Cultural and linguistic issues in the assessment and treatment of pediatric cancer survivors

Rates of childhood cancer have increased in recent years while the mortality rate has decreased with help from advancements in treatment and improvements in diagnosis [1, 2]. As a result, childhood cancer is becoming a chronic disease that can have many neurodevelopmental implications in cognitive functioning, emotional functioning, socialization, and brain-behavior relationships. These neurocognitive consequences are unfortunately common among pediatric patients and are associated with central nervous system (CNS) neoplastic growths and/or involvement along with complex pharmacological and/or radiation treatments. Additionally, these effects often have a delayed onset, long after survival has been established. Hence, neuropsychological assessment and diagnosis is important for a pediatric cancer survivor’s quality of life. When working with those from a minority cultural group, acculturation status, language or barriers to health care become concerns in the assessment and diagnosis of childhood cancer survivors. Adequately validated research or assessment instruments and the use of interpreters may need to be considered. As many empirically validated treatments are based primarily on research involving European-Americans, the neuropsychologist needs a cultural awareness and understanding when evaluating those from different cultures. Subsequently, this chapter discusses culture and language and how they relate to each other, and how both relate to the assessment and treatment of the pediatric cancer survivor.