Implementation of Developmental Screening Guidelines for Children with Congenital Heart Disease

Knutson, Stacie; Kelleman, Michael; Kochilas, Lazaros

doi:10.1016/j.jpeds.2016.05.029

Cited by 30 publications

(45 citation statements)

References 33 publications

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“…The questionnaire used in a survey to determine the implementation of the 2012 AHA guideline by cardiac care practitioners in the United States (US), was adapted and expanded. (2,4) Response options to questions on clinical practice settings were adapted to the South African context. (Table I).…”

Section: Methodsmentioning

confidence: 99%

“…(1)(2)(3) For this reason, neurodevelopment has become one of the most important outcomes being investigated in children with CHD. (1,2,4) As many as half of children with CHD present with neurodevelopmental delays characterised by mild impairments across multiple domains, including deficits in gross and fine motor skills, cognition and language, and inattention, impulsivity, impaired executive function and psychosocial problems. (5)(6)(7)(8) For many parents, over time, the neurodevelopmental difficulties faced by their child outweigh the daily burden caused by their heart disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurodevelopmental evaluation and referral practices in children with congenital heart disease in central South Africa

Smith¹,

Nel²,

Marais³

et al. 2019

SAHJ

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The guideline is not context-specific and serves as a universal tool to facilitate clinical decision-making based on best practice evidence. (4,11) The guideline uses a riskstratification approach with a clinical algorithm, including a combination of developmental surveillance, screening and evaluation aimed at the early identification of developmental delays. (1,2,4,10) By extension, the successful implementation of the guideline also results in the appropriate referral of children with developmental delays to intervention therapies, including physiotherapy, occupational therapy and speech therapy, as well as for psychological and educational support-to optimise their developmental outcome. (1,12-14

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental evaluation and referral practices in children with congenital heart disease in central South Africa

Smith¹,

Nel²,

Marais³

et al. 2019

SAHJ

View full text Add to dashboard Cite

show abstract

“…The provision of preventive healthcare services, other than vaccination, was assessed in eight studies 48‐55 . All of them were cross‐sectional studies of low quality.…”

Section: Resultsmentioning

confidence: 99%

Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review

et al. 2020

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Aim The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. Methods MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. Results Fifty‐four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. Conclusion According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.

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“…Additionally, these guidelines outlined the need for scheduled longitudinal neurodevelopmental re‐evaluation and recommended that referrals for additional interventions and therapies be made when a developmental disorder was identified. A recent survey regarding the implementation of the 2012 AHA guidelines among primary care providers reported that only 21% of participants were aware of the guidelines . Most referrals for a developmental evaluation made by this group of providers occurred after a failed routine childhood screening test or on the basis of a self‐reported concern from a parent.…”

Section: Introductionmentioning

confidence: 99%

“…A recent survey regarding the implementation of the 2012 AHA guidelines among primary care providers reported that only 21% of participants were aware of the guidelines. 7 Most referrals for a developmental evaluation made by this group of providers occurred after a failed routine childhood screening test or on the basis of a self-reported concern from a parent. Only 22% of referrals were made proactively due to a history of heart surgery.…”

Section: Introductionmentioning

confidence: 99%

Ancillary referral patterns in infants after initial assessment in a cardiac developmental outcomes clinic

Monteiro

Serrano

Tsang

et al. 2019

Congenital Heart Disease

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Objective Neurodevelopmental impairment is common after surgery for congenital heart disease (CHD) in infancy. While neurodevelopmental follow‐up of high‐risk patients has increased, the referral patterns for ancillary services following initial evaluation have not been reported. The aim of this study is to describe the rates and patterns of referral at the initial visit to our outcomes clinic of patients who underwent surgery for CHD during infancy. Outcomes Measures The Cardiac Developmental Outcomes Program clinic at Texas Children’s Hospital provides routine longitudinal follow‐up with developmental pediatricians and child psychologists for children who required surgery for CHD within the first 3 months of life. Demographic, diagnostic, and clinical data, including prior receipt of intervention and referral patterns at initial presentation, were abstracted from our database. Results Between April 2013 and May 2017, 244 infants under 12 months of age presented for initial evaluation at a mean age of 7 ± 1.3 months. At presentation, 31% (76/244) were referred for either therapeutic intervention (early intervention or private therapies), ancillary medical services, or both. Referral rates for low‐risk (STAT 1‐3) and high‐risk (STAT 4‐5) infants were similar (28 vs. 33%, P = .48). Referrals were more common in: Hispanic white infants (P = .012), infants with non‐cardiac congenital anomalies (P = .001), history of gastrostomy tube placement (P < .001), and infants with prior therapy (P = .043). Infants of non‐English speaking parents were three times more likely to be referred (95% CI = 1.5, 6.4; P = .002). Conclusions At the time of presentation, nearly 1 in 3 infants required referral. Referral patterns did not vary by traditional risk stratification. Sociodemographic factors and co‐morbid medical conditions increased the likelihood of referral. This supports the need for routine follow‐up for all post‐surgical infants regardless of level of surgical complexity. Further research into the completion of referrals and long‐term referral patterns is needed.

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Implementation of Developmental Screening Guidelines for Children with Congenital Heart Disease

Cited by 30 publications

References 33 publications

Neurodevelopmental evaluation and referral practices in children with congenital heart disease in central South Africa

Neurodevelopmental evaluation and referral practices in children with congenital heart disease in central South Africa

Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review

Ancillary referral patterns in infants after initial assessment in a cardiac developmental outcomes clinic

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