School adjustment of children with congenital heart disease

A correlation study was conducted to investigate school adjustment of school-age children and adolescents with varying degrees of severity of congenital heart disease. School adjustment was inferred from scholastic achievement, scholastic grade average, social competence and behavior as assessed by mothers, and adaptive functioning and behavior as assessed by teachers. Forty-eight children with mild, moderate, and severe congenital heart disease (16 children in each group) and their mothers and teachers participated in the study. Data were obtained from: (a) the Coopersmith Self-Esteem Inventory, and the Children's Depression Inventory completed by the children; (b) the Child Behavior Checklist and demographic data sheet completed by the mothers; (c) the Child Behavior Checklist--Teacher's Report Form, and the information sheet on Absence Rate and Scholastic Grade Average completed by the teachers; and (d) the children's medical records. Two-way and three-way analysis of variance were performed between the mean scores for each of the variables. Statistical significance was found (a) between the means for absence rate, behavior as assessed by teachers, and depression with respect to severity of congenital heart disease; (b) between the means for scholastic achievement, scholastic grade average, and adaptive functions and behavior as assessed by teachers according to IQ level; (c) between the means for scholastic achievement, scholastic grade average, and social competence as assessed by mothers regarding level of self-esteem; (d) between the mean scores for social competence with respect to level of depression. There were also three significant interactions: between age and sex for the means of behavior as assessed by mothers; between severity of heart disease and I level for the means of behavior as assessed by teachers; and between severity of heart disease and depression level for the means of social competence. It was concluded that children with congenital heart disease with the added burdens of below average IQ, low self-esteem, and high depression were at particular risk for poor school adjustment.