Leadership Connections

Half of newly diagnosed cases of invasive pediatric cancer occur in children under 5 years of age, with more than a quarter of cases (27%) occurring in the first year of life. Some of these young children were already receiving integrated, family-centered early intervention services in their home communities due to developmental delay or risk of developmental delay prior to their diagnosis of cancer– and some likely should have received early intervention services but were not yet identified in their home communities prior to cancer diagnosis. Furthermore, many of these young children, even those without prior developmental delays or risk of developmental delay, are now at risk for significantly impaired functioning due to disease and/or treatment-related factors.

With this in mind, 2018-2020 Fellow Jennifer (Jen) Harman, PhD, led efforts to create an interdisciplinary early childhood clinic at St. Jude Children’s Research Hospital. This clinic provides dyadic infant mental health services alongside developmental assessment and hospital-based early intervention services and has served more than 350 young children with cancer and their families to date.

A recent analysis of clinic outcome data highlighted that the majority of these children need, and as a result of Harman’s clinic, receive developmental therapy (99%), occupational therapy (83%), physical therapy (84%), and/or speech language therapy (85%) services during active cancer-directed treatment at St. Jude Children’s Research Hospital. Additional data demonstrated that increased rates of developmental delay are common among young children with cancer regardless of the type of cancer (e.g., hematological malignancy, brain tumor, or non-central nervous system solid tumors).

Harman’s early childhood clinic is the first, and, to date, only of its kind in the pediatric oncology world – but that will not be the case for long. Indeed, manuscripts and presentations related to the early childhood clinic are changing the landscape of support services for infants/toddlers with cancer and their families. As one example, following a presentation at the 54th Congress of the International Society of Pediatric Oncology in Barcelona, Spain last year, Harman was asked to consult with professionals from Children’s Health Ireland at Crumlin. These professionals are informing the creation of national standards for the care of children with cancer in Ireland–standards that are now slated to include intentional, proactive support services for infants/toddlers with cancer and their families.