Pragmatic and cognitive abilities in children and adolescents after pediatric brain tumor

Pediatric Brain Tumors (PBT) vary in type, grade, and location, and lead to different clinical outcomes and treatments. Standard interventions often include neurosurgery followed by chemotherapy and/or radiotherapy, which improve survival rates and reduce the risk of relapse, but can also lead to neurocognitive impairments. Although there has been increasing interest in the neuropsychological effects of PBT, pragmatic ability (i.e. the way people use verbal and non-verbal communication in a given context) is still under-researched. This study aimed to help fill the gap in identifying and characterizing pragmatic ability in children following PBT. In particular, children's performance has been compared with that of children with Typical Development (TD). The study involved 20 PBT survivors (aged 6–16 years) who were matched by age and sex with 23 TD children. Pragmatic ability was assessed using the Assessment Battery for Communication (ABaCo), which evaluates several pragmatic phenomena in both comprehension and production using various means of expression. The results showed that children after PBT performed significantly worse than the TD group in both pragmatic comprehension and production. In particular, children who underwent both radiotherapy and chemotherapy showed the greatest difficulties. These results emphasize the importance of a comprehensive and multimodal communicative assessment, as provided by the ABaCo, and highlight the need to focus on less commonly studied areas, such as the use of gestures and paralinguistic cues, contextual sensitivity and conversational skills, to gain a better understanding of communication outcomes following PBT.