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Long-Term Neuromotor Speech Deficits in Survivors of Childhood Posterior Fossa Tumors: Effects of Tumor Type, Radiation, Age at Diagnosis, and Survival Years

Department of Pediatrics and University of Toronto, Ontario, Canada

Kim Bradley, PhD

Brenda Spiegler, PhD

Hematology/Oncology Program The Hospital for Sick Children, Toronto, Ontario, Canada, NeuroRehabilitation Program, Bloorview-MacMillan Children's Centre, Toronto, Ontario, Canada

Maureen Dennis, PhD

Department of Surgery and Psychology University of Toronto, Ontario, Canada, maureen.dennis{at}sickkids.ca, Behavior Program and The Hospital for Sick Children, Toronto, Ontario, Canada

The cerebellum is important for the coordination of fluent speech. The authors studied how childhood cerebellar tumors affect long-term neuromotor speech outcomes, including the relation between outcome and tumor type, radiation, age at diagnosis, and survival years. Videotaped speech samples of child and adult long-term survivors of childhood cerebellar astrocytoma (nonradiated) and medulloblastoma (radiated) tumors and healthy controls were analyzed by 2 speech pathologists for ataxic dysarthria, dysfluency, and speech rate. Ataxia varied with tumor type/radiation. Medulloblastoma survivors had significantly more ataxic dysarthric features than either survivors of astrocytomas or controls, who did not differ from each other. Dysfluency varied with a history of a posterior fossa tumor. Medulloblastoma and astrocytoma survivors were each significantly more dysfluent than controls but did not differ from each other. Speech rate varied with age and tumor type. Adult controls were significantly faster than child controls, although adult tumor survivors were comparable to their child counterparts. Adult controls had significantly faster speech rates than adult survivors of medulloblastoma tumors. Ataxic dysarthric speech characteristics are more frequent in radiated survivors of medulloblastoma tumors than nonradiated survivors of astrocytoma tumors. Dysfluent and slow speech occur in cerebellar tumor survivors, regardless of tumor type and radiation history. Cerebellar tumors in childhood limit speech rate in adulthood.

Key Words: dysarthria • medulloblastoma • astrocytoma

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