ACCEPTED ABSTRACTS for the American Academy of Pediatric Neuropsychology (AAPdN) Virtual Conference 2021

Abstract

ACCEPTED ABSTRACTS for the American Academy of Pediatric Neuropsychology (AAPdN) Virtual Conference 2021 Identifying Neurocognitive Late-Effects of a Transgender Patient with Pediatric Leukemia Nicole Baggett, MS [email protected] (949) 302-6666 730 SE Oak St., Suite F Hillsboro, OR 97123 Pacific University, School of Graduate Psychology Justin B. Lee, PhD [email protected] (877) 346-0640 707 SW Gaines St., Suite 2115 Portland, OR 97239 Oregon Health & Science University, School of Medicine Objective: Survivors of childhood acute lymphoblastic leukemia (ALL) may demonstrate neurocognitive late effects. There is limited literature regarding neurocognitive functioning of transgender females in light of gender-affirming medical intervention.Moreover, normative samples utilized in neuropsychological tests present a challenge when working with transgender youth. The aim of this case study is to help identify the challenges when working with transgender youth and their families. Methods: Leia is an 11-year-old transgender female treated with intrathecal chemotherapy for high-risk ALL diagnosed at 2 years. She has not received puberty blockers. Primary concerns with executive functioning and mood were endorsed. Leia was administered a comprehensive neuropsychological battery assessing her cognitive functioning, executive functioning, memory, academic skills, fine motor skills, and emotional and behavioral functioning. Results: Leia demonstrated strengths in vocabulary, processing speed, and “cold” executive functioning. Conversely, she demonstrated weaknesses in attention, concentration, and “hot” executive functioning skills. The authors debated on the use of gender-specific reference norms for interpreting selfand parent-report questionnaires. When compared to same-aged cisgender girls, Leia’s profile was flagged with several more “clinically significant” areas of concern than when compared to sameaged cisgender boys. Conclusions: Broadly, Leia’s performance was commensurate with that of the literature examining neurocognitive late-effects of pediatric ALL. Within that context, these authors considered additional factors that may have moderated Leia’s performance including her mood-related concerns, psychosocial difficulties, and the use of gender-specific reference norms. The authors came across limited literature about transgender youth’s neuropsychological performance and additional outcomes to consider when working with this population. Of the existing literature, it was apparent that the medical terminology referring to transgender youth was variable and at times outdated and lacking in inclusivity. This clinical case highlighted the growing impetus to address matters of diversity, equity, and inclusion in the field of pediatric neuropsychology. Sustained Attention’s Contribution to Statistical Discrepancy between Reading Comprehension Tasks Rebecca Bridges, M.A. [email protected] 19555 N 59th Ave, Glendale, AZ 85308 (928)-848-2838 Academic affiliation: Midwestern University, Glendale AZ Jessica Powell Psy.D. [email protected] 19555 N 59th Ave, Glendale, AZ 85308 (623)-572-3215 Academic affiliation: Midwestern University, Glendale AZ Objectives: Anecdotally, on the Academic Achievement Battery (AAB), many examinees performed discrepantly on the two reading comprehension tasks that make up the reading comprehension index (e.g., average on Reading Comprehension:Words and Sentences (RC:WS) but borderline on Reading Comprehension:Passages (RC:P)). Higher order functions (like sustained attention) and oral language skills have been thoroughly researched regarding their impact on reading comprehension as a whole; however, there is currently no research examining how these factors may differentially affect varying types of reading comprehension tasks. It was hypothesized that (H1) the anecdotally observed poorer performance on RC:P compared to RC:WS would be a statistically significant difference, and (H2) deficits in sustained attention and oral language would account for a significant amount of variance in examinee’s RC:P scores. Methods: Archival data from 43 examinees (16+ years) was collected, which included scores from both reading comprehension tasks on the AAB; the Test of Variables of Attention (TOVA) Omission Error Score; and the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Vocabulary score. Results: Results of the two-tailed paired samples t test indicated a significant difference between RC:WS (M=98.33, SD=10.48) and RC:P (M=90.16, SD14.24), t(42)=4.09, p<.001. A standard multiple regression was conducted to determine the accuracy of the independent variables (RC:WS; TOVA; WAIS-IV Vocab) predicting RC:P scores. Regression results indicate that the overall model significantly predicted RC:P scores [R = .342, Radj = .292, F(3, 96) = 6.767, p< .001] and accounts for 29.2% of the variance. Beta weights indicate that only two variables, RC:WS β=.471, t(96)=3.50, p=.001, and TOVA β=.273, t(96)=2.07, p=.045, significantly contributed to the model. Conclusions: Results indicate that deficits in sustained attention predict a significant amount of variance in RC:P scores, whereas oral language does not. Implications for pediatric and adult neuropsychological evaluations utilizing measures such as the AAB, and intervention implications, are further discussed. Journal of Pediatric Neuropsychology https://doi.org/10.1007/s40817-021-00098-7