1. Communication

What are the communication outcomes associated with childhood brain tumour or leukaemia?

GRADE RecommendationQuestion mark transparent.png Grade Approval
Evidence-based Recommendation 1: Communication

Communication assessment and intervention should be offered to children diagnosed with childhood brain tumour or leukaemia.

Strong 23-Nov-2020 –
22-Nov-2025
  • Clinical question:Communication outcomes#Recommendation_1
  • Evidence-based Recommendation 1: Communication

Communication assessment and intervention should be offered to children diagnosed with childhood brain tumour or leukaemia.

  • GRADE recommendation
Practice pointQuestion mark transparent.png

Assessment & Intervention

When to assess

  • Communication assessment should occur at or as soon as possible after cancer diagnosis.
  • Communication assessment should occur during the oncology treatment phase and oncology follow-up phase. Multiple assessments during these phases may be required if concerns are indicated by the oncology care team and/or family.
  • Regular monitoring of the child’s communication development should continue throughout the survivorship phase until end of adolescence.


What to assess

  • A comprehensive assessment of speech and language should be conducted. Assessment needs to be tailored to the age and developmental level of the child. Where appropriate, language assessment should include high-level language, discourse-level skills and literacy.
  • Assessment should include a range of individualised assessment procedures such as norm-referenced assessments, criterion-referenced tools, care-giver report and clinical observations across environments.


When to intervene

  • Children diagnosed with CBTL should be provided with early individualised intervention during the oncology treatment phase for identified communication difficulties.
  • Children diagnosed with CBTL should be provided with timely individualised intervention for communication difficulties identified during the oncology follow-up and survivorship phases through until the end of adolescence.
  • Clinical question:Communication outcomes#Practice_point_1
  • Assessment & Intervention

When to assess

  • Communication assessment should occur at or as soon as possible after cancer diagnosis.
  • Communication assessment should occur during the oncology treatment phase and oncology follow-up phase. Multiple assessments during these phases may be required if concerns are indicated by the oncology care team and/or family.
  • Regular monitoring of the child’s communication development should continue throughout the survivorship phase until end of adolescence.


What to assess

  • A comprehensive assessment of speech and language should be conducted. Assessment needs to be tailored to the age and developmental level of the child. Where appropriate, language assessment should include high-level language, discourse-level skills and literacy.
  • Assessment should include a range of individualised assessment procedures such as norm-referenced assessments, criterion-referenced tools, care-giver report and clinical observations across environments.


When to intervene

  • Children diagnosed with CBTL should be provided with early individualised intervention during the oncology treatment phase for identified communication difficulties.
  • Children diagnosed with CBTL should be provided with timely individualised intervention for communication difficulties identified during the oncology follow-up and survivorship phases through until the end of adolescence.
  • Good practice point
Practice pointQuestion mark transparent.png

Education

  • Education about communication development and difficulties in CBTL should be provided to families at cancer diagnosis or as early as possible.
  • Education about communication development and difficulties in CBTL should continue to be provided to families throughout the oncology treatment and follow-up phases.
  • Education about potential long-term communication difficulties in CBTL should be provided to families and education professionals throughout the oncology follow-up and survivorship phases.
  • Clinical question:Communication outcomes#Practice_point_2
  • Education
  • Education about communication development and difficulties in CBTL should be provided to families at cancer diagnosis or as early as possible.
  • Education about communication development and difficulties in CBTL should continue to be provided to families throughout the oncology treatment and follow-up phases.
  • Education about potential long-term communication difficulties in CBTL should be provided to families and education professionals throughout the oncology follow-up and survivorship phases.
  • Good practice point
Practice pointQuestion mark transparent.png

Care Team

  • Speech Pathologists should be involved as integral members of the oncology care team from the point of cancer diagnosis and throughout the oncology treatment and follow-up phases.
  • All members of the oncology care team should be informed about communication difficulties and involved in management throughout the oncology treatment and follow-up phases.
  • Speech Pathologists should work in partnership with oncologists, family members and education professionals to monitor communication development throughout the survivorship phase until the end of adolescence.
  • Clinical question:Communication outcomes#Practice_point_3
  • Care Team
  • Speech Pathologists should be involved as integral members of the oncology care team from the point of cancer diagnosis and throughout the oncology treatment and follow-up phases.
  • All members of the oncology care team should be informed about communication difficulties and involved in management throughout the oncology treatment and follow-up phases.
  • Speech Pathologists should work in partnership with oncologists, family members and education professionals to monitor communication development throughout the survivorship phase until the end of adolescence.
  • Good practice point

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2. Swallowing

What are the swallowing outcomes associated with childhood brain tumour or leukaemia?

GRADE RecommendationQuestion mark transparent.png Grade Approval
Evidence-based Recommendation 1: Swallowing

Swallowing assessment and management should be offered to children diagnosed with childhood brain tumour or leukaemia.

Strong 23-Nov-2020 –
22-Nov-2025
  • Clinical question:Swallowing outcomes#Recommendation_1
  • Evidence-based Recommendation 1: Swallowing

Swallowing assessment and management should be offered to children diagnosed with childhood brain tumour or leukaemia.

  • GRADE recommendation
Practice pointQuestion mark transparent.png

Assessment & Intervention

When to assess

  • Swallowing assessment should occur at or as soon as possible after diagnosis of CBTL.
  • Swallowing assessment should occur during the oncology treatment phase.
  • Multiple assessments may be required where concerns are indicated by the oncology care team and/or family. Regular monitoring of the child’s swallowing should continue throughout the oncology follow-up and survivorship phases until end of adolescence.

What to assess

  • A comprehensive swallowing assessment should be conducted. Assessment needs to be tailored to the age and developmental level of the child. All phases of the swallow (pre-oral anticipatory, oral-preparatory, oral and pharyngeal) need to be assessed.
  • Videofluoroscopy Swallowing Study (VFSS) should be considered on a case-by-case basis as part of the assessment protocol to examine aspiration if required.

When to intervene

  • Children diagnosed with CBTL should be provided with early individualised management for swallowing difficulties during the oncology treatment phase.
  • Children diagnosed with CBTL should be provided with individualised management for swallowing difficulties identified by the oncology care team and/or family in the oncology follow-up and survivorship phases.
  • Clinical question:Swallowing outcomes#Practice_point_1
  • Assessment & Intervention

When to assess

  • Swallowing assessment should occur at or as soon as possible after diagnosis of CBTL.
  • Swallowing assessment should occur during the oncology treatment phase.
  • Multiple assessments may be required where concerns are indicated by the oncology care team and/or family. Regular monitoring of the child’s swallowing should continue throughout the oncology follow-up and survivorship phases until end of adolescence.

What to assess

  • A comprehensive swallowing assessment should be conducted. Assessment needs to be tailored to the age and developmental level of the child. All phases of the swallow (pre-oral anticipatory, oral-preparatory, oral and pharyngeal) need to be assessed.
  • Videofluoroscopy Swallowing Study (VFSS) should be considered on a case-by-case basis as part of the assessment protocol to examine aspiration if required.

When to intervene

  • Children diagnosed with CBTL should be provided with early individualised management for swallowing difficulties during the oncology treatment phase.
  • Children diagnosed with CBTL should be provided with individualised management for swallowing difficulties identified by the oncology care team and/or family in the oncology follow-up and survivorship phases.
  • Good practice point
Practice pointQuestion mark transparent.png

Care Team

  • Speech Pathologists should be involved as integral members of the oncology care team from the point of cancer diagnosis and throughout the oncology treatment phase to manage swallowing.
  • All members of the oncology care team should be informed about swallowing difficulties and involved in their management as needed throughout oncology phases.
  • Speech Pathologists should work in partnership with oncologists and family members to monitor swallowing throughout the survivorship phase until the end of adolescence.
  • Clinical question:Swallowing outcomes#Practice_point_2
  • Care Team
  • Speech Pathologists should be involved as integral members of the oncology care team from the point of cancer diagnosis and throughout the oncology treatment phase to manage swallowing.
  • All members of the oncology care team should be informed about swallowing difficulties and involved in their management as needed throughout oncology phases.
  • Speech Pathologists should work in partnership with oncologists and family members to monitor swallowing throughout the survivorship phase until the end of adolescence.
  • Good practice point
Practice pointQuestion mark transparent.png

Education

  • Education about swallowing difficulties in CBTL should be provided to families at cancer diagnosis or as early as possible.
  • Education about swallowing difficulties in CBTL should continue to be provided to families throughout the oncology treatment and follow-up phases.
  • Clinical question:Swallowing outcomes#Practice_point_3
  • Education
  • Education about swallowing difficulties in CBTL should be provided to families at cancer diagnosis or as early as possible.
  • Education about swallowing difficulties in CBTL should continue to be provided to families throughout the oncology treatment and follow-up phases.
  • Good practice point
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The guideline recommendations were approved by the Chief Executive Officer of the National Health and Medical Research Council on 23 November, 2020 under section 14A of the National Health and Medical Research Council Act 1992. expand arrow

In approving the guideline recommendations, National Health and Medical Research Council (NHMRC) considers that they meet the NHMRC standard for clinical practice guidelines. This approval is valid for a period of five years.

NHMRC is satisfied that the guideline recommendations are systematically derived, based on the identification and synthesis of the best available scientific evidence, and developed for health professionals practising in an Australian health care setting.

This publication reflects the views of the authors and not necessarily the views of the Australian Government.

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