Clinical psychology and neuropsychology

Child life, social workers and nursing staff regularly provide psychosocial support services to children undergoing cancer treatment and their families, but there are times when a consult with our psychology services staff would be helpful. Typically this is when emotional/behavioral health and neurocognitive/learning issues become acute, interfere with treatment, or limit the child’s quality of life. Our psychologists and postdoctoral fellows will:

• Consult with your child, your family and your child's medical team on emotional/behavioral health and neurocognitive/learning issues to make recommendations for how to improve your child’s quality of life.
• Conduct a neuropsychological evaluation if your child's ability to think, reason or learn has been impacted by cancer treatment.
• Offer ongoing inpatient or outpatient therapy for psychological issues related to cancer treatment.
• Strategize with your child's treatment team when emotional/behavioral health and neurocognitive/learning issues interfere with the delivery or acceptance of optimal medical care.
• Make referrals to providers in the community or communicate with your child’s school as appropriate.

When a psychology consult may be recommended

• Persistent, intense distress. A patient expresses persistent, intense distress that interferes with his quality of life or ability to access medical care. Children may experience withdrawal, throw tantrums, have difficulty eating or sleeping or refuse to comply with recommended treatment.
• Distress or pain related to treatments or procedures. A patient experiences intense distress or pain during procedures or other aspects of treatment that interferes with her quality of life or ability to access medical care.
• Disease-related pain. A patient experiences persistent, intense disease-related pain that interferes with his quality of life or ability to access medical care.
• School refusal. A patient refuses to attend school when she has been medically cleared and is physically capable of going to school.
• Poor adherence. A patient does not follow medical recommendations.
• Patient’s safety. There are concerns about the patient’s safety because of statements or behaviors.
• Psychological disorder. A patient has a known or suspected history of a psychological disorder such as ADHD, anxiety or depression that interferes with his quality of life or ability to access medical care.
• Developmental disorder. A patient has a known or suspected history of a developmental or communication disorder such as Down syndrome or autism that interferes with her quality of life or ability to access medical care.
• General consultation. Psychology staff can consult with the care team to help them support families in difficult situations, such as families experiencing intense distress, conflicts or communication problems.

When a neuropsychological evaluation may be recommended

• For specific diagnoses and treatments. If your child was treated by the neuro-oncology team for tumors of the brain or central nervous system, has neurofibromatosis, had neuro-surgery, received cranial or focal radiation therapy or received intrathecal chemotherapy treatment.

• You notice a change in your child. These changes could include lower grades, difficulty studying or completing homework; behavior problems at home or school; new struggles with attention, planning, organization, self-monitoring, language, learning and memory; or visual spatial/motor functioning.

• Demands at school are about to increase. This normally happens at the start of elementary school, third grade, the start of middle school, seventh grade, the start of high school and during post-secondary school preparation.