Late Effects Assessment Programme: Thinking and learning

Late Effects Assessment Programme: Thinking and learning

Your cancer or cancer treatment may cause problems with your ability to think and learn. Research indicates that survivors of childhood cancer are more likely to have learning difficulties than their peers. Attending the Late Effects Assessment Programme (LEAP) will help you identify if there is a problem and what you should do about that.

Key points to remember

  • the LEAP Programme provides regular assessment and monitoring for all survivors of childhood cancer throughout New Zealand
  • at the LEAP clinic your child or young person will be seen by:
    • a haematologist or oncologist
    • a nurse specialist
    • a clinical psychologist
  • your child is welcome to bring their parent or other family member with them
  • as part of this assessment, the clinical psychologist will ask your child about their thinking and learning (cognitive) ability, and if there are any concerns, a further assessment may occur. This is called a neuropsychological assessment

What causes thinking and learning (cognitive) difficulties?

Your child may experience long term or ‘late effects’ from their disease or treatment. It depends on the type of cancer, type of treatment, and their thinking and learning (cognitive) ability before treatment. Sometimes learning difficulties show up several years after treatment.

Research indicates that in general survivors of childhood cancer are more likely to have learning difficulties than their peers.  However, it is important to remember that everybody is different. One survivor may have a number of different learning difficulties, while for many others there may be no problems at all.

Which areas are most likely to be affected?

  • attention and concentration
  • working memory (doing things ‘in your head’ such as mental arithmetic)
  • planning and organising
  • processing speed – rate of thinking and the speed with which thinking tasks are completed
  • problems in these areas may then affect academic functioning – those skills required to cope with day to day school performance

Research indicates that there are several factors that may increase the chance of a cancer survivor experiencing cognitive difficulties / problems.

These include:

  • biological factors (such as tumour size and location)
  • type of treatment used (such as surgery, cranial irradiation, chemotherapy drugs which cross the blood/brain barrier)
  • more aggressive treatment (cognitive difficulties are more likely to be associated with higher doses of drug/radiation)
  • being younger at age of treatment
  • being female
  • non-biological factors (such as missed school days, loss of social and environmental stimulation)

What is the purpose of a neuropsychological assessment?

  • to identify problems in thinking which might affect learning or learning the skills needed for everyday living
  • to provide the young person and their family with information on their strengths and difficulties - this can help with important decisions about education, life and career choices
  • to recommend extra help where appropriate

What does a neuropsychological assessment involve?

  • before the assessment your child must agree to undergo a in-depth assessment
  • the assessor will collect information from your child, you (their parent) and their school. This involves completing several questionnaires as well as discussion
  • the assessment will take up to six hours of face to face contact between your child and the clinical psychologist.  This may be spread over two or more sessions. During this process, your child will be asked to answer questions and do tasks which involve problem solving such as building patterns with blocks, remembering information and paying attention

What happens after the assessment?

  • The LEAP team will discuss the results with you and your child
  • after discussion, a report is finalised and copies will be sent to the you and your child’s health care team
  • depending on the needs of the your child (and with you and your child’s consent), the clinical psychologist may seek support from the Ministry of Education, their school, the Child Cancer Foundation and CanTeen. These organsiations will make a decision about what type of support they are able to offer


All the fact sheets in the Childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the National Child Cancer Network Clinical Leader.

Attached Files: 

This page last reviewed 12 April 2013.
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