Academic Performance in Swedish Ninth Grade Students Treated for Brain Tumours

Sammanfattning: The overall aim of this thesis was to investigate how children in Sweden treated for brain tumours performed in their ninth year at school compared with matched controls. The studies investigated grades and results from national tests in the theoretical subjects of Swedish, English, and mathematics; grades in the practical and aesthetic subjects of art, crafts, music, home and consumer studies, physical education and health; and the frequency of delayed graduation and qualification for school years 10-12 (corresponding to upper-secondary school or high school).The results from this thesis demonstrate significant differences in performance between the group of children treated for brain tumours (cases) and their controls, both in the theoretical subjects and in the practical and aesthetic subjects. However, there were larger differences between cases and controls in the theoretical subjects than in the practical and aesthetic subjects. The largest differences were found in the subject of English, and there were also significant differences between cases and controls with regard to delayed graduation and qualification for school years 10-12. Graduation for children treated for brain tumours was delayed more often than for controls, and qualification for school years 10-12 was significantly higher among controls than for children treated for brain tumours. The results also showed different effects based on sex. For example, the gap between the girls treated for brain tumours and their controls was, in most cases, greater than for the boys and their controls. Whether the child had been treated for a high- or low-grade tumour did not have any significant impact on the results in any of the studies. Children treated at ages 0-5 and 6-9 years old were at particular risk of lower average grades in theoretical subjects or not qualifying for school years 10-12, although the latter result was significant only for the girls. Age at diagnosis was another significant factor for national test performance. There was also a positive correlation between the parents’ education levels and qualification for school years 10-12 for children treated for brain tumours.The implication of the results are that the academic performance of all children treated for brain tumours, regardless of sex, age at diagnosis, tumour grade, or parents’ education should be closely monitored when starting or returning to school after brain tumour treatment. It is also important to have a long-term perspective, as school difficulties do not disappear, but rather may increase over the years. Children treated before starting school should be monitored extra closely as well as children treated at ages 6-9, as a considerable number of basic skills are taught during these first school years. Moreover, it is of particular importance that girls and boys are equally monitored. Yet, the range of difficulties for children treated for brain tumours is wide and extremely heterogeneous. Thus, the type of support or intervention should be adapted to each child’s individual needs.