Social functioning of children surviving bone marrow transplantation

Objective: To evaluate the behavioral reputation and peer acceptance of pediatric bone marrow transplant (BMT) survivors. Methods: Forty-eight BMT survivors (8-16 years of age) were compared to 48 nonchronically ill, same-classroom, same-gender comparison peers (COMP). Peer, teacher, and self-report data were collected. Results: Relative to COMP, BMT survivors had fewer friends and were described by peers, but not teacher or self-report, as more socially isolated. In addition, peers described BMT survivors as being less physically attractive and athletically skilled. Further analyses suggested that these nonsocial attributes (physical appearance and athletic ability) and treatment variables (whether cranial irradiation was received) mediated the social difficulties of BMI survivors. Conclusions: These data are suggestive of an unremitting pattern of difficulties with peers that has the potential to disrupt normal social and emotional development. Differences between peer, teacher and self-reports highlight the need for multiple informants in future work.