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Peer Interactions, Quality of Play, and Social Problem Solving in Young Children with Brain Tumors

Fri, April 9, 4:30 to 5:30pm EDT (4:30 to 5:30pm EDT), Virtual

Abstract

Introduction: Brain tumors (BT) are a common type of childhood cancer, and incidence rates are highest among children under 5 years of age. Following treatment, children with BT are known to experience interpersonal difficulties such as social isolation and limited social acceptance, and tend to report fewer friends than their same-aged, healthy peers. Nevertheless, little is known about how young children with BT experience friendships or engage in play. By comparing children with BT to an age-matched group with non-CNS solid tumors (ST), this study aimed to assess their social functioning skills and difficulties in social experiences, while also exploring associations between friendships, play, and social skills to inform novel means of intervention.
Methods: Young children (n=51; 62.7% male; 60.8% Caucasian) aged 4-6 (5.27 ±0.76) years, were diagnosed with BT (n=21) or ST (n=30), and ≥5 months off-treatment (1.66 ±1.64 years post-treatment) at the time of assessment. Participants completed a measure of social problem solving (Challenging Situations Task), while parents completed measures of their child’s social functioning (Social Competence Inventory, NIH Toolbox – Emotion Measures), emotional and behavioral functioning (Behavior Assessment for Children, 3rd Edition [BASC-3]), and friendship quality (Quality of Play Questionnaire). Independent samples t-tests were used to compare functioning based on diagnosis, while Pearson’s correlations were used to assess possible relationships between relevant variables.
Results: Young children with BT did not differ significantly from those with ST on indicators of friendship quality, style of play, or social problem solving. Parents reported that children with BT experienced more peer rejection (NIH Peer Rejection; t(48)=-2.18, p<0.05), while children with ST were reported to demonstrate more emotional externalizing (BASC-3 Externalizing Problems; t(47)=3.22, p<0.01) and problematic behaviors (BASC-3 Behavioral Symptoms Index; t(47)=2.60, p<0.05). Children with BT demonstrated significantly stronger associations between peer rejection and social initiative (Z=-2.13, p<0.05), and between positive peer interactions and social initiative (Z=3.26, p<0.01) than peers with ST. Among young children with a playmate, those with BT exhibited stronger relationships between prosocial approaches to problem solving and imaginary play (Z=3.3, p<0.01) and art activities/crafting play (Z=2.09, p<0.05), as well as between aggressive approaches to problem solving and play with computer/video games (Z=2.65, p<0.01). In contrast, those with ST exhibited a stronger relationship between prosocial approaches to problem solving and talking during play (Z=3.57, p<0.01). Though no differences in having a playmate existed between groups, children who did not have a playmate were reported to experience greater peer rejection (t(48)=2.96, p<0.01), and exhibited lower adaptability and social skills (BASC-3 Adaptive Skills; t(46)=-2.07, p<0.05).
Conclusions: Findings indicate that, although young children with BT do not differ significantly in the ways that they interact with friends and peers, their resulting experiences are demonstrably different from age-matched peers. And while they are reported to experience greater peer rejection than their peers, findings also demonstrate that children with BT are more likely to find social benefit from engaging in interactive, creative play with peers, and by building skills of social initiation.

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