Functional Outcomes of Paediatric Posterior Fossa Tumour Survivors at Two Quaternary Hospitals in Johannesburg, Gauteng

Abstract

Background. In South Africa, posterior fossa tumours (PFT) are among the most common brain tumours in paediatric neurosurgery units. Little literature has been published on the South African population; therefore, the need for occupational therapy (OT) services has yet to be discovered. This research study aimed to identify the cognitive, visual perception, motor and behaviour outcomes experienced by paediatric PFT survivors that impact their ability to participate in age-appropriate categories of occupation and quality of life (QoL). Methods. This research study was an explanatory, non-experimental multiple case study. Eight children were assessed using standardised assessments before undergoing surgical resection for a PFT, and three children were reassessed six months post-surgery due to the exclusion criteria. The results of the initial assessment and follow-up assessments' results were compared to determine the child’s functional outcome. Results. All three children presented with unique findings regarding their cognitive, visual perception, motor and behavioural outcomes. There was a decline in cognition and behaviour in the male children and visual perception was found to be impacted in the younger children. Motor skills were negatively affected in all the children. Although the children were mostly independent in their activities of daily living (ADLs), the two younger children had developed new onset difficulties with continence and feeding. Regarding quality of life, the children’s self- reports differed from the experience of their caregivers. Conclusion. Paediatric PFT survivors face many challenges that impact their cognitive, visual perception, motor, and behaviour outcomes, which affect their ability to engage in ADLs and their QoL. The results showed that treatment of the PFT rather than the tumour itself resulted in lower QoL in the survivors. By gaining more insight into this population's challenges, OT can be motivated and optimised to suit their specific needs and improve their QoL.