**Author details**

• Screening for internalising problems in children and adolescents with brain tumours. • Baseline and follow-up screening/assessment for ADHD symptoms prior to treatment

have significant implications for educational abilities.

When considering posterior fossa tumour resection

not returning to some functional speech.

**4. Conclusion**

190 Brain Tumors - An Update

guistic rehabilitation.

○ Externalising problems are less common than internalising problems but, if missed, will

• In those for whom the symptoms represent an adjustment reaction, there is an improved outcome if a truthful, complete and consistent approach to communication is taken.

• The complication of cerebellar mutism is rarely mentioned to parents during the consent for surgery of a posterior fossa tumour. It is a common syndrome and, reassuringly, to the authors' knowledge there have been no reported cases of a child with cerebellar mutism

The era of molecular informed neuro-oncology has set a foundation for precise diagnosis and tailored anti-neoplastic therapy. Such changes may lead to great improvements in overall survival of paediatric patients and so inadvertently marks an auspicious time for neuropsychiatry, which has never been more relevant. In concert with an optimal medical model, neuropsychiatric informed care is required to ensure a truly holistic and integrated approach. In their ability to weave together so many disparate perspectives—psychiatric, neurological, cognitive, psychosocial and many more—these specialists will be invaluable in leading multidisciplinary rehabilitation programs. Contemporary studies indicate that mood, cognition and psychosocial functioning are important factors in early diagnosis, as well as mediating health outcomes following radical and risk-adapted anti-neoplastic treatment. In addition to psychological burden, the neuropsychiatric aspects of childhood CNS tumours, including posterior fossa syndrome and cerebellar cognitive affective syndrome, are increasingly recognised as crucial causes of poor outcomes. Current research highlights the necessity for routine psychological and psychiatric screenings of children with suspected brain tumours and at follow-up of childhood brain tumour survivors. Thus, we provided a review of the available neuropsychiatric guidelines for identification of brain tumours in primary, secondary and tertiary health services. However, further progress is still required in these areas and in the sphere of public awareness. In the future, neuropsychiatric intervention should aim to complement the anticipated challenges of neuro-oncological management, e.g., a left-handed child treated for medulloblastoma would have intensive neuropsychiatric screening and lin-

As our understanding of the neuroscience relevant to childhood neuro-oncology expands, neuropsychiatric input will be invaluable at crucial stages of care, including at time of diagnosis, pre- and post-operatively. Earlier intervention will consolidate a child's resilience through a multi-axial combination of psychometrics, psychoeducation, psychosocial support, psychotherapy and psychopharmacological intervention. Specifically, neuropsychological

