Family Environmental Factors Associated with Psychosocial Outcomes for “Head Start” 4 SHH Medulloblastoma Survivors Treated Without Radiation Therapy

Abstract Background This study investigates whether family environmental factors, including household disorganization, parental stress response, and parenting practices, are associated with psychosocial outcomes among sonic hedgehog (SHH) medulloblastoma survivors treated without radiation therapy. Methods SHH participants (N = 21) were treated under the Head Start 4 protocol active at 25 North American and New Zealand sites. Caregivers completed surveys assessing environmental factors and child outcomes, including cognitive, emotional and behavioral symptomatology, adaptive behavior, and health rated quality of life approximately two years post-diagnosis. Pearson correlations were used to analyze associations between family factors and child psychosocial outcomes at follow-up. Results Household disorganization was significantly associated with poorer adaptive functioning, executive functioning, and health-related quality of life (r = 0.51 to 0.64, P < .05). Negative parenting behavior was associated with lower physical quality of life (r = -0.75, P < .001). No significant associations were found between parental stress response or parental acceptance and psychosocial outcomes. Conclusions Household disorganization was more consistently linked to child psychosocial outcomes than other features of parent and family functioning among SHH medulloblastoma survivors. These preliminary findings suggest that assessing and supporting family home environment and routines may be an important area for clinical attention during treatment and survivorship care.