In clinical settings, the Verbal Fluency Test is a diagnostic tool for assessing cognitive deficits. Despite its established use in clinical practice, the applicability of the test in neuropsychological monitoring of paediatric oncology patients has rarely been examined. In this study, we focused on aspects of verbal fluency in children and adolescents treated for brain tumours. The clinical group (N = 57) consisted of 25 boys and 32 girls who, between 2018 and 2025, participated in regular neuropsychological monitoring. At the time of testing, they were between 8 and 18 years old (M = 12.58; SD = 2.85). We formed a control group matched to the clinical group by age, gender, and parental education. Data were collected using the D-KEFS Verbal Fluency Test and the Coding and Symbol Search subtests from an age-appropriate Wechsler scale. We found that, compared to healthy peers, the clinical group scored lower on the Letter and Category Fluency subtests, with the difference being more pronounced in Category Fluency. Processing speed and category switching, along with age at testing, were significant predictors of performance on both subtests. Age at diagnosis, the presence of radiation therapy, and tumour location did not predict verbal fluency. Results of the temporal dynamics analysis showed that word production declined over time. This trend was more pronounced in the clinical group, particularly in the Category Fluency subtest. We assume that the decline in the clinical group was related to multiple factors (e.g., impaired executive functions) that cannot be considered in isolation. We emphasize the importance of individual monitoring of the cognitive consequences of the disease and highlight the need for more diverse measures that capture more than just total scores on the Verbal Fluency Test. One of the main limitations of our study was the small and heterogeneous clinical group, so caution is needed when generalizing the results. Nevertheless, the study raises important questions for future research, which can contribute to a deeper understanding of Verbal Fluency Test results in this specific population.
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