Developmental Screening of Children Diagnosed with Congenital Heart Defects

Weinberg, Stacey; Kern, Jeffrey H.; Weiss, Kim Altman; Ross, Gail

doi:10.1177/000992280104000904

Cited by 18 publications

(22 citation statements)

References 14 publications

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“…The need for routine developmental follow-up evaluation for this population has been suggested previously [6, 17, 24, 30, 37], but most pediatric cardiac centers do not routinely assess these patients for developmental delay as part of standard clinical care [20]. More recently, pediatric cardiac programs have developed ND follow-up programs to meet the needs of this group of patients [5].…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcomes for Children With Hypoplastic Left Heart Syndrome at the Age of 5 Years

et al. 2013

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This study aimed to determine the neurodevelopmental (ND) outcome for children with hypoplastic left heart syndrome (HLHS) at early school age. English-speaking patients who underwent the Norwood procedure between 2000 and 2005 were eligible at 4–6 years of age for ND testing. Of the 72 eligible patients, 44 (61 %) agreed to participate, and 37 completed ND testing before the close of the study. Three subjects were excluded from analyses due to late stroke. The ND testing included intelligence, visual motor integration, memory and motor and language skills. Parents and teachers completed measures of behavior and attention problems. Subjects’ scores and parent/teacher ratings were converted to z-scores and compared with test norms. Higher scores on child measures represent better outcomes, whereas higher scores on parent and teacher rating scales indicate more problems. The average ND performance of the tested cohort fell within one standard deviation of the test norms for all measures. However, the subjects performed significantly lower than the test norms on measures of visual-motor integration, fine motor skills, memory, and word structure (z = −0.42 to −0.54; p < 0.005). On the parent and teacher completed measures, the subjects scored higher than the test norms on attention problems (z = 0.40–0.62; p < 0.005). Although the overall ND performance of the cohort was normal, the subjects showed relative weakness in visual motor and attention skills. Ongoing developmental monitoring of these children is recommended to guide interventions that may improve individual outcomes and to assess the impact of changes in clinical management strategies on functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcomes for Children With Hypoplastic Left Heart Syndrome at the Age of 5 Years

et al. 2013

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“…[4][5][6][7][8][9][10][11][12] Children with CHD have been found to have higher rates of attention problems, behavioral problems, visual-motor/visual-spatial defi-cits, fine and gross motor delays, and language difficulties when compared to the normal population. 19,[27][28][29][30] Parents of children with CHD may view their children as "normal" in spite of developmental delays, 31 and thus, may not seek out early intervention services, even if they are recommended. 19,[27][28][29][30] Parents of children with CHD may view their children as "normal" in spite of developmental delays, 31 and thus, may not seek out early intervention services, even if they are recommended.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26] It has been suggested that these children would benefit from routine developmental followup. 19,[27][28][29][30] Parents of children with CHD may view their children as "normal" in spite of developmental delays, 31 and thus, may not seek out early intervention services, even if they are recommended. Furthermore, the availability of services through early intervention programs has declined over the years due to budget cuts, 32 and there is a growing concern that without a routine developmental follow-up program, many children with CHD in need of services may not be identified.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Routine Developmental Follow-up Program for Children with Congenital Heart Disease: Early Results

Soto

Olude

Hoffmann

et al. 2011

Congenital Heart Disease

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“…[9][10][11] More recently, research has suggested that patients requiring cardiac surgery early in life would benefit from routine developmental followup. 8,12,13 In 2012, a comprehensive scientific statement was published by the American Heart Association (AHA) and later endorsed by the American Academy of Pediatrics providing an algorithm for evaluating and managing patients with CHD who are at risk for developmental delay. 14 Cardiac surgical centers have developed specialized developmental follow-up programs for children with CHD, yet it is unknown if these specialized programs will have a clinical impact.…”

Section: Introductionmentioning

confidence: 99%

Improving Neurodevelopmental Surveillance and Follow-up in Infants with Congenital Heart Disease

Michael

Scharf

Letzkus

et al. 2016

Congenital Heart Disease

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Objective. We hypothesize that neurodevelopmental surveillance of targeted patients with congenital heart disease during the admission for their cardiac surgery would improve neurodevelopmental assessment and outpatient followup rates. Design. All patients under 12 months of age who were operated on between October 2013 and October 2014 and were considered at risk for neurodevelopmental delay in accordance with the 2012 American Heart Association Scientific Statement were included. A protocol was implemented to increase surveillance of targeted patients during the hospitalization for their cardiac surgery. A historical control cohort was used from a 6-month period that preceded initiation of the program from July 2012 to December 2012. Univariate analysis assessed the effects of patient demographics, anatomy, postoperative course, and distance from clinic on inpatient screening and follow-up to evaluate areas for future improvement. Results. Neurodevelopmental surveillance in the post-protocol period increased from 21% to 82% (P < .001) as did compliance rates for outpatient follow-up from 38% to 52% (P < .001). Patients receiving consultation were younger (median 1.2 months range 0.3-3.1 vs. 4.0 range 1.2-5.5, P 5 .002), had a longer intensive care unit duration (median 8 days range 4-13 vs. 4 range 3-8, P 5 .044), and a longer total hospital duration (median 14 days range 8-25 vs. 8 range 6-16, P 5 .023). The presence of single ventricle anatomy was associated with a lower follow-up rate at 29% than those with biventricular hearts at 64% (P 5 .009). Distance from the clinic did not have an effect on follow-up (P 5 .39). Conclusion. The protocol described increased neurodevelopmental surveillance of high risk patients. Individuals that were younger and in the hospital longer were more likely to be successfully seen and comply with outpatient follow-up than those not receiving inpatient risk assessment. Patients with single ventricle anatomy may benefit from a modified follow-up schedule to improve compliance rates. Travel distance has no effect on likelihood of outpatient cardiac neurodevelopmental follow-up.

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Developmental Screening of Children Diagnosed with Congenital Heart Defects

Cited by 18 publications

References 14 publications

Neurodevelopmental Outcomes for Children With Hypoplastic Left Heart Syndrome at the Age of 5 Years

Neurodevelopmental Outcomes for Children With Hypoplastic Left Heart Syndrome at the Age of 5 Years

Implementation of a Routine Developmental Follow-up Program for Children with Congenital Heart Disease: Early Results

Improving Neurodevelopmental Surveillance and Follow-up in Infants with Congenital Heart Disease

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