Livia Taverna

Adaptive Behaviors in Young Children: A Unique Cultural Comparison in Italy

On account of a series of unique historical events, the present-day denizens of South Tyrol inhabit a cultural, political, and linguistic autonomous region that intercalates Italians and Austrian/ German Italians. The authors compared contemporary Italian and Austrian/German Italian girls’ and boys’ adaptive behaviors in everyday activities in this region. Using the Vineland Adaptive Behavior Scales, the authors first interviewed mothers about their children’s communication, daily living, socialization, and motor skills. Main effects of local culture (and no interactions with gender) emerged: Austrian/German Italian children were rated higher than Italian children in both adaptive daily living and socialization skills. Next, the authors explored ethnic differences in childrearing. Austrian/German Italians reported fostering greater autonomy in their children than Italians, and children’s autonomy was associated with their adaptive behavior. Children living in neighboring Italian and Austrian/German Italian cultural niches appear to experience subtle but consequentially different conditions of development that express themselves in terms of differing levels of adaptive behaviors.

Self-Esteem and Academic Difficulties in Preadolescents and Adolescents Healed from Paediatric Leukaemia

Adolescents with cancer may demonstrate problems in their self-esteem and schooling. This study aims to screen the preadolescents and adolescents more at risk in their self-esteem perception and schooling difficulties post-five years from the end of therapy. Twenty-five paediatric ex-patients healed from leukaemia were recruited at the Haematology-Oncologic Clinic (University of Padua). The mean age of the children was 13.64 years (Standard Deviation (SD)) = 3.08, range = 10–19 years), most were treated for acute lymphoblastic leukaemia (ALL) (84%) and relatively equally distributed by gender. They filled in the Multidimensional Self-Esteem Test, while parents completed a questionnaire on their child’s schooling. Global self-esteem was mostly below the 50 percentile (58.5%), especially regarding interpersonal relationships (75%). An independent sample t-test showed significant mean differences on the emotionality scale (t = 2.23; degree of freedom (df) = 24; p = 0.03) and in the bodily experience scale (t = 3.02; df = 24; p = 0.006) with survivors of Acute Myeloid Leukaemia (AML) having lower scores. An Analysis of Variance (ANOVA) showed significant mean differences in the bodily experience scale (F = 12.31; df = 2, p = 0.0001) depending on the survivors’ assigned risk band. The parent reports showed that 43.5% of children had difficulties at school. Childhood AML survivors with a high-risk treatment were more at risk in their self-esteem perceptions. Preventive interventions focusing on self-esteem and scholastic wellbeing are suggested in order to help their return to their normal schedules.

Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor

CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07–5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children’s motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS’s total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children’s motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis’ tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

Adaptive functioning of 48 preschooler children with leukemia post 1 year of therapies compared with sane peers

Background: Due to advances in chemotherapy and supportive care, about 83% of childhood cancer survivors aged 0-19 years will survive 5 years. More attention has been paid to understand the impact of cancer treatments on children’s development, in particular with respect to late effects Original Research Article Taverna et al.; BJESBS, 18(4): 1-15, 2016; Article no.BJESBS.30322 2 on academic, physical and social functioning, essential for optimization of long-term outcome. Scant literature addresses the functioning of children during acute treatment, mainly focusing on childhood cancer survivors. Aims: This study was aimed at comparing the adaptive functioning in preschooler children with leukemia post 1 year of treatment and a control group of peers who had no history of serious illness. The link between medical factors and adaptive outcomes were investigated. Study Design: Case control study. Place and Duration of Study: Department of Child and Woman Health (Oncology Hematology Division), University of Padua, and pediatricians’ ambulatories in the region of Trentino Alto Adige, between January 2007 and January 2008. Methodology: The participants in this study included 48 leukemic children and their families, recruited at the Haematology-Oncologic Clinic of the Department of Child and Woman Health, University of Padua. Children’s mean age was 52.35 months (SD = 12.85, range = 23-72 months), 22 males and 26 females. Most children had Acute Lymphoblastic Leukemia (ALL) (N = 44), while 4 had Acute Myeloid Leukemia (AML) with a mean days of hospitalization of 56.13 (SD = 49.36, range: 28-315). Sane peers (N=48) were recruited at pediatricians’ ambulatories in the region of Trentino Alto Adige. Each family was interviewed about their children’s adaptive functioning by Vineland Adaptive Behavior Scales. Results: The two samples were homogeneous both for children’s characteristics (age in months and gender) and for their parents’ socio-demographic characteristics. Paired-sample t-tests revealed that parents of children with leukemia reported in their children significantly less adaptive functioning both composite and in three of the four domains: Communication, Socialization and Motor Abilities. The results of a series of ANCOVAs showed that the adaptive functioning in children with leukemia had the following at-risk factors: children aged 37-48 months, major days of hospitalization and the high risk therapy. Conclusion: Future studies should understand better, with an ampler sample and using a multimethod approach, these lower adaptive outcomes in children with leukemia. These findings can guide specific interventions for parents and for children to support the potential developmental delay due to therapies, such as occupational therapy and socialization/educational programs during hospitalization, in occasion of day-hospital follow-ups and at school.