Review of the literature among pediatric cancer survivors reveals mixed results with respect to psychosocial adjustment outcomes. No studies were found that explored school reintegration as an outcome variable. The objective of the current study was to determine the extent to which illness severity, parental stress, and parental perceptions of child vulnerability predict child adjustment (e.g., quality of life, depression, anxiety) and school reintegration outcome among children diagnosed with pediatric cancer. Identified variables were selected from a comprehensive disability-stress-coping model among children with chronic illnesses. Forty-nine parent child dyads were recruited from a large hospital-based cancer facility in a metropolitan city in Texas. Parent (or child caregiver) participants completed self-report measures of parental stress and parental perception of child vulnerability. Child and adolescent participants completed three measures of psychosocial adjustment. Parents (or child caregivers) also provided written consent to obtain school attendance records. Medical personnel provided an assessment of children's illness severity.

Results of standard multiple regression analyses support the predictive capacity of parental stress and severity of illness, with respect to child ratings of anxiety, after controlling for other predictor variables. Additional findings regarding the role of certain demographic variables in child outcomes are discussed. Results support the need to assess parental stress and intervene at the time of children's diagnoses and throughout treatment. Further, results of correlational analyses lend tentative support to the transactional nature of parent-child interactions, namely vulnerable child syndrome. Results also underscore the need to consider pediatric cancer survivors' adaptive coping repertoires upon diagnosis and throughout cancer treatment. Implications for pediatric psychology, in addition to pediatric school psychology, are discussed.