Consensus Statements: Development and Testing of the School Competency Assessment Scale

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71
Consensus
Statements:
Development
and
Testing
of
the
School
Competency
Assessment
Scale
Audrey
Nelson,
PhD,
RN,
Julia
Challinor,
PhD,
RN,
Ida
(Ki)
Moore,
DNS,
RN,
Robert
B.
Noll,
PhD,
Nancy
Cushen
White,
EdD,
Jill
Brace
O’Neill,
MSN,
RN-CS,
PNP,
and
Laura
Clarke-Steffen,
PhD,
RN
CONSENSUS
STATEMENTS:
Development
and
Testing
of
the
School
Competency
Assessment
Scale
Survival
rate
of
children
under
15 years
of
age
from
acute
lymphoblastic
leukemia
(ALL)
is
approximately
80%
(Greenlee,
Murray,
Bolden,
&
Wingo,
2000).
Treatment
of
ALL
includes
whole-brain
radiation,
intrathecal
chemotherapy,
and
high-dose
systemic
chemotherapy.
These
modalities
are
effective
in
reducing
the
risk
of
central
nervous
system
(CNS)
relapse
(Balis
&
Poplack,
1989).
However,
the
effects
of
CNS
treatment
result
in
declines
of
the
child’s
cognitive
and
academic
skills
(Brown
et
al.,
1996;
Copeland,
Moore,
Francis, Jaffe,
&
Culbert,
1996;
the
MacLean
et
al.,
1995;
Smibert,
Anderson,
Godber,
&
Ekert,
1996).
Moore
and
colleagues
(2000)
reported
preliminary
evidence
that
CNS
injury
may
result
in
differences
in
intellectual
and
academic
outcomes
in
children
with
ALL
receiving
CNS
treatment.
They
identified
other
factors
that
may
also
affect
academic
performance.
These
include
missed
school,
fatigue,
and
availability
of
tutorial
assistance.
Additionally,
it
has
been
recommended
that
the
process
of
developing
and
testing
interventions
through
interdisciplinary
collaboration
needs
to
be
outlined
(Auger
et
al.,
2000).
A
preconference
workshop
at
the
Association
of
Pediatric
Oncology
Nursing’s
24th
Annual
Conference,
held
in
2000,
focused
on
the
development
and
testing
of the
School
Competence
Assessment
Scale
(SCAS).
The
SCAS
is
a
questionnaire
including
forms
for
the
parent
of
children
who
are
newly
diagnosed
with
cancer
as
well
as
their
teacher
and
health
team.
Numerous
factors
related
to
cognitive
and
academic
deficits
for
children
with
ALL
were
identified.
These
included
age
of
the
child
when
ALL
treatment
was
received,
gender,
socioeconomic
status
of
the
family,
school
class
size,
and
interaction
with
others.
After
the
workshop,
the
presenters
and
workshop
planning
committee
members
reviewed
the
notes
from
discussion
and
developed
consensus
statements.
These
consensus
statements
are
as
follows:
1.
A
psychosocial
team
that
includes
nurses,
social
workers,
psychologists,
child
life,
and
educators
contribute
to
the
treatment
plan
of
a
child/adolescent
with
cancer.
2.
Age-appropriate
cognitive
and
readiness
assessments
need
to
be
incorporated
in
the
child’s
treatment
plan.
3.
A
child’s
treatment
plan
needs
to
include
cognitive
and
readiness
assessments
annually
after
the
From
the
University
of Nebraska
Medical
Center,
College
of Nursing,
Omaha,
NE;
University
of
California,
San
Francisco
Division
of
Pediatric
Oncology,
San
Franczsco,
CA;
University
of Arizona
Division
of Pediatric
HematologylOncology,
Tucson,
AZ;
Chzldren’s
Hospital
Medical
Center
Division
of
HematologylOncology,
Cincinnati,
OH;
University
of
California,
San
Francisco,
Department
of Pediatrics,
Division
of Adolescent
Medicine,
San
Francisco,
CA;
Dana
Farber
Cancer
Institute,
Boston,
MA;
and
Phoenix
Children’s
Hospital,
Phoenix,
AZ.
Address
reprint
requests
to
Audrey
Nelson,
PhD,
RN,
Associate
Professor,
University
of
Nebraska Medical
Center,
College
of
Nursing,
985330
Nebraska
Medical
Center,
Omaha,
NE
68198-5330.
©
2003
by
Association
of Pediatric
Oncology
Nurses
1043-4542/03/2002-0005$30.00/0
doz:10.1053!jpon.2003.78
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72
initial
evaluation
shortly
after
the
diagnosis
and
6
months
following
completion
of
treatment.
Assessment
tools
will
vary
according
to
the
child’s
age
and
developmental
progress.
4.
Health
care
providers
need
to
promote
the
parent’s
understanding
of
the
findings
from
these
assessments
and
to
identify
available
resources
for
the
child.
Networking
between
the
health
team
members
and
the
education
experts
at
the
child’s
home
school
and
health
care
facility
is
essential.
5.
The
SCAS
is
a
screening
tool
for
assessing
risk
for
academic
and
progression
problems
by
school
age
children
and
adolescents
receiving
CNS
treatment
for
cancer.
The
screening
tool
focuses
on
mathematics
computational
skills,
reading
and
spelling.
6.
Findings
from
the
SCAS
will
assist
the
health
team
and
educators
to
determine
frequency
of
continued
assessment,
referrals
for
improvement
in
cognitive
function
and
development
of
the
individual
education
plan
(IEP)
when
appropriate.
7.
Future
research
is
needed
to
develop
an
evidence-based
algorithm
to
illustrate
interventions
for
a
child
with
a
cancer
diagnosis
at
risk
for
or
experiencing
cognitive
deficits
that
may
affect
academic
success
and
progress
by
the
young
adult
in
advanced
school
settings.
8.
Additional
research
is
needed
to
evaluate
the
stability
of
the
SCAS
over
time
for
the
individual
child
dealing
with
cognitive
deficits
after
cancer
treatment.
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