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[Formula: see text]Congenital heart disease: A primer for the pediatric neuropsychologist
Adam R Cassidy1, Dawn Ilardi2, Susan R Bowen3
1a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA.
Insights
Congenital heart disease (CHD) survivors face neurological and neurobehavioral challenges. Pediatric neuropsychologists play a key role in monitoring these children for optimal development and quality of life.
Area of Science:
- Pediatric Psychology
- Neurodevelopmental Disorders
- Cardiology
Background:
- Congenital heart disease (CHD) affects millions globally, with over one million children in the U.S.
- Despite improved survival rates (>90%), CHD survivors are at risk for neurological injury and neurodevelopmental challenges.
- Neuropsychologists are increasingly vital in cardiac care for optimizing outcomes in pediatric CHD survivors.
Purpose of the Study:
- To provide an evidence-based primer on CHD for pediatric neuropsychologists.
- To guide clinical assessment and management strategies for children and adolescents with CHD.
- To enhance understanding of neurodevelopmental outcomes in CHD survivors.
Main Methods:
- Review of current standard-of-care guidelines for pediatric CHD management.
- Overview of brain development in the context of CHD.
- Examination of neuropsychological outcomes and influencing factors in CHD patients.
Main Results:
- Children and adolescents with CHD are susceptible to neurological and neurobehavioral issues.
- Variability in outcomes is influenced by multiple factors.
- Neuropsychological assessment is crucial for identifying and addressing challenges.
Conclusions:
- Pediatric neuropsychologists are essential members of the multidisciplinary team for CHD care.
- Understanding CHD's impact on brain development is key to improving quality of life.
- This primer offers a clinical framework for neuropsychological support of CHD survivors.
Abstract:
Congenital heart disease (CHD) affects millions of people worldwide, including over one million children in the United States. Approximately 25% of children born with CHD require intensive surgical intervention within the first year of life. Despite improved rates of survival into adulthood - rates that exceed 90% in the modern era - children and adolescents with CHD remain at risk for neurological injury and a range of neurobehavioral and psychosocial challenges that pose a threat to quality of life across the lifespan. Consequently, as experts in both clinical psychology and brain development, neuropsychologists are becoming increasingly involved in cardiac follow-up and monitoring to promote optimal developmental outcomes. The primary objective of this paper is to provide an evidence-based, clinically-oriented primer on CHD for pediatric neuropsychologists working with this growing population of survivors. Following an introduction to current standard-of-care guidelines for managing children and adolescents with CHD, we present an overview of brain development within the context of CHD, review neuropsychological outcomes, examine factors influencing variability in outcomes, and discuss implications and strategies for clinical assessment.
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