Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: the role of parenting strategies

Background. Behavioral and emotional difficulties are a recognised side effect of childhood acute lymphoblastic leukemia (ALL) treatment. Modifiable factors, such as parenting strategies, may be an appropriate target for interventions to assist families with managing their child’s behavior, potentially leading to improved psychosocial and clinical outcomes. This study examined whether parenting strategies are associated with child behavioral and emotional problems in a pediatric oncology context, with the aim of establishing whether parenting is a potential modifiable target for psychosocial intervention. Procedure. Participants included 73 parents of children aged 2–6 years who were either (i) in the maintenance phase of treatment for ALL at the Royal Children’s Hospital Children’s Cancer Centre, Melbourne (N¼43), or (ii) had no major medical history (healthy control group) (N¼30). Participants completed psychometrically validated questionnaires that assessed parenting strategies and child emotional and behavioral problems. Results. Results revealed that the ALL group parents reported higher lax parenting and more spoiling and bribing of their child than the healthy control group. Results from regression models indicated that, after controlling for the significant contribution of illness status and child age on child emotional and behavioral difficulties, parental laxness and parental overprotection were significantly associated with child emotional and behavioral difficulties. Conclusions. Supporting parents to minimise sub-optimal parenting strategies, particularly lax parenting, may offer a fruitful avenue for future research directed toward modifiable factors associated with managing child emotional and behavioral problems in a pediatric oncology context.