SPECIFIC LEARNING-PROBLEMS AMONG CHILDREN TREATED FOR ACUTE LYMPHOBLASTIC-LEUKEMIA

Since the introduction of central nervous system prophylaxis in the tr eatment of childhood acute lymphoblastic leukemia, cognitive deficits have been apparent in the increasing numbers of survivors of the disea se. Originally this iatrogenic effect was widely attributed to prophyl actic cranial irradiation, but it does not appear to have been removed by substitution of more intensive chemotherapy. Psychological studies of survivors of acute lymphoblastic leukemia initially focused on dem onstrating the existence of this cognitive deficit, but more recently have turned to elucidation of its nature. A consensus is emerging that the deficit is manifested primarily in memory and attention, although some visual processes also seem to be particularly affected. A slowin g of processing and/or a reduction in attentional capacity has been pr oposed to account for these findings, but several aspects of the defic it, and the contributions of treatment variables to it, remain to be e lucidated. This article examines the literature on the subject, with p articular attention to studies since 1988.