Today, Scarlett had her second evaluation with the neuropsychologist. This is one of the most interesting aspects of her protocol, monitoring her psychological and cognitive development as she progresses through treatment. Children who battle central nervous system (brain or spine) tumors often have cognitive impairments due to the effects of treatment on the developing brain. In the past, this was a very rarely studied aspect of treatment, since there were very few survivors. Now, improved treatment protocols are resulting in more survivors, and their challenges after treatment are being studied.
Survivorship is of particular interest to Scarlett's doctor, and he has done a variety of papers and lectures on this topic (some of which Chris and I have read or seen online). In my mind, this is a critical difference in approach from other doctors we have dealt with; others are only focused on the immediate needs and effects, while our doctor is looking at (and betting on) the best long-term outcome for Scarlett and our family. It is a difference we felt right away when we were making treatment decisions, and it has continued to give us an optimistic outlook.
Today's test was a repeat of a test Scarlett has been given a few times by different doctors. It is an overall developmental test that evaluates her cognitive, language, fine and gross motor, social and self-help skills. It is amazing to see how differently she tests each time. Last week, she scored at an average of 3-6 months in all areas. The last time this doctor saw her was in the early Spring, and she was fascinated at the difference in Scarlett's development. Today, Scarlett showed some great advancements in a few key areas. For instance, she has begun grabbing items she wants from other surfaces. She lifted a bell and shook it. She grasped a block and knocked it against another block. She pulled a blanket to reach the bell placed on the opposite end. These were huge - I have never seen her do that! Last week she could barely lift the block, and she dropped it a few seconds later. She is stronger and more accurate with her right hand, but can grasp with both.
Her cognitive development will continue to be monitored as part of the study until she is 8 years old. Most likely, these same kinds of tests will continue to be given through schools and other therapists as she gets older. My past in psychology and education give me a sharp interest in learning how she learns, watching how she progresses and changes over time.