62(3):375-84. doi: 10.1002/pbc.25300. Epub 2014 Nov 8.
citation: Hile S, Erickson SJ, Agee B, Annett RD. Parental stress predicts functional outcome in pediatric cancer survivors. Psychooncology. 2014 Oct;23(10):1157-64. doi: 10.1002/pon.3543. Epub 2014 May 10.
citation: Harman JL, Molnar AE Jr, Cox LE, Jurbergs N, Russell KM, Wise J, Willard VW. Parent-reported executive functioning in young children treated for cancer. Child Neuropsychol. 2019 May;25(4):548-560. doi: 10.1080/09297049.2018.1503647. Epub 2018 Jul 26.
citation: Grieco JA, Evans CL, Yock TI, Pulsifer MB. Psychosocial and executive functioning late effects in pediatric brain tumor survivors after proton radiation. Childs Nerv Syst. 2024 Nov;40(11):3553-3561. doi: 10.1007/s00381-024-06579-2. Epub 2024 Sep 2.
citation: Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997 Jul;38(5):581-6. doi: 10.1111/j.1469-7610.1997.tb01545.x.
citation: Godoy PBG, Simionato NM, de Mello CB, Suchecki D. Assessment of Executive Functions after Treatment of Childhood Acute Lymphoid Leukemia: a Systematic Review. Neuropsychol Rev. 2020 Sep;30(3):386-406. doi: 10.1007/s11065-020-09446-4. Epub 2020 Jul 27.
citation: French AE, Tsangaris E, Barrera M, Guger S, Brown R, Urbach S, Stephens D, Nathan PC. School attendance in childhood cancer survivors and their siblings. J Pediatr. 2013 Jan;162(1):160-5. doi: 10.1016/j.jpeds.2012.06.066. Epub 2012 Jul 24.
citation: Fehr KK, Leraas BC, Littles MMD. Behavioral Health Needs, Barriers, and Parent Preferences in Rural Pediatric Primary Care. J Pediatr Psychol. 2020 Sep 1;45(8):910-920. doi: 10.1093/jpepsy/jsaa057.
citation: Elling S, Lentz L, de Jong M, van den Bergh H. Measuring the quality of governmental websites in a controlled versus an online setting with the 'Website Evaluation Questionnaire'. Government Information Quarterly. 2012;29(3):383-93.
citation: Eisenberg N, Valiente C, Eggum ND. Self-Regulation and School Readiness. Early Educ Dev. 2010 Sep 1;21(5):681-698. doi: 10.1080/10409289.2010.497451.
citation: Duncan GJ, Dowsett CJ, Claessens A, Magnuson K, Huston AC, Klebanov P, Pagani LS, Feinstein L, Engel M, Brooks-Gunn J, Sexton H, Duckworth K, Japel C. School readiness and later achievement. Dev Psychol. 2007 Nov;43(6):1428-1446. doi: 10.1037/0012-1649.43.6.1428.
citation: Dumka, L. E., Stoerzinger, H. D., Jackson, K. M., & Roosa, M. W. (1996). Examination of the Cross-Cultural and Cross-Language Equivalence of the Parenting Self-Agency Measure. Family Relations, 45(2), 216-222. https://doi.org/10.2307/585293
citation: Denham SA. Social-Emotional Competence as Support for School Readiness: What Is It and How Do We Assess It? Early Education and Development. 2006;17(1):57-89. doi: 10.1207/s15566935eed1701_4
citation: Denham SA, Brown C. "Plays Nice With Others": Social-Emotional Learning and Academic Success. Early Education and Development. 2010;21(5):652-80. doi: 10.1080/10409289.2010.497450.
citation: Curtis ME, Clingan SE, Guo H, Zhu Y, Mooney LJ, Hser YI. Disparities in digital access among American rural and urban households and implications for telemedicine-based services. J Rural Health. 2022 Jun;38(3):512-518. doi: 10.1111/jrh.12614. Epub 2021 Aug 6.
citation: Cox LE, Kenney AE, Harman JL, Jurbergs N, Molnar AE Jr, Willard VW. Psychosocial Functioning of Young Children Treated for Cancer: Findings From a Clinical Sample. J Pediatr Oncol Nurs. 2019 Jan/Feb;36(1):17-23. doi: 10.1177/1043454218813905.
citation: Cortes Pascual A, Moyano Munoz N, Quilez Robres A. The Relationship Between Executive Functions and Academic Performance in Primary Education: Review and Meta-Analysis. Front Psychol. 2019 Jul 11;10:1582. doi: 10.3389/fpsyg.2019.01582. eCollection 2019.
citation: Raj SP, Antonini TN, Oberjohn KS, Cassedy A, Makoroff KL, Wade SL. Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents. J Head Trauma Rehabil. 2015 Sep-Oct;30(5):347-56. doi: 10.1097/HTR.0000000000000052.
citation: Campbell LK, Scaduto M, Van Slyke D, Niarhos F, Whitlock JA, Compas BE. Executive function, coping, and behavior in survivors of childhood acute lymphocytic leukemia. J Pediatr Psychol. 2009 Apr;34(3):317-27. doi: 10.1093/jpepsy/jsn080. Epub 2008 Jul 30.
citation: Burek B, Ford MK, Hooper M, Green R, Kohut SA, Andrade BF, Ravi M, Sananes R, Desrocher M, Miller SP, Wade SL, Williams TS. Transdiagnostic feasibility trial of internet-based parenting intervention to reduce child behavioural difficulties associated with congenital and neonatal neurodevelopmental risk: introducing I-InTERACT-North. Clin Neuropsychol. 2021 Jul;35(5):1030-1052. doi: 10.1080/13854046.2020.1829071. Epub 2020 Oct 8.
citation: Boterhoven de Haan KL, Hafekost J, Lawrence D, Sawyer MG, Zubrick SR. Reliability and validity of a short version of the general functioning subscale of the McMaster Family Assessment Device. Fam Process. 2015 Mar;54(1):116-23. doi: 10.1111/famp.12113. Epub 2014 Nov 11.
citation: Bird M, Li L, Ouellette C, Hopkins K, McGillion MH, Carter N. Use of Synchronous Digital Health Technologies for the Care of Children With Special Health Care Needs and Their Families: Scoping Review. JMIR Pediatr Parent. 2019 Nov 21;2(2):e15106. doi: 10.2196/15106.
citation: Beauchamp MH, Seguin M, Gagner C, Lalonde G, Bernier A. The PARENT model: a pathway approach for understanding parents' role after early childhood mild traumatic brain injury. Clin Neuropsychol. 2021 Jul;35(5):846-867. doi: 10.1080/13854046.2020.1834621. Epub 2020 Oct 26.
citation: Baumel A, Fleming T, Schueller SM. Digital Micro Interventions for Behavioral and Mental Health Gains: Core Components and Conceptualization of Digital Micro Intervention Care. J Med Internet Res. 2020 Oct 29;22(10):e20631. doi: 10.2196/20631.
citation: Aguilar JM, Cassedy AE, Shultz EL, Kirkwood MW, Stancin T, Yeates KO, Taylor HG, Wade SL. A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors. J Head Trauma Rehabil. 2019 Mar/Apr;34(2):65-76. doi: 10.1097/HTR.0000000000000443.
citation: Ackerman DJ, Friedman-Krauss AH. Preschoolers' executive function: Importance, contributors, research needs and assessment options. ETS Research Report Series. 2017;2017(1):1-24.
citation: Ach E, Gerhardt CA, Barrera M, Kupst MJ, Meyer EA, Patenaude AF, Vannatta K. Family factors associated with academic achievement deficits in pediatric brain tumor survivors. Psychooncology. 2013 Aug;22(8):1731-7. doi: 10.1002/pon.3202. Epub 2012 Oct 12.