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Cognitive flexibility in critical CHD: a target for intervention.

Adam R Cassidy1

  • 1Center for Neuropsychology, Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.

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PubMed
Summary

Children with critical congenital heart disease (CHD) often face challenges with cognitive flexibility, a crucial skill for lifelong quality of life. This paper reviews cognitive flexibility in CHD and offers strategies for support.

Keywords:
Acceptance and commitment therapycardiacexecutive functionmindfulnessneurodevelopment

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Area of Science:

  • Neuroscience
  • Pediatrics
  • Developmental Psychology

Background:

  • Increased survival rates for critical congenital heart disease (CHD) highlight associated neurodevelopmental challenges.
  • Executive function deficits, including inhibitory control, working memory, and cognitive flexibility, are prevalent in children with CHD.
  • Cognitive flexibility has received less attention than other executive functions despite its high prevalence and lifelong importance.

Purpose of the Study:

  • To review the construct of cognitive flexibility, encompassing its definition, development, measurement, and neuroanatomical underpinnings.
  • To summarize the impact of CHD on cognitive flexibility in affected individuals.
  • To provide evidence-based recommendations for supporting cognitive flexibility development in the context of CHD.

Main Methods:

  • Literature review of cognitive flexibility.
  • Synthesis of research on executive function in pediatric CHD populations.
  • Development of evidence-based recommendations.

Main Results:

  • Cognitive flexibility is a key executive function with significant implications for quality of life.
  • Children and adolescents with critical CHD exhibit a high prevalence of cognitive flexibility deficits.
  • Specific recommendations for intervention and support are proposed.

Conclusions:

  • Cognitive flexibility is a critical, yet under-recognized, executive function affected by critical CHD.
  • Systematic support for cognitive flexibility is essential for improving long-term outcomes in individuals with CHD.
  • Further research and clinical attention are warranted to address cognitive flexibility deficits in this population.