To determine the nature, incidence and severity of adverse neuropsychological sequelae, if any, for three different methods of central nervous system (CNS) prophylaxis: (CNS) prophylaxis by intrathecal methotrexate alone; CNS prophylaxis by intrathecal methotrexate plus 2400 rads cranial radiation; CNS prophylaxis by intrathecal methotrexate plus 1800 rads cranial radiation in children who have been successfully treated for childhood acute lymphoblastic leukemia (ALL). A fourth group with embryonal rhabdomyosarcoma who received intensive, systemic chemotherapy and who experienced the psychosocial disruption of a cancer diagnosis but who have no CNS disease or treatment to the CNS will also be studied as a comparison. Specific dependent variables to be studied will be 1) overall general intelligence 2) recent memory 3) language function and verbal reasoning 4) visual motor integration 5) perceptual organization 6) perceptual function and non-verbal reasoning 7) attention/concentration (freedom from distractability) 8) academic achievement (reading, arithmetic, spelling) 9) social competence and behavior problems. The dependent variables will be derived from objective, standardized psychological and neuropsychological tests. Studies on these four groups will 1) contribute to better assessment of the risk/benefit ratio for oncologists as they plan future treatment protocols for ALL 2) forcus inquiry in future studies by defining, if any, specific functional deficit areas. This could also provide for more effective remediation and contribute to greater understanding of brain behavior relationship 3) facilitate the future education and vocational planning for any children identified as having specific or generalized neuropsychological deficit 4) allow for the differential effects on neuropsychological function of different treatments, time from initial treatment and, age at treatment in a rigorous statistical method since the study population is sufficiently large. All children enrolled in the study will have been in complete continuous remission from the induction phase to the completion of treatment and throughout two points of neuropsychological testing. The two points of neuropsychological testing will be: Post-Treatment (within one year after completing treatment protocol) and Long-Term (two years after Post-Treatment neuropsychological evaluation).
