Metacognitive factors in the visuospatial skills of long‐term survivors of acute lymphoblastic leukemia: An experimental approach to the Rey‐Osterrieth complex figure test

Abstract
Long‐term survivors of childhood acute lymphoblastic leukemia (ALL) can exhibit increased difficulty with visuospatial reasoning tasks. The present study was undertaken to ascertain whether this difficulty reflects underlying spatial/visuoperceptual deficits or has a metacognitive basis. Two studies were carried out investigating performance on the Rey‐Osterrieth Complex Figure test. In Study 1, 51 survivors performed the task in the standard format. They recalled fewer organizing‐scheme components than normative expectation but more incidental features. In Study 2 the encoding phase of the task was manipulated. Thirty‐four survivors were randomized to a linear (LIN) or configurational (CON) presentation and memory productions were evaluated. Organization scores for the CON group were above normative expectation, whereas those of the LIN group remained unchanged. Visuospatial reasoning problems in these children have a metacognitive basis and do not represent a fundamental visuoperceptual or spatial deficit.